The information contained within this bulletin is provided on the understanding that although it may be used to assist in your final clinical decision,
the Clinical Pharmacology Department at Christchurch Hospital does not accept any responsibility for such decisions.
Clinical Pharmacology Bulletin
D e p a rtme n t of C l i n ical P h ar maco l o g y ,C hr istc hurch Hos p ital, P r ivate Ba g 4710, Christc h urch
Drug Information Service
Drug Utilisation Review
September 2004 No. 009/04
Vitamin D and Calcium for the Prevention and Treatment of Osteoporosis
Osteoporosis is a common systemic skeletal disorder that is responsible for bone fractures in 50% of women and 30% of
men in New Zealand1. International guidelines on the use of vitamin D and calcium for this condition have been the
subject of some debate. Therefore, the evidence basis for prescribing vitamin D and calcium has been reviewed to
provide local guidelines. The following is a summary of these guidelines.
Vitamin D deficiency and osteoporosis
Vitamin D deficiency
to secondary hyper-
parathyroidism, increased bone turnover, bone loss and
osteoporosis. People at high risk of vitamin D deficiency
house-bound or institutionalised, especially the elderly
with chronic debilitating illnesses
on enzyme-inducing anticonvulsants (eg. phenytoin)
with dark skin or extensively covered skin
older than 50 years (men or women), presenting with
fractures or low bone mineral density
A local study investigating older adults with fractures
related to minimal trauma, found that vitamin D deficiency
(serum 25-hydroxyvitamin D3 concentrations < 50 nmol/L)
occurred in 95% of patients admitted to the orthogeriatric
rehabilitation ward at Burwood Hospital2.
Endogenous synthesis of vitamin D
The term ‘vitamin D’ refers to two closely related
compounds ergocalciferol (vitamin D2) and cholecalciferol
(vitamin D3) which have the same pharmacological action.