Vitamin D

Identification

Summary

Vitamin D is an ingredient found in a variety of supplements and vitamins.

Brand Names
Mvc-fluoride, Vitafol-one
Generic Name
Vitamin D
DrugBank Accession Number
DB11094
Background

Vitamin D ultimately comprises a group of lipid-soluble secosteroids responsible for a variety of biological effects, some of which include increasing the intestinal absorption of calcium, magnesium, and phosphate. With reference to human use, there are 2 main forms of vitamin D - vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol). When non-specific references are made about 'vitamin d', the references are usually about the use of vitamin D3 and/or D2.

Vitamin D3 and D2 require hydroxylation in order to become biologically active in the human body. Since vitamin D can be endogenously synthesized in adequate amounts by most mammals exposed to sufficient quantities of sunlight, vitamin D functions like a hormone on vitamin D receptors to regulate calcium in opposition to parathyroid hormone. Vitamin D plays an essential physiological role in maintaining calcium homeostasis and metabolism. There are several different vitamin D supplements that are given to treat or to prevent osteomalacia and rickets, or to meet the daily criteria of vitamin D consumption.

Type
Small Molecule
Groups
Approved, Nutraceutical, Vet approved
Synonyms
  • Calciferol
  • Vitamin D NOS
  • Vitamin D, unspecified form

Pharmacology

Indication

Vitamin D is indicated for use in the treatment of hypoparathyroidism, refractory rickets (also known as vitamin D resistant rickets), and familial hypophosphatemia Label.

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Used in combination to preventDeficiency, vitamin dCombination Product in combination with: Cholecalciferol (DB00169)•••••••••••••••••••• • •••••
Used in combination to treatDeficiency, vitamin dCombination Product in combination with: Cholecalciferol (DB00169)•••••••••••••••••••• • •••••
Prevention ofDeficiency, vitamin d••• •••
Contraindications & Blackbox Warnings
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Pharmacodynamics

The in vivo synthesis of the predominant two biologically active metabolites of vitamin D occurs in two steps. The first hydroxylation of vitamin D3 or D2 occurs in the liver to yield 25-hydroxyvitamin D while the second hydroxylation happens in the kidneys to give 1, 25-dihydroxyvitamin D Label. These vitamin D metabolites subsequently facilitate the active absorption of calcium and phosphorus in the small intestine, serving to increase serum calcium and phosphate levels sufficiently to allow bone mineralization Label. Conversely, these vitamin D metabolites also assist in mobilizing calcium and phosphate from bone and likely increase the reabsorption of calcium and perhaps also of phosphate via the renal tubules Label. There exists a period of 10 to 24 hours between the administration of vitamin D and the initiation of its action in the body due to the necessity of synthesis of the active vitamin D metabolites in the liver and kidneys Label. It is parathyroid hormone that is responsible for the regulation of such metabolism at the level of the kidneys Label.

Mechanism of action

Most individuals naturally generate adequate amounts of vitamin D through ordinary dietary intake of vitamin D (in some foods like eggs, fish, and cheese) and natural photochemical conversion of the vitamin D3 precursor 7-dehydrocholesterol in the skin via exposure to sunlight.2

Conversely, vitamin D deficiency can often occur from a combination of insufficient exposure to sunlight, inadequate dietary intake of vitamin D, genetic defects with endogenous vitamin D receptor, or even severe liver or kidney disease 1. Such deficiency is known for resulting in conditions like rickets or osteomalacia, all of which reflect inadequate mineralization of bone, enhanced compensatory skeletal demineralization, resultant decreased calcium ion blood concentrations, and increases in the production and secretion of parathyroid hormone 2. Increases in parathyroid hormone stimulates the mobilization of skeletal calcium and the renal excretion of phosphorus 2. This enhanced mobilization of skeletal calcium leads towards porotic bone conditions 2.

