Zinc Sulfate

Pronunciation

Pronunciation: zink SUL-fate
Class: Trace element

Trade Names

Concentrated Zinc Sulfate
- Injection zinc 5 mg/mL (as zinc sulfate 12.32 mg/mL)

Eye-Sed
- Solution 0.25%

Orazinc
- Tablets, oral 110 mg (zinc 25 mg)
- Capsules, oral 220 mg (zinc 50 mg)

Verazinc
- Capsules, oral 220 mg (zinc 50 mg)

Zinc 15
- Tablets, oral 66 mg (zinc 15 mg)

Zinc-220
- Capsules, oral 220 mg (zinc 50 mg)

Zinc Sulfate
- Injection zinc 1 mg/mL (as zinc sulfate 2.46 mg/mL)

Zincate
- Capsules, oral 220 mg (zinc 50 mg)

Rivasol (Canada)

Pharmacology

Acts as an 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.

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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

Approximately 90% is excreted through the intestines; approximately 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 disease.

Contraindications

Direct injection of undiluted solution into peripheral vein.

Dosage and Administration

Astringent
Adults

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

Dietary Supplement
Adults

PO 25 to 50 mg/day.

Supplementation in Patients Receiving TPN
Full-term infants and children up to 5 y of age

IV 100 mcg/kg/day of zinc added to TPN.

Metabolically stable adults

IV 2.5 to 4 mg/day of zinc added to TPN. Add 2 mg/day for acute catabolic state.

Premature infants (birth weight less than 1,500 g) up to 3 kg

IV 300 mcg/kg/day of zinc added to TPN.

Stable adults with fluid loss from small bowel

IV Increase dose by 12.2 mg of zinc per liter of TPN or 17.1 mg of zinc per kilogram of loose stool or ileostomy output.

General Advice

  • Do not give injection undiluted by direct injection into a peripheral vein.
  • Add to TPN solution.

Drug Interactions

Fluoroquinolones, tetracyclines

Absorption of these agents may be decreased.

Adverse Reactions

GI

Nausea; vomiting (especially in large oral doses).

Precautions

Monitor

Frequent monitoring of zinc blood levels is suggested for patients receiving more than the usual maintenance dosage level of zinc.


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.

Aluminum toxicity

Parenteral products may contain aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk.

Concomitant copper therapy

Administration of parenteral zinc in the absence of copper may cause a decrease in serum copper levels. Periodic determination of serum copper as well as zinc is suggested as a guideline for subsequent zinc administration.

Excessive intake

May be harmful in healthy people.

Overdosage

Symptoms

Abdominal pain, dehydration, dizziness, electrolyte imbalances, hyperamylasemia, incoordination, lethargy, nausea, profuse sweating, restlessness, sideroblastic anemia, vomiting.

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 solution.
  • Advise patient that parenteral medication will be prepared and administered by a health care provider in a hospital setting.
  • Teach patient proper administration technique for eye drops.

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