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Zinc Acetate Dosage

Applies to the following strength(s): 50 mg ; 25 mg

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Wilson's Disease

Maintenance (following initial chelation therapy):
50 mg orally 3 times a day on an empty stomach. All doses should be administered at least one hour before or two to three hours after consumption of any food and beverage other than water.,

Usual Pediatric Dose for Zinc Deficiency

Clinical response may not occur for up to 6 to 8 weeks

RDA: Oral:

Neonates and Infants less than 12 months: 5 mg elemental zinc/day

Children 1 to 10 years: 10 mg elemental zinc/day

Children less than or equal to 11 years and adults: Male: 15 mg elemental zinc/day Female: 12 mg elemental zinc/day

Zinc deficiency: Oral:

Infants and children: 0.5 to 1 mg elemental zinc/kg/day divided 1 to 3 times/day; larger doses may be needed if impaired intestinal absorption or an excessive loss of zinc (e.g., excessive, prolonged diarrhea)

Supplement to parenteral nutrition solutions (clinical response may not occur for up to 6-8 weeks): IV (all doses are mcg or mg of elemental zinc):

Premature Infants: 400 mcg/kg/day
Term Infants less than 3 months: 300 mcg/kg/day
Infants greater than or equal to 3 months and children less than or equal to 5 years: 100 mcg/kg/day (maximum: 5 mg/day)
Children greater than 5 years and adolescents: 2.5 to 5 mg/day

Usual Pediatric Dose for Wilson's Disease

Zinc acetate is not indicated for the initial treatment of Wilson's disease but for maintenance after initial therapy with a chelating agent (approximately 4-6 months).

Maintenance treatment of Wilson's disease: Zinc acetate: Dose is in mg elemental zinc: Note: Indicated for initial treatment of Wilson's disease in asymptomatic or presymptomatic patients or for maintenance after initial therapy with a chelating agent (approximately 1 to 5 years).

Children 5 to 18 years:
less than 50 kg: 25 mg/dose 3 times/day
greater than or equal to 50 kg: 50 mg/dose 3 times/day

Renal Dose Adjustments

Zinc acetate should be used cautiously in this patient with renal impairment. Therapeutic doses in renal disease are not well defined. The majority of studies evaluating zinc acetate in patients with Wilson's disease have not reported dose adjustments.

Liver Dose Adjustments

Zinc acetate should be used cautiously in this patient with hepatic impairment. Therapeutic doses in liver disease are not well defined. The majority of studies evaluating zinc acetate in patients with Wilson's disease have not reported dose adjustments.

Dose Adjustments

In pregnant women, a lower dosage of 25 mg orally three times a day may be more appropriate. The dosage may be adjusted up to 50 mg orally three times a day if monitoring indicates a loss of disease control.

Dialysis

The hemodialysis clearance of zinc acetate is unknown. Excessive uptake or loss of zinc may occur during dialysis depending on their relative concentrations in plasma and dialysate and the degree of binding to proteins and red blood cells. Zinc acetate is highly protein bound therefore hemodialysis clearance should be minimal. However, toxicity has been reported in patients with renal failure on hemodialysis due to contamination of the dialysate from zinc present within adhesive plastic used on dialysis coils or from galvanized pipes. The toxic effects manifest as anemia, fever, and central nervous system disturbances.

The peritoneal dialysis clearance of zinc acetate is unknown. Excessive uptake or loss of zinc may occur during dialysis depending on their relative concentrations in plasma and dialysate and the degree of binding to proteins and red blood cells. Zinc acetate is highly protein bound therefore peritoneal clearance should be minimal. However, toxicity has been reported in patients with renal failure on hemodialysis due to contamination of the dialysate from zinc present within adhesive plastic used on dialysis coils or from galvanized pipes. The toxic effects manifest as anemia, fever, and central nervous system disturbances.

Other Comments

Treatment is usually started two to six months after initial decoppering and should be continued indefinitely.

Patients should be counseled on the importance of life-long, continued treatment for Wilson's disease. Abruptly stopping treatment may lead to irreversible neurologic and hepatic damage.

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