VIGANTOL

Patient Information Leaflet

Warning! Please keep this leaflet. The information on the immediate packaging is in a foreign language.
Vigantol
500 micrograms/ml (20,000 IU/ml), oral drops, solution
Cholecalciferolum
Please read this leaflet carefully before using this medicine, as it contains
important information for the patient.
This medicine should always be used exactly as described in this patient leaflet or as directed by
your doctor or pharmacist.

• Keep this leaflet so that you can read it again if necessary.
• If you need advice or further information, please consult your pharmacist.
• If you experience any adverse reactions, including any possible adverse reactions not listed in this leaflet, inform your doctor, pharmacist, or nurse. See section 4.
• If there is no improvement or if you feel worse, consult your doctor.

Table of Contents:

1. What is Vigantol and what is it used for?
2. Important information before taking Vigantol
3. How to use Vigantol
4. Possible side effects
5. How to store Vigantol
6. Contents of the pack and other information

1. What is Vigantol and what is it used for?

Vigantol contains the active substance vitamin D (cholecalciferol), which is important for bone formation.
Vitamin D (cholecalciferol) is physiologically produced in the skin upon exposure to UV radiation, but may also be supplied to the body through diet.
Vitamin D deficiency leads to disturbances in bone mineralization (rickets) or loss of calcium from bones (osteomalacia).
Vigantol is used:

• for the prevention of rickets and osteomalacia in children and adults,
• for the prevention of rickets in premature infants,
• for the prevention of disorders in cases where there is a risk of vitamin D deficiency in children and adults,
• for the prevention of vitamin D deficiency in children and adults,
• as adjunctive treatment in osteoporosis in adults.

2. Important information before using Vigantol

When not to use Vigantol

• if the patient is allergic to the active substance or to any of the other ingredients of this medicine (listed in section 6),
• in case of hypercalcaemia (excessively high calcium levels in the blood) or hypercalciuria (excessive excretion of calcium in urine),
• if the patient has kidney stones or severe renal insufficiency,
• in case of pseudohypoparathyroidism.

Warnings and precautions
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Before starting treatment with Vigantol, consult your doctor or pharmacist, as Vigantol should be used under medical supervision:

• if the patient is also taking other medicines containing vitamin D, because additional doses of vitamin D should only be taken under medical supervision,
• if the patient has sarcoidosis (an immune system disorder that may increase vitamin D levels in the body),
• if the patient has impaired kidney function,
• if the patient is being treated with cardiac glycosides or diuretics,
• in newborns, infants and young children,
• if vitamin D treatment is long-term, as in such cases the doctor should monitor serum and urinary calcium levels and assess kidney function by measuring blood creatinine levels.

Vigantol and other medicines
Inform your doctor or pharmacist about all medicines the patient is currently taking, has recently taken, or plans to take.
Antacids containing aluminium, used in the treatment of hyperacidity, taken concomitantly with Vigantol, may increase aluminium levels in the blood, increasing the risk of aluminium toxicity in bones.
Antacids containing magnesium used simultaneously with Vigantol may increase magnesium levels in the blood.
Some antiepileptic, sedative or hypnotic drugs (containing phenytoin and barbiturates), when used together with Vigantol, may reduce its effectiveness.
Some diuretics (thiazides) may lead to hypercalcaemia (elevated calcium levels) caused by reduced renal excretion of calcium. During long-term treatment, serum and urinary calcium levels should be monitored.
Concomitant use of glucocorticoids (synthetic corticosteroid hormones) may counteract the effect of Vigantol.
Vigantol may enhance the action and toxicity of cardiac glycosides, increasing the risk of cardiac arrhythmias. In such cases, the doctor should monitor serum and urinary calcium levels and perform periodic ECG examinations.
Concomitant use of vitamin D metabolites or analogues (e.g. calcitriol) and Vigantol is possible only on a doctor's prescription and only in exceptional cases, under regular monitoring of serum calcium levels.
Rifampicin and isoniazid may reduce the effectiveness of Vigantol.

Pregnancy and breastfeeding
If the patient is pregnant or breastfeeding, suspects she may be pregnant, or is planning to have a child, she should consult her doctor before using this medicine.

Pregnancy
Vigantol should be used during pregnancy only on the advice of a doctor.
Excessive intake of vitamin D during pregnancy should be avoided, as it may lead to delayed physical and mental development, congenital heart defects, and retinal disorders (retinopathy) in the child.

Breastfeeding
Consult your doctor before using this medicine.

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Driving and operating machinery
Vigantol has no influence on the ability to drive motor vehicles or operate machinery.

3. How to use Vigantol

This medicine should always be taken exactly as described in this patient leaflet or as directed by a
physician or pharmacist. If in doubt, consult a doctor.
Dosage

• Premature infants: 2 drops daily of Vigantol solution (1000 IU vitamin D ). After reaching the
  40th week of corrected age, the prophylactic dose should be reduced. The dosage must be determined by the attending physician.
• Newborns and infants (up to 12 months): 1 drop daily of Vigantol solution (corresponding to 500 IU vitamin D ).

