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Zinc Acetate

Medically reviewed by Drugs.com. Last updated on Apr 25, 2020.

Pronunciation

(zink AS e tate)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule, Oral:

Galzin: 25 mg, 50 mg

Brand Names: U.S.

  • Galzin

Pharmacologic Category

  • Chelating Agent, Oral

Pharmacology

Zinc induces production of the copper binding protein metallothionein in enterocytes. Copper binding within enterocytes results in an impairment of the intestinal absorption of dietary copper and reabsorption of endogenously secreted copper in saliva, bile, gastric acid. Following enterocyte desquamation, bound copper is eliminated in the feces.

Absorption

Small intestine (IOM 2001); impaired with food and beverages (other than water)

Distribution

Stored primarily in skeletal muscle and bone (IOM 2001)

Excretion

Feces and urine (IOM 2001)

Protein Binding

Albumin and alpha 1-macroglobulin (Foote 1984).

Use: Labeled Indications

Wilson disease: Maintenance treatment of Wilson disease following chelation therapy.

Contraindications

Hypersensitivity to zinc acetate or any component of the formulation.

Dosing: Adult

Wilson disease: Oral: Note: Dose expressed in mg elemental zinc:

Usual dosage: 50 mg 3 times daily; may administer 25 mg 3 times daily if patient is compliant with therapy (increase dose to 50 mg 3 times daily if inadequate response to lower dose).

Pregnant females: 25 mg 3 times daily; may increase to 50 mg 3 times daily if inadequate response to lower dose.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Wilson disease: Note: Dose expressed in mg of elemental zinc:

Children ≥5 years to <10 years: Limited data available: Oral: 25 mg 3 times daily (AASLD [Roberts 2008])

Children ≥10 years and Adolescents: Oral: 25 to 50 mg 3 times daily (AASLD [Roberts 2008]; manufacturer's labeling)

Administration

Oral: Administer on empty stomach at least 1 hour before or 2 to 3 hours after meals, and at least 1 hour separated from beverages other than water. Gastric irritation is most commonly associated with morning dose; may administer morning dose between breakfast and lunch if gastric irritation occurs. Swallow capsule whole; do not chew or open.

Storage

Store at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Protect from light.

Drug Interactions

Baloxavir Marboxil: Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil. Avoid combination

Bictegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Bictegravir. Management: Administer bictegravir under fasting conditions at least 2 hours before or 6 hours after polyvalent cation containing products. Coadministration of bictegravir with or 2 hours after most polyvalent cation products is not recommended. Consider therapy modification

Bisphosphonate Derivatives: Polyvalent Cation Containing Products may decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Exceptions: Pamidronate; Zoledronic Acid. Consider therapy modification

Ceftibuten: Zinc Salts may decrease the serum concentration of Ceftibuten. Management: Consider administering oral zinc salts at least 3 hours after ceftibuten. Consider therapy modification

Cephalexin: Zinc Salts may decrease the absorption of Cephalexin. Management: Consider administering oral zinc salts at least 3 hours after cephalexin. Consider therapy modification

Deferiprone: Polyvalent Cation Containing Products may decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Consider therapy modification

Dolutegravir: Zinc Salts may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral zinc salts. Administer the dolutegravir/rilpivirine combination product at least 4 hours before or 6 hours after oral zinc salts. Consider therapy modification

Eltrombopag: Polyvalent Cation Containing Products may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product. Consider therapy modification

Elvitegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Elvitegravir. Management: Administer elvitegravir 2 hours before or 6 hours after the administration of polyvalent cation containing products. Consider therapy modification

PenicillAMINE: Polyvalent Cation Containing Products may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour. Consider therapy modification

Quinolones: Zinc Salts may decrease the serum concentration of Quinolones. Management: Give oral quinolones at several hours before (4 h for moxi- and sparfloxacin, 2 h for others) or after (8 h for moxi-, 6 h for cipro/dela-, 4 h for lome-, 3 h for gemi-, and 2 h for enox-, levo-, nor-, pe- or ofloxacin or nalidixic acid) oral zinc salts. Exceptions: LevoFLOXacin (Oral Inhalation). Consider therapy modification

Raltegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Raltegravir. Management: Administer raltegravir 2 hours before or 6 hours after administration of the polyvalent cations. Dose separation may not adequately minimize the significance of this interaction. Consider therapy modification

Tetracyclines: Zinc Salts may decrease the absorption of Tetracyclines. Only a concern when both products are administered orally. Management: Consider doxycycline as a noninteracting tetracycline derivative. Separate dose administration of oral tetracycline derivative and oral zinc salts by at least 2 hours to minimize interaction. Exceptions: Doxycycline; Eravacycline; Tigecycline. Consider therapy modification

Trientine: Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant administration of trientine and oral products that contain polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. If other oral polyvalent cations are needed, separate administration by 1 hour. Consider therapy modification

Adverse Reactions

Frequency not defined.

Central nervous system: Neurological deterioration (uncommon)

Gastrointestinal: Gastric irritation, increased serum amylase, increased serum lipase

Hepatic: Increased serum alkaline phosphatase

<1%, postmarketing, and/or case reports: Hepatic insufficiency

Warnings/Precautions

Concerns related to adverse effects:

• Central nervous system: Neurological deterioration may occur with initial therapy as copper stores are mobilized; effects are less common when compared to chelation therapy.

• GI effects: Gastric irritation/upset may occur with use and particularly with the morning dose.

Other warnings/precautions:

• Appropriate use: Not recommended for initial treatment of Wilson disease in symptomatic patients; may be used as maintenance therapy after patient has been stabilized on initial chelation therapy.

• Therapy management: Hepatic copper levels should not be used to manage therapy as they do not differentiate between potentially toxic free copper and safely bound copper.

Monitoring Parameters

Serum non-ceruloplasmin bound copper, 24-hour urinary copper excretion, 24-hour urinary zinc level; LFTs, neurologic evaluation including speech

Pregnancy Risk Factor

A

Pregnancy Considerations

Adequate, well-controlled studies in pregnant women have not shown an increased risk of fetal abnormalities. The risk of fetal harm appears remote with use of zinc acetate during pregnancy.

Patient Education

What is this drug used for?

• It is used to treat Wilson disease.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Nausea

• Vomiting

• Diarrhea

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Pancreatitis like severe abdominal pain, severe back pain, severe nausea, or vomiting

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

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