A combined formulation of alendronate with cholecalciferol (vitamin D3) is inadequate for sole treatment of vitamin D deficiency, the latest edition of NPS RADAR states.

The weekly dose of 2800 units, which is equivalent to 400 units daily, is not enough on its own to treat deficiency, or to prevent deficiency in high-risk groups.

Further, there is no evidence that a combined formulation of alendronate with vitamin D will reduce the risk of fracture compared with alendronate alone, in people who already have an existing minimal trauma fracture.

Sunlight exposure is the major source of vitamin D. At highest risk of vitamin D deficiency are institutionalised or housebound elderly people.

‘If a patient is vitamin D deficient, he or she needs a bigger supplement than this,’ Dr Peter Roush, of NPS said.

‘There may be a cost saving to the patient through the PBS if this combination tablet contributes some of the required vitamin D supplement, by reducing the amount of supplement the patient will need to purchase.’

‘But GPs should question if a supplement is necessary for patients who can obtain their vitamin D intake through sunlight exposure and are unlikely to be deficient.’

‘Combination products are becoming more common and the test to apply to each of them is this: is adding a vitamin or a drug in combination the best option for the patient?

‘If you believe a patient is not getting enough vitamin D, limited, safe, exposure to sunshine might be an adequate prescription,’ Dr Roush said.

The product is listed for treatment of established osteoporosis in patients with fracture and an authority is required.

End.

NPS RADAR provides independent information about new medicines and changes to PBS listings important to GPs, pharmacists and other health professionals involved in primary care management of patients.