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Zinc Sulfate

Pronouncation: (zink SULL-fate)
Class: Trace element

Trade Names:
Eye-Sed
- Solution 0.25%

Trade Names:
Orazinc
- Tablets 110 mg (25 mg zinc)
- Capsules 220 mg (50 mg zinc)

Trade Names:
Verazinc
- Capsules 220 mg (50 mg zinc)

Trade Names:
Zinc 15
- Tablets 66 mg (15 mg zinc)

Trade Names:
Zinc-220
- Capsules 220 mg (50 mg zinc)

Trade Names:
Zinca-Pak
- Injection 1 mg/ml (as sulfate [as 4.39 mg heptahydrate or 2.46 mg anhydrous])
- Injection 5 mg/ml (as 21.95 mg sulfate)

Trade Names:
Zincate
- Capsules 220 mg (50 mg zinc)

Neosporin Ointment (Canada)

Pharmacology

Acts as integral part of several enzymes important to protein and carbohydrate metabolism, wound healing, maintenance of normal growth and skin hydration, and senses of taste and smell.

Pharmacokinetics

Absorption

Some studies indicate that ingestion with certain foods may inhibit zinc absorption. It is poorly absorbed from the GI tract (only 20% to 30%).

Distribution

Major stores of zinc are in the skeletal muscle and bone.

Elimination

About 90% is excreted through the intestines; about 2% in the urine.

Indications and Usage

Dietary supplementation; supplement to IV solutions given for TPN; treatment or prevention of zinc deficiencies. Ophthalmic solution used as mild astringent for relief of eye irritation.

Unlabeled Uses

Treatment of acrodermatitis enteropathica and delayed wound healing associated with zinc deficiency; treatment of acne, rheumatoid arthritis, Wilson's disease.

Contraindications

Direct injection of undiluted solution into peripheral vein.

Dosage and Administration

Dietary Supplement
Adults

PO 25 to 50 mg/day.

Supplement to IV Solutions
Metabolically stable adults

IV 2.5 to 4 mg/day. Add 2 mg/day for acute catabolic state.

Stable adults with fluid loss from small bowel

IV Increase dose by 12.2 mg/L TPN or 17.1 mg/kg loose stool or ileostomy output.

Full-term infants and children under 5 yr

IV 100 mcg/kg/day.

Premature infants under 3 kg

IV 300 mcg/kg/day.

Astringent
Adults

Ophthalmic 1 to 2 gtt into eye(s) up to 4 times daily.

Drug Interactions

Fluoroquinolones; tetracyclines

Absorption of these agents may be decreased.

Laboratory Test Interactions

None well documented.

Adverse Reactions

GI

Nausea; vomiting (especially in large oral doses).

Precautions

Pregnancy

Category C . Routine supplementation during pregnancy is not recommended.

Lactation

Excreted in breast milk.

Renal Function

Dosage reduction may be required in patients with renal dysfunction.

Excessive intake

In healthy people may be harmful.

Benzyl alcohol

Some of these products contain benzyl alcohol, which has been associated with a fatal “gasping” syndrome in premature infants.

IV products

Some contain benzyl alcohol, which is associated with fatal “gasping syndrome” in infants.

Overdosage

Symptoms

Nausea, vomiting, dehydration, restlessness, sideroblastic anemia, profuse sweating, hyperamylasemia.

Patient Information

Tell patient to contact health care provider if nausea, severe vomiting, dehydration, or restlessness occurs.
Identify food sources of zinc (eg, seafood, organ meats, wheat germ).
Inform patient that sense of taste and smell, skin hydration, and wound healing should improve.
Instruct patient to follow RDA guidelines and limitations in terms of vitamin and mineral supplementation.
Tell patient to take with food if GI upset occurs but to avoid foods high in calcium, phosphorus, and phytate. Inform patient that bran, caffeine, and dairy products may decrease absorption.
Tell patient to notify health care provider if change in vision occurs or if eye irritation or pain persists or increases while using ophthalmic form.
Teach patient proper administration technique for eye drops.