Ordinarily, while vitamin D3 is made naturally via photochemical processes in the skin, both itself and vitamin D2 can be found in various food and pharmaceutical sources as dietary supplements. The principal biological function of vitamin D is the maintenance of normal levels of serum calcium and phosphorus in the bloodstream by enhancing the efficacy of the small intestine to absorb these minerals from the diet 2. At the liver, vitamin D3 or D2 is hydroxylated to 25-hydroxyvitamin D and then finally to the primary active metabolite 1,25-dihydroxyvitamin D in the kidney via further hydroxylation 2,1. This final metabolite binds to endogenous vitamin d receptors, which results in a variety of regulatory roles - including maintaining calcium balance, the regulation of parathyroid hormone, the promotion of the renal reabsorption of calcium, increased intestinal absorption of calcium and phosphorus, and increased calcium and phosphorus mobilization of calcium and phosphorus from bone to plasma to maintain balanced levels of each in bone and the plasma 2,1.

TargetActionsOrganism
UVitamin D3 receptorNot AvailableHumans
UVitamin D-binding proteinNot AvailableHumans
Absorption

Vitamin D3 and D2 are readily absorbed from the small intestine (proximal or distal) 2,1.

Volume of distribution

Not Available

Protein binding

Some studies suggest vitamin D3 demonstrates protein binding of 50-80% 1 while others discuss vitamin D2 having >99.8% protein binding 2.

Metabolism

In the liver, vitamin D3 and D2 are hydroxylated to calcidiol (25-hydroxycholecalciferol) 1 and ercalcidiol (25-hydroxyergocalciferol) 2, respectively, by the enzyme 25-hydroxylase. At the level of the kidney, calcidiol and ercalcidiol are hydroxylated to yield calcitriol (1,25-dihydroxycholecalciferol) 1 and ercalcitriol (1,25-dihydroxyergocalciferol) 2, the primary biologically active forms of vitamin D3 and D2 respectively, by the enzyme 1-alpha-hydroxylase.

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Route of elimination

The primary excretion route of vitamin D is via the bile into the feces 3.

Half-life

Although certain studies suggest the half-life of 1,25-hydroxyvitamin D3 may be approximately 15 hours, the half-life of 25-hydroxyvitamin D3 appears to have a half-life of about 15 days 6. Intriguingly however, the half-lives of any particular administration of vitamin d can vary and in general the half-lives of vitamin D2 metabolites have been demonstrated to be shorter overall than vitamin D3 half-lives with this being affected by vitamin d binding protein concentrations and genotype in particular individuals 4.

Clearance

Some studies propose an estimated clearance rate for 1,25-dihydroxyvitamin D as 31 +/- 4 ml/min in healthy adults 5.

Adverse Effects
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Toxicity

The use of pharmacological or nutraceutical vitamin d and/or even excessive dietary intake of vitamin d is contraindicated in patients with hypercalcemia, malabsorption syndrome, abnormal sensitivity to the toxic effects of vitamin d, and hypervitaminosis D Label.

Hypersensitivity to vitamin d is one plausible etiologic factor in infants with idiopathic hypercalcemia - a case in which vitamin d use must be strictly restricted Label.

As vitamin d intake is available via fortified foods, dietary supplements, and clinical drug sources, serum concentrations and therapeutic dosages should be reviewed regularly and readjusted as soon as there is clinical improvement Label. Dosage levels are required to be individualized on an individual patient by patient basis as caution must be exercised to prevent the presence of too much vitamin d in the body and the various potentially serious toxic effects associated with such circumstances Label.

In particular, the range between therapeutic and toxic doses is quite narrow in vitamin d resistant rickets Label. When high therapeutic doses are used, progress should be followed with frequent blood calcium determinations Label.

When treating hypoparathyroidism, intravenous calcium, parathyroid hormone, and/or dihydrotachysterol may be required Label.