Vigantol should be administered under medical supervision in premature infants, newborns, and infants.
Do not exceed the recommended dose.

• Children and adolescents: 1 drop daily of Vigantol solution (corresponding to 500 IU vitamin D ).
• Adults and elderly individuals: 2 drops daily of Vigantol solution (corresponding to 1000 IU vitamin D ).
• Adjunctive treatment of osteoporosis in adults: 4 drops daily of Vigantol solution (corresponding to 2000 IU vitamin D ).
• Adults with obesity (including elderly individuals) and individuals over 75 years of age: 8 drops daily of Vigantol solution (corresponding to 4000 IU vitamin D )

Do not use this medicinal product long-term or in higher doses without medical supervision.
Additionally, do not use other medicines, dietary supplements, or foodstuffs containing vitamin D (cholecalciferol), calcitriol, or other metabolites and analogues of vitamin D concurrently without medical supervision.
Method of administration
Premature infants, newborns, and infants:
Vigantol should be administered to children from the second week of life until the end of the first year of life.
Administer drops with a spoonful of milk or food. If drops are added to a bottle or food, ensure that the child consumes the entire meal; otherwise, the full dose will not be ingested.
Older children and adults
Vigantol should be administered with a spoonful of liquid.
Use of a higher than recommended dose of Vigantol
If a higher than recommended dose of Vigantol is used, contact a doctor.
The doctor will decide on appropriate treatment.
Symptoms of overdose: nausea, vomiting, diarrhoea followed by constipation, loss of appetite,
fatigue, headache, muscle pain, joint pain, muscle weakness, drowsiness, azotemia (increased
blood levels of nitrogen compounds), excessive thirst, polyuria and dehydration. With high
calcium levels in blood, disturbances in heart function, kidney failure, psychoses, and even
coma may occur. Laboratory tests may reveal hypercalcemia (elevated calcium levels in blood), hypercalciuria (excessive excretion of calcium in urine), and increased serum 25-hydroxycalciferol levels. There is no known specific antidote for vitamin D.
Overdose requires measures to control hypercalcemia, which may be prolonged and sometimes life-threatening. In case of overdose, inform a doctor, who will decide on appropriate treatment.
Missed dose of Vigantol
Do not take a double dose to make up for a missed dose.

4. Possible adverse reactions

Like all medicines, this medicine can cause adverse reactions, although not everyone experiences them.
Gastrointestinal disorders such as constipation, bloating, nausea, abdominal pain or diarrhoea.
Hypersensitivity reactions such as: skin itching, rash or urticaria.
In case of prolonged use of high doses – hypercalcaemia (excess calcium concentration in the blood) and hypercalciuria (excessive excretion of calcium in urine). In isolated cases, fatal outcomes have been reported.
Reporting of adverse reactions
If any adverse reactions occur, including any adverse reactions not listed in this leaflet, inform your doctor, pharmacist or nurse. Adverse reactions can be reported directly to the Department of Monitoring of Adverse Drug Reactions of the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products: Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: + 48 22 49 21 301, fax: + 48 22 49 21 309, website: https://smz.ezdrowie.gov.pl
By reporting adverse reactions, additional information regarding the safety of the medicine can be collected.

5. How to store Vigantol

Keep this medicine out of sight and reach of children.
Store the bottle in the outer packaging to protect it from light.
The shelf life of the medicine after first opening the bottle is 12 months.
Do not use this medicine after the expiry date stated on the packaging. The expiry date refers to the last day of the stated month.
Medicines must not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer in use. This will help protect the environment.

6. Contents of the packaging and other information

What Vigantol contains

• The active substance is cholecalciferol. 1 ml (40 drops) contains 500 micrograms of cholecalciferol (equivalent to 20,000 IU of vitamin D). One drop contains 12.5 micrograms of cholecalciferol (equivalent to 500 IU of vitamin D).
• The other ingredient is: medium-chain triglycerides.

What Vigantol looks like and contents of the pack
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Vigantol is an oral solution in the form of drops.
The bottle is closed with a screw cap and includes a dropper.
The bottle is placed in a cardboard box.
For more detailed information, please contact the responsible party or the parallel importer.
Responsible party in Bulgaria, country of export:
P&G Health Germany GmbH, Sulzbacher Strasse 40, 65824 Schwalbach am Taunus, Germany
Manufacturer:
Lusomedicamenta Sociedade Técnica Farmacêutica, S.A.
Estrada Consiglieri Pedroso, n°. 66, 69-B, Queluz de Baixo, 2730-055 Barcarena, Portugal
Parallel importer:
Delfarma Sp. z o.o., ul. Św. Teresy od Dzieciątka Jezus 111, 91-222 Łódź
Repackaged in:
Delfarma Sp. z o.o., ul. Św. Teresy od Dzieciątka Jezus 111, 91-222 Łódź
Bulgaria, country of export, marketing authorization number: 9900340
Parallel import authorization number: 115/21
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