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Zinc Gluconate

Index Terms

  • Zincum Gluconicum 2x

Dosage Forms

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

Capsule, Oral [preservative free]:

Zn-50: 50 mg [dye free, sugar free, yeast free]

Gum, Oral:

Cold-Eeze: 13.3 mg (18 ea) [bubble-gum flavor]

Cold-Eeze: 13.3 mg (20 ea) [cinnamon flavor]

Lozenge, Mouth/Throat:

Cold-Eeze: 13.3 mg (6 ea)

Cold-Eeze: 13.3 mg (18 ea) [cherry flavor]

Cold-Eeze: 13.3 mg (18 ea) [citrus flavor]

Cold-Eeze: 13.3 mg (18 ea) [honey-lemon flavor]

Cold-Eeze: 13.3 mg (18 ea) [menthol flavor]

Cold-Eeze: 13.3 mg (18 ea) [tropical fruit flavor]

Generic: 10 mg (100 ea)

Solution, Intravenous:

Generic: 10 mg/10 mL (10 mL)

Tablet, Oral:

Generic: 15 mg, 30 mg, 50 mg, 100 mg

Tablet, Oral [preservative free]:

Generic: 50 mg

Brand Names: U.S.

  • Cold-Eeze [OTC]
  • Zn-50 [OTC]

Pharmacologic Category

  • Trace Element

Pharmacology

Zinc is an essential mineral that is found in almost every cell. It stimulates the activity of approximately 100 enzymes (IOM, 2001). Zinc deficiency may be associated with an increased risk of infection. When used to treat the common cold, zinc may interfere with rhinovirus cleavage or adhesion, and may protect plasma membranes from microbial toxins and complement (Nahas, 2011).

Absorption

Small intestine (IOM, 2001)

Distribution

Stored primarily in skeletal muscle and bone (IOM, 2001)

Excretion

Feces and urine (IOM, 2001)

Protein Binding

Primarily to albumin (IOM, 2001)

Use: Labeled Indications

Common cold: To reduce the duration and severity of symptoms associated with the common cold.

Dietary supplement: For use as a dietary supplement.

Contraindications

There are no contraindications listed in the manufacturer's labeling.

Dosing: Adult

Recommended daily allowance (RDA): Oral (dose expressed as elemental zinc) (IOM, 2001):

Males: 11 mg daily

Females: 8 mg daily

Pregnancy: 11 mg daily

Lactation: 12 mg daily

Common cold: Note: For best results, begin therapy 24 to 48 hours prior to symptom onset: Dissolve one 13.3 mg lozenge in mouth every 2 to 4 hours as needed. Maximum: 6 lozenges daily

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Adequate intake (AI): Oral (dose expressed as elemental zinc): Infants 1 to 6 months: 2 mg daily (IOM, 2001)

Recommended daily allowance (RDA): Oral (dose expressed as elemental zinc) (IOM, 2001):

Infants 7 to 12 months: 3 mg daily

Children 1 to 3 years: 3 mg daily

Children 4 to 8 years: 5 mg daily

Children and Adolescents 9 to 13 years: 8 mg daily

Adolescents 14 to 18 years:

Males: 11 mg daily

Females: 9 mg daily

Pregnancy: 12 mg daily

Lactation: 13 mg daily

Common cold: Note: For best results, begin therapy 24 to 48 hours prior to symptom onset: Children ≥12 years and Adolescents ≤17 years of age: Dissolve one 13.3 mg lozenge in mouth every 2 to 4 hours as needed. Maximum: 4 lozenges daily

Dosing: Renal Impairment

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Hepatic Impairment

There are no dosage adjustments provided in the manufacturer’s labeling.

Administration

May be taken with food to avoid stomach upset.

Lozenge: Dissolve in mouth; do not chew. Avoid citrus fruits/juices and products containing citric acid within 30 minutes prior to or after use.

Dietary Considerations

Dietary sources of zinc are red meat, some seafood, and whole grains. When dietary phytate is increased (as with some vegetarian diets), dietary absorption of zinc is decreased (IOM, 2001).

Lozenge: Avoid citrus fruits/juices and products containing citric acid within 30 minutes prior to or after use.

Storage

Store at controlled room temperature.

Drug Interactions

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: Zinc Salts 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. Consider therapy modification

Eltrombopag: Zinc Salts may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any zinc-containing product. Consider therapy modification

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

Tetracycline Derivatives: Zinc Salts may decrease the absorption of Tetracycline Derivatives. 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. Consider therapy modification

Trientine: May decrease the serum concentration of Zinc Salts. Zinc Salts may decrease the serum concentration of Trientine. Consider therapy modification

Adverse Reactions

Frequency not defined; may vary with different salts. Adverse reactions reported with excess dietary zinc (IOM, 2001).

Central nervous system: Headache

Endocrine & metabolic: Copper deficiency, decreased HDL cholesterol, decreased LDL cholesterol

Gastrointestinal: Abdominal cramps, decreased appetite, diarrhea, epigastric pain, gastrointestinal distress, nausea, vomiting

Hematologic & oncologic: Immunodeficiency

Warnings/Precautions

Disease related concerns:

• Malabsorption syndromes: Absorption of zinc may be decreased and urinary excretion increased in patients with Crohn’s disease, short bowel syndrome and sprue (IOM, 2001).

Other warnings/precautions:

• Self-medication (OTC use): When used for self medication (OTC) to treat the common cold, notify healthcare provider if symptoms continue for greater than 7 days. Increase fluid intake during therapy.

Pregnancy Risk Factor

C

Pregnancy Considerations

Zinc crosses the placenta and can be measured in the cord blood and placenta. Fetal concentrations are regulated by the placenta (de Moraes, 2011). The RDA is increased during pregnancy (IOM, 2001).

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

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