Maintenance of normal serum phosphorus levels by dietary phosphate restriction and/or administration of aluminum gels as intestinal phosphate binders in those patients with hyperphosphatemia as frequently seen in renal osteodystrophy is essential to prevent metastatic calcification Label.

Mineral oil interferes with the absorption of lipid-soluble vitamins, including vitamin d preparations Label.

The administration of thiazide diuretics to hypoparathyroid patients who are concurrently being treated with vitamin d can result in hypercalcemia Label.

At this time, no long term animal studies have been performed to evaluate vitamin potential for carcinogens, mutagenesis, or fertility Label.

As various animal reproduction studies have demonstrated fetal abnormalities in several species associated with hypervitaminosis D, the use of vitamin d in excess of the recommended dietary allowance during normal pregnancy should be avoided Label. The safety in excess of 400 USP units of vitamin d daily during pregnancy has not been established Label. The abnormalities observed are similar to the supravalvular aortic stenosis syndrome described in infants that is characterized by supravalvular aortic stenosis, elfin facies, and mental retardation Label.

In a nursing mother given large doses of vitamin D, 25-hydroxycholecalciferol appeared in the milk and caused hypercalcemia in her child. Caution is subsequently required when contemplating the use of vitamin d in a nursing woman, and the necessity of monitoring infants' serum calcium concentration if vitamin d is administered to a breastfeeding woman Label.

Adverse reactions associated with the use of vitamin d are primarily linked to having hypervitaminosis D occurring [FDA Lanel]. In particular, hypervitaminosis D is characterized by effects specific effects on specific organ systems. At the renal system, hypervitaminosis D can cause impairment of renal function with polyuria, nocturne, polydipsia, hypercalciuria, reversible asotemia, hypertension, nephrocalcinosis, generalized vascular calcification, or even irreversible renal insufficiency which may result in death Label. Elsewhere, hypervitaminosis D can also cause CNS mental retardation Label. At the level of soft tissues, it can widespread calcification of the soft tissues, including the heart, blood vessels, renal tubules, and lungs Label. In the skeletal system, bone demineralization (osteoporosis) in adults can occur while a decline in the average rate of linear growth and increased mineralization of bones, dwarfism, vague aches, stiffness, and weakness can occur in infants and children Label. Finally, hypervitaminosis D can also lead to nausea, anorexia, and constipation at the gastrointestinal level as well as mild acidosis, anemia, or weight loss via metabolic processes Label.

The LD(50) in animals is unknown Label.

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbametapirThe serum concentration of Vitamin D can be increased when it is combined with Abametapir.
AcetyldigitoxinThe risk or severity of ventricular arrhythmias and Cardiac Arrhythmia can be increased when Vitamin D is combined with Acetyldigitoxin.
AlfacalcidolThe risk or severity of adverse effects can be increased when Alfacalcidol is combined with Vitamin D.
Aluminum hydroxideThe serum concentration of Aluminum hydroxide can be increased when it is combined with Vitamin D.
AmiodaroneThe metabolism of Vitamin D can be decreased when combined with Amiodarone.
Food Interactions
  • Take with or without food. Recommendations vary from product to product - consult individual product monographs for additional information.

