Medically reviewed by Drugs.com. Last updated on Jul 14, 2019.
(zink SUL fate)
- ZnSO4 (error-prone abbreviation)
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Orazinc: 220 mg
Zinc-220: 220 mg
Generic: 50 mg, 220 mg
Solution, Intravenous [preservative free]:
Generic: 1 mg/mL (10 mL); 5 mg/mL (5 mL)
Eye-Sed: 0