How often are Vitamin D shots administered?

Vitamin D Injection Frequency

Vitamin D injections (intramuscular) are typically administered every 2-3 months for patients with recurrent vitamin D deficiency or malabsorption issues. 1, 2

Vitamin D Injection Protocols

• For patients with documented vitamin D deficiency who cannot absorb oral supplements, intramuscular (IM) vitamin D is recommended at a dose of 50,000 IU administered every 2-3 months 1, 2
• IM administration is particularly effective for patients with malabsorptive conditions such as post-bariatric surgery, inflammatory bowel diseases, pancreatic insufficiency, and short-bowel syndrome 2
• For severe deficiency (<10 ng/mL), a loading dose approach may be needed before transitioning to maintenance dosing 2

Dosing Considerations

• The standard IM dose is typically 50,000 IU of vitamin D per injection 3, 4
• For patients with persistent malabsorption, IM administration should be continued as the preferred route over oral supplementation 2
• In adults with intellectual disability living in nursing homes, a single IM injection of 150,000 IU has been studied, showing improvement in vitamin D status that lasted approximately 6 months 5

Monitoring and Follow-up

• After initiating treatment, follow-up vitamin D levels should be measured after 3-6 months to ensure adequate dosing 2
• The goal of treatment is to achieve and maintain a 25(OH)D level of at least 30 ng/mL for optimal health benefits 2, 4
• Individual response to vitamin D supplementation is variable due to genetic differences in vitamin D metabolism, making monitoring essential 2

Alternative Options

• For patients who can tolerate oral supplementation, options include:
  • Daily dosing: 1,000-4,000 IU per day for maintenance 2, 4
  • Weekly dosing: 50,000 IU once weekly for 8-12 weeks for deficiency, followed by maintenance dosing 2, 4
  • Monthly dosing: 50,000 IU monthly for convenience (equivalent to approximately 1,600 IU daily) 2

Important Considerations

• IM vitamin D availability varies by country and may not be universally accessible 2
• IM administration may be contraindicated in patients on anticoagulation or with infection risk 1
• In some countries, oral calcifediol [25(OH)D] is available as an alternative to IM injection for patients with decreased intestinal absorption capacity 1

Special Populations

• For patients with chronic kidney disease (CKD), vitamin D supplementation is particularly important as kidney disease is a major risk factor for deficiency 2
• For elderly patients, higher maintenance doses may be required due to decreased skin synthesis 2