TABLE 142-5.
Vitamin and Mineral Doses Used in the Treatment of Malabsorption
| VITAMIN | ORAL DOSE | PARENTERAL DOSE |
|---|---|---|
| Vitamin A* | Water-soluble A, 25,000 U/day† | |
| Vitamin E | Water-soluble E, 400-800 U/day† | |
| Vitamin D‡ | 25,000-50,000 U/day | |
| Vitamin K | 5 mg/day | |
| Folic acid | 1 mg/day | |
| Calcium§ | 1500-2000 mg elemental calcium/day | |
| Calcium citrate, 500 mg calcium/tablet† | ||
| Calcium carbonate, 500 mg calcium/tablet† | ||
| Magnesium | Liquid magnesium gluconate† | 2 mL of a 50% solution (8 mEq) both buttocks IM |
| 1-3 tbsp (12-36 mEq magnesium) in 1-2 L of ORS or sports drink sipped throughout the day | ||
| Magnesium chloride hexahydrate† 100-600 mg elemental magnesium/day | ||
| Zinc | Zinc gluconate† | |
| 20-50 mg elemental zinc/day‖ | ||
| Iron | 150-300 mg elemental iron/day | Iron sucrose¶ |
| Polysaccharide-iron complex† | Sodium ferric gluconate complex¶ | |
| Iron sulfate or gluconate | Iron dextran (as calculated for anemia) (IV or IM¶; Chapter 162) | |
| B-complex vitamins | 1 megadose tablet/day | |
| Vitamin B12 | 2 mg/day | 1 mg IM or SC/mo** |
ORS = oral rehydration solution.
*
Monitor serum vitamin A level to avoid toxicity, especially in patients with hypertriglyceridemia.
†
Form best absorbed or with least side effects.
‡
Monitor serum calcium and 25-OH vitamin D levels to avoid toxicity.
§
Monitor 24-hr urine calcium to assess adequacy of dose.
‖
If intestinal output is high, additional zinc should be given. Monitor for copper deficiency with high doses.
¶
Parenteral therapy should be given in a supervised outpatient setting because of the risk of fatal reactions. Decreased risk of fatal reactions when compared with iron dextran.
**
For vitamin B12 deficiency, 1 mg IM or SC twice a week for 4 wk, then once a month.