Products

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Active Moieties
NameKindUNIICASInChI Key
Cholecalciferolunknown1C6V77QF4167-97-0QYSXJUFSXHHAJI-YRZJJWOYSA-N
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
OstoforteCapsule50000 unitOralMerck Ltd.1951-12-312007-10-31Canada flag
Radiostol Solution 100000iu/mlLiquid100000 unit / mLOralAllen & Hanburys A Glaxo Canada Ltd. Co.1951-12-311996-09-10Canada flag
Over the Counter Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Theraplex D Tab 250unitTablet250 unit / tabOralTherapeutic Foods Co.1987-12-311996-09-09Canada flag
Vitamin DTablet400 unit / tabOralHealth Wise Nutrition Inc.2000-04-032002-07-18Canada flag
Vitamin D 1000 Iu TabletsTablet1000 unitOralNatural Factors Nutritional Products Ltd.1988-12-312008-07-17Canada flag
Vitamin D 200unitCapsule200 unit / capOralSwiss Herbal Remedies Ltd.1972-12-311999-08-13Canada flag
Vitamin D Tab 1000unitTablet1000 unitOralSwiss Herbal Remedies Ltd.1974-12-312009-08-04Canada flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
50 PlusVitamin D (400 unit) + Ascorbic acid (200 mg) + Biotin (20 mcg) + Choline bitartrate (20 mg) + Cyanocobalamin (20 mcg) + Folic acid (.2 mg) + Inositol (20 mg) + Niacin (20 mg) + Calcium pantothenate (20 mg) + Pyridoxine hydrochloride (20 mg) + Racemethionine (20 mg) + Riboflavin (20 mg) + Thiamine hydrochloride (20 mg) + Vitamin A palmitate (10000 unit) + Vitamin E (20 unit)TabletOralQuest Vitamins A Div Of Purity Life Health Products1998-08-042001-07-06Canada flag
A and D OintmentVitamin D (213 unit / g) + Vitamin A (1500 unit / g)OintmentTopicalSchering Plough1951-12-312002-07-12Canada flag
A D Calcium TabVitamin D (400 unit) + Calcium (126 mg) + Vitamin A (5000 unit)TabletOralStar Pharmaceuticals, Llc1979-12-311999-07-21Canada flag
A-D Calcium CapVitamin D (133 unit) + Calcium (170 mg) + Vitamin A (2500 unit)CapsuleOralVitalab1990-12-312005-07-12Canada flag
Ad & Calcium CapVitamin D (133 unit) + Calcium (170 mg) + Vitamin A (2500 unit)CapsuleOralLaboratoire Lalco Inc.1977-12-312001-10-15Canada flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
CitraNatal 90 DHAVitamin D (400 [iU]/1) + Ascorbic acid (120 mg/1) + Calcium citrate tetrahydrate (159 mg/1) + Cupric oxide (2 mg/1) + Docusate sodium (50 mg/1) + Ferrous gluconate dihydrate (5 mg/1) + Folic acid (1 mg/1) + Iron (85 mg/1) + Nicotinamide (20 mg/1) + Potassium Iodide (150 ug/1) + Pyridoxine hydrochloride (20 mg/1) + Riboflavin (3.4 mg/1) + Thiamine chloride (3 mg/1) + Thiamine mononitrate (4.54 mg/1) + Zinc oxide (25 mg/1) + alpha-Tocopherol acetate (30 [iU]/1)TabletOralMission Pharmacal Company2014-04-11Not applicableUS flag
CitraNatal 90 DHAVitamin D (400 [iU]/1) + Ascorbic acid (120 mg/1) + Calcium citrate tetrahydrate (160 mg/1) + Cupric oxide (2 mg/1) + Docusate sodium (50 mg/1) + Folic acid (1 mg/1) + Iron (90 mg/1) + Nicotinamide (20 mg/1) + Potassium triiodide (150 ug/1) + Pyridoxine hydrochloride (20 mg/1) + Riboprine (3.4 mg/1) + Thiamine chloride (3 mg/1) + Zinc oxide (25 mg/1) + alpha-Tocopherol acetate (30 [iU]/1)TabletOralMission Pharmacal2010-02-01Not applicableUS flag
CitraNatal DHAVitamin D (400 [iU]/1) + Ascorbic acid (120 mg/1) + Calcium citrate tetrahydrate (124 mg/1) + Cupric oxide (2 mg/1) + Doconexent (250 mg/1) + Docusate sodium (50 mg/1) + Folic acid (1 mg/1) + Icosapent (0.625 mg/1) + Iron (27 mg/1) + Nicotinamide (20 mg/1) + Potassium Iodide (150 mg/1) + Pyridoxine hydrochloride (20 mg/1) + Riboflavin (3.4 mg/1) + Thiamine chloride (3 mg/1) + Zinc oxide (25 mg/1) + alpha-Tocopherol acetate (30 [iU]/1)KitOralMission Pharmacal Company2014-05-22Not applicableUS flag
CitraNatal DHAVitamin D (400 [iU]/1) + Ascorbic acid (120 mg/1) + Calcium citrate tetrahydrate (125 mg/1) + Cupric oxide (2 mg/1) + Docusate sodium (50 mg/1) + Folic acid (1 mg/1) + Iron (27 mg/1) + Nicotinamide (20 mg/1) + Potassium Iodide (150 mg/1) + Pyridoxine hydrochloride (20 mg/1) + Riboflavin (3.4 mg/1) + Thiamine chloride (3 mg/1) + Zinc oxide (25 mg/1) + alpha-Tocopherol acetate (30 [iU]/1)TabletOralMission Pharmacal2007-11-20Not applicableUS flag
CitraNatal RxVitamin D (400 [iU]/1) + Ascorbic acid (120 mg/1) + Calcium citrate tetrahydrate (124 mg/1) + Cupric oxide (2 mg/1) + Folic acid (1 mg/1) + Iron (27 mg/1) + Nicotinamide (20 mg/1) + Potassium Iodide (150 mg/1) + Pyridoxine hydrochloride (20 mg/1) + Riboflavin (3.4 mg/1) + Thiamine chloride (3 mg/1) + Zinc oxide (25 mg/1) + alpha-Tocopherol acetate (30 [iU]/1)TabletOralMission Pharmacal2014-08-11Not applicableUS flag

