Dehydroepiandrosterone + Folic Acid + Vitamin D3 (cholecalciferol)

Dosage Forms Available

• Dehydroepiandrosterone + Folic Acid (Vitamin B9) + Vitamin D3 (Cholecalciferol) may be available as an oral tablet or capsule.
• The strengths of the three ingredients can differ between products. The exact composition should therefore be confirmed from the current product label.

Age and Dose Restrictions

• Dehydroepiandrosterone + Folic Acid (Vitamin B9) + Vitamin D3 (Cholecalciferol) is primarily intended for selected adult women under the supervision of a fertility specialist.
• It should not be used in individuals younger than 18 years unless specifically prescribed by an appropriate specialist.
• The dose and duration should be determined according to the product strength, the reason for use and the treating doctor’s instructions.

Contraindications

• Do not take Dehydroepiandrosterone + Folic Acid (Vitamin B9) + Vitamin D3 (Cholecalciferol) if you are allergic to DHEA, folic acid, vitamin D3 or any other ingredient in the product.
• DHEA should be avoided during pregnancy and breastfeeding because it can alter androgen and oestrogen activity. Contact your fertility specialist as soon as pregnancy is confirmed.
• Do not use DHEA without specialist approval if you have or previously had breast, ovarian, uterine or another hormone-sensitive cancer.
• Inform your doctor if you have high blood calcium levels, kidney disease, kidney stones or a parathyroid disorder before taking vitamin D3.

Other Medications to Avoid

• Tell your doctor if you take medicines containing oestrogen, testosterone or other hormones because DHEA can add to their hormonal effects.
• Tell your doctor if you take medicines for depression, anxiety, sleep disorders or other mental health conditions because DHEA may affect mood or behaviour in some individuals.
• Folic acid can interact with methotrexate used for certain conditions and with seizure-control medicines such as phenytoin, carbamazepine and valproate.
• Vitamin D3 can interact with orlistat, corticosteroids and thiazide diuretics. Thiazide diuretics taken with vitamin D may increase the risk of high blood calcium levels.
• Inform your doctor about all prescription medicines, non-prescription medicines, vitamins, herbal products and nutritional supplements you use.

Overdose and Missed Dose

• If more than the prescribed amount of Dehydroepiandrosterone + Folic Acid (Vitamin B9) + Vitamin D3 (Cholecalciferol) is taken, contact a doctor or the nearest medical facility promptly.
• The effects of an overdose depend on the amounts of DHEA, folic acid and vitamin D3 in the particular product.
• Excessive vitamin D intake can cause high blood calcium levels, nausea, vomiting, weakness, excessive thirst, frequent urination, kidney problems or abnormal heart rhythms.
• If a dose is missed, take it when remembered unless it is almost time for the next dose. Skip the missed dose when the next dose is due soon.
• Do not take a double dose to make up for a missed dose.

Management of Side Effects

Most side effects may be mild, but persistent or severe symptoms should not be ignored.

• Ask your doctor whether the medicine can be taken with food if it causes nausea or stomach discomfort.
• Drink sufficient fluids if you develop diarrhoea or vomiting. Contact your doctor if these symptoms continue.
• Inform your doctor if you develop acne, increased facial hair, scalp hair loss or menstrual changes.
• Consult your doctor if you experience insomnia, marked irritability, agitation or other mood changes.
• Do not change the dose or stop a prescribed fertility-treatment plan without consulting the treating specialist.

Use in Driving and Operating Machinery

• Dehydroepiandrosterone + Folic Acid (Vitamin B9) + Vitamin D3 (Cholecalciferol) is not generally expected to directly impair driving ability.
• Do not drive or operate machinery if you experience dizziness, headache, reduced alertness or any symptom that affects safe performance.

Use in Pregnancy and Lactation

• Dehydroepiandrosterone + Folic Acid (Vitamin B9) + Vitamin D3 (Cholecalciferol) should not be continued during pregnancy or breastfeeding unless the treating specialist has explicitly reviewed and approved its use.
• DHEA is hormonally active and should generally be avoided during pregnancy and breastfeeding.
• Folic acid and vitamin D may be required during pregnancy, but they should be taken in the appropriate doses and products recommended by the doctor rather than automatically continuing a DHEA-containing combination.

Caution in Other Conditions

• Inform your doctor if you have liver disease, kidney disease, high blood calcium, kidney stones, high cholesterol, coronary artery disease or a hormone-sensitive condition.
• Inform your doctor if you have a history of depression, bipolar disorder, mania or another significant mood disorder because DHEA may worsen behavioural or mood symptoms in susceptible individuals.
• Do not start DHEA without specialist evaluation if you have irregular periods, severe acne, excessive facial hair or rapid scalp hair loss.
• People with kidney disease, high blood calcium or parathyroid disorders require medical assessment before taking vitamin D3. Excessive vitamin D can cause hypercalcaemia and kidney-related complications.

Special Dietary and Lifestyle Recommendations

• Follow a balanced diet containing vegetables, fruits, pulses, whole grains and adequate protein.
• Include folate-containing foods such as green leafy vegetables, beans, lentils and fortified grain products.
• Maintain an appropriate body weight and follow the physical-activity advice provided by your fertility specialist.
• Avoid smoking and alcohol while preparing for pregnancy, as both can adversely affect reproductive health and pregnancy outcomes.
• Do not add other DHEA, folic acid, vitamin D or fertility supplements without informing your doctor.