Current aspects of cholecalciferol use in children in light of new clinical guidelines

Risnik D.V., Kodentsova V.M.

1) Lomonosov Moscow State University, Department of Biophysics, Faculty of Biology, Moscow, Russia; 2) Federal Research Center for Nutrition, Biotechnology and Food Safety, Moscow, Russia

Vitamin D is an essential micronutrient. Adequate intake yields pleiotropic effects, including immune system strengthening, reduced inflammation risk, and cardiovascular system support.
This review aims to update data on the vitamin D status of Russian children and provide current information on effectively correcting vitamin D deficiency in this population, in light of recently enacted clinical guidelines.
Reduced blood levels of 25-hydroxyvitamin D are observed in 21–85,5% of Russian children across all age groups. The severity of the deficiency increases with age and exhibits seasonal fluctuations, worsening during winter and spring.
Many publications have previously proposed high doses of vitamin D-comparable to therapeutic doses – as a preventive measure against dietary insufficiency. A key strength of the new clinical guidelines «Vitamin D Deficiency. Rickets» is the consensus among specialists from various fields: these guidelines clearly distinguish between preventive doses (to correct dietary insufficiency) and therapeutic doses. Because preventive doses align with the body’s physiological requirements, they are suitable for continuous use – particularly given that vitamin D levels gradually revert to a state of insufficiency once supplementation ceases. Therapeutic doses exceed physiological doses and are recommended for administration in courses as prescribed by a physician. Limiting the duration of therapeutic-dose cholecalciferol administration allows for the correction of severe deficiency and clinical signs of rickets without the risk of exceeding the upper safe intake level. Concomitant dietary deficiencies in other micronutrients can reduce the efficacy of cholecalciferol supplementation.
Conclusion: The key provisions of the clinical guidelines «Vitamin D Deficiency. Rickets» (2026) include a clear distinction between vitamin D dosages, the continuous intake of prophylactic doses, and the administration of therapeutic doses in courses.

For citations: Risnik D.V., Kodentsova V.M. Current aspects of cholecalciferol use in children in light of new clinical guidelines. Pharmateca. 2026;33(7):6-13. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.7.6-13

Authors’ contribution: All authors contributed to the conception, analysis and interpretation of data and gave final approval to the manuscript for publication. 
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare. 
Funding: The study was conducted without any sponsorship.

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About the Authors

Dmitry V. Risnik, Cand. Sci. (Biol.), Leading Researcher, Department of Biophysics, Faculty of Biology, Lomonosov Moscow State University, Moscow, Russia; biant3@mail.ru, ORCID ID: https://orcid.org/0000-0002-3389-8115
Vera M. Kodentsova, Dr. Sci. (Biol.), Professor, Chief Researcher, Laboratory of Vitamins and Minerals, Federal Research Center for Nutrition, Biotechnology and Food Safety, Moscow, Russia; kodentsova@ion.ru, ORCID ID: https://orcid.org/0000-0002-5288-1132 (corresponding author)

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