Categories

Drug Categories
Classification
Not classified
Affected organisms
Not Available

Chemical Identifiers

UNII
9VU1KI44GP
CAS number
1406-16-2

References

General References
  1. Armas LA, Hollis BW, Heaney RP: Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab. 2004 Nov;89(11):5387-91. [Article]
  2. DeLuca HF: Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1689S-96S. [Article]
  3. DeLuca HF: Metabolism of vitamin D: current status. Am J Clin Nutr. 1976 Nov;29(11):1258-70. [Article]
  4. Jones KS, Assar S, Harnpanich D, Bouillon R, Lambrechts D, Prentice A, Schoenmakers I: 25(OH)D2 half-life is shorter than 25(OH)D3 half-life and is influenced by DBP concentration and genotype. J Clin Endocrinol Metab. 2014 Sep;99(9):3373-81. doi: 10.1210/jc.2014-1714. Epub 2014 Jun 2. [Article]
  5. 2. (1984). In Vitamin D: Basic and Clinical Aspects (pp. 81). Martinus Nijhoff Publishing. [ISBN:978-1-4612-9793-2]
  6. Vitamin D Supplementation: An Update [Link]
  7. Sandoz: PediaVit D (vitamin D) oral solution [Link]
PubChem Substance
347911113
RxNav
11253
Wikipedia
Vitamin_D
FDA label
Download (175 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4Active Not RecruitingPreventionFood Allergy1
4Active Not RecruitingTreatmentCoronavirus Disease 2019 (COVID‑19) / COVID-19 Respiratory Infection1
4CompletedNot AvailableOsteopenia (Disorder)1
4CompletedBasic ScienceDeficiency, Vitamin D2
4CompletedDiagnosticPolycystic Ovarian Syndrome (PCOS)1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
OintmentTopical
SyrupOral
Tablet, film coatedOral
CreamTopical
WaferOral
TabletOral
LiquidOral
Tablet, extended releaseOral
SolutionOral100000 IU
Tablet, film coated
LozengeOral
Tablet, coatedOral150 mcg
CapsuleOral0.266 mg
LiquidIntravenous
SolutionIntravenous
ElixirOral
Liquid; tabletOral
Tablet, chewableOral
Tablet, sugar coatedOral
KitOral
CapsuleOral50000 unit
Capsule, coatedOral
LiquidOral100000 unit / mL
Capsule, gelatin coatedOral
Tablet, effervescentOral
EmulsionOral
Tablet, coatedOral
TabletOral250 unit / tab
Capsule; liquidOral
Solution / dropsOral
SolutionOral
CapsuleOral
Capsule, liquid filled; kitOral
Capsule, liquid filledOral
Capsule; kit; tablet, coatedOral
TabletOral400 unit / tab
CapsuleOral200 unit / cap
TabletOral1000 unit
CapsuleOral195 unit / cap
PowderOral
Prices
Not Available
Patents
Not Available

