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Agenzia Italiana del Farmaco
FAQ - Vitamin D medicines
November 2019
What is Vitamin D?
It is a hormone produced in the skin following sun exposure. Small quantities can also be taken through diet (cod liver oil, salmon, oily fish, egg yolk, milk and dairy products, pork, beef liver, etc.).
What is Vitamin D used for?
- It regulates the intestinal absorption of calcium and phosphorus, promoting normal bone formation and mineralization.
- It contributes to normal muscle contractility.
- It acts on the immune system.
How to ensure a sufficient intake of vitamin D?
Regular sun exposure is the most natural and effective way. Diet cannot be considered an adequate source because its presence in food is rather limited.
When should the level of vitamin D in the body be measured?
The dosage should be carried out only in the presence of specific risk conditions, following a medical recommendation.
How is the vitamin D level measured?
The level of vitamin D is measured through a blood test (dosage in the form of 25 (OH) D).
When is it appropriate to start vitamin D therapy in asymptomatic healthy people?
Although vitamin D dosing (25OHD) in asymptomatic healthy people is inappropriate, the cut-off level for initiating therapy is 10-12 ng/mL (or 25-30 nmol/L).
When is pharmacological vitamin D supplementation indicated, regardless of dosing?
- people living in nursing homes
- people with severe motor deficits or bedridden people living at home
- pregnant or breastfeeding women
- people with osteoporosis from any cause for whom remineralisation therapy is not indicated
When is the pharmacological integration of vitamin D indicated following the dosage?
- vitamin D levels below 12 ng/mL (or 30 nmol/L) and symptoms of hypovitaminosis (asthenia, myalgias, widespread or localised pain, frequent unexplained falls)
- occasional finding of vitamin D levels below 12 ng/mL (or 30 nmol/L) in an asymptomatic person
- vitamin D levels lower than 20 ng/mL (or 50 nmol/L) in a person on long-term therapy with medicines that interfere with vitamin D metabolism (antiepileptics, glucocorticoids, antiretrovirals, antifungals, etc.)
- vitamin D levels below 20 ng/mL (or 50 nmol/L) in a person with disease that can cause malabsorption in adults (cystic fibrosis, celiac disease, Crohn's disease, bariatric surgery, etc.)
- vitamin D levels below 30 ng/mL (or 75 nmol/L) in a person with primary or secondary hyperparathyroidism
- vitamin D levels below 30 ng/mL (or 75 nmol/L) in a person with osteoporosis of any cause or established osteopathy who is a candidate for remineralisation therapy for whom correction of hypovitaminosis should be a prerequisite for initiating therapy
In which cases is the administration of vitamin D drugs ineffective or inappropriate?
The administration of vitamin D is ineffective and inappropriate for cardiovascular and cerebrovascular prevention and for cancer prevention.
Vitamin D administration is also ineffective in protecting against Covid-19 and respiratory infections in general.
Can vitamin D medicines be bought without a medical prescription?
No, they need a medical prescription.
