Medication Summary
Treatment for rickets is with cholecalciferol, which may be gradually administered over several months or in a single-day dose. [7] The single-day therapy avoids problems with compliance and may be helpful in differentiating nutritional rickets from familial hypophosphatemia rickets (FHR). In nutritional rickets, the phosphorous level rises in 96 hours and radiographic healing is visible in 6-7 days. Neither happens with FHR.
Vitamin D is well stored in the body and is gradually released over many weeks. Because both calcitriol and calcidiol have short half-lives, they are unsuitable; they would bypass the natural physiologic controls of vitamin D synthesis.
Vitamin D
Class Summary
Vitamin D is a fat-soluble vitamin used to prevent or treat vitamin D deficiency.
Cholecalciferol (Vitamin D3, Ddrops Kids, Delta-D3)
For treatment of rickets, cholecalciferol can be given in a single-day dose of 15,000 mcg (600,000 U), which is usually divided into 4 or 6 oral doses. An intramuscular injection is also available.
An alternative regimen is to give 125-250 mcg (5000-10,000 U) daily for 2-3 months until healing is well established and the alkaline phosphatase concentration is approaching the reference range. Because this gradual method requires daily treatment, success depends on compliance.
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Findings in patients with rickets.
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Anteroposterior and lateral radiographs of the wrist of an 8-year-old boy with rickets demonstrates cupping and fraying of the metaphyseal region.
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Radiographs of the knee of a 3.6-year-old girl with hypophosphatemia depict severe fraying of the metaphysis.
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Radiograph in a 4-year-old girl with rickets depicts bowing of the legs caused by loading.