Properties

State
Not Available
Experimental Properties
Not Available
Predicted Properties
Not Available
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
Not Available
Chromatographic Properties
Collision Cross Sections (CCS)
Not Available

Targets

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Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Zinc ion binding
Specific Function
Nuclear hormone receptor. Transcription factor that mediates the action of vitamin D3 by controlling the expression of hormone sensitive genes. Recruited to promoters via its interaction with BAZ1B...
Gene Name
VDR
Uniprot ID
P11473
Uniprot Name
Vitamin D3 receptor
Molecular Weight
48288.64 Da
References
  1. Choi M, Yamada S, Makishima M: Dynamic and ligand-selective interactions of vitamin D receptor with retinoid X receptor and cofactors in living cells. Mol Pharmacol. 2011 Dec;80(6):1147-55. doi: 10.1124/mol.111.074138. Epub 2011 Sep 14. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Vitamin transporter activity
Specific Function
Involved in vitamin D transport and storage, scavenging of extracellular G-actin, enhancement of the chemotactic activity of C5 alpha for neutrophils in inflammation and macrophage activation.
Gene Name
GC
Uniprot ID
P02774
Uniprot Name
Vitamin D-binding protein
Molecular Weight
52963.025 Da
References
  1. Arnaud J, Constans J: Affinity differences for vitamin D metabolites associated with the genetic isoforms of the human serum carrier protein (DBP). Hum Genet. 1993 Sep;92(2):183-8. [Article]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Substrate
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Has a D-25-hydroxylase activity on both forms of vitamin D, vitamin D(2) and D(3).
Gene Name
CYP2R1
Uniprot ID
Q6VVX0
Uniprot Name
Vitamin D 25-hydroxylase
Molecular Weight
57358.82 Da
References
  1. DeLuca HF: Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1689S-96S. [Article]
  2. Armas LA, Hollis BW, Heaney RP: Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab. 2004 Nov;89(11):5387-91. [Article]
  3. DeLuca HF: Metabolism of vitamin D: current status. Am J Clin Nutr. 1976 Nov;29(11):1258-70. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Substrate
General Function
Iron ion binding
Specific Function
Catalyzes the conversion of 25-hydroxyvitamin D3 (25(OH)D) to 1-alpha,25-dihydroxyvitamin D3 (1,25(OH)2D) plays an important role in normal bone growth, calcium metabolism, and tissue differentiation.
Gene Name
CYP27B1
Uniprot ID
O15528
Uniprot Name
25-hydroxyvitamin D-1 alpha hydroxylase, mitochondrial
Molecular Weight
56503.475 Da
References
  1. DeLuca HF: Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1689S-96S. [Article]
  2. DeLuca HF: Metabolism of vitamin D: current status. Am J Clin Nutr. 1976 Nov;29(11):1258-70. [Article]
  3. Armas LA, Hollis BW, Heaney RP: Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab. 2004 Nov;89(11):5387-91. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
References
  1. Griffin J. and D'Arcy P. (1997). A manual of adverse drug interactions (5th ed.). Elsevier. [ISBN:0-444-82406-5]

Drug created at December 03, 2015 16:51 / Updated at March 19, 2024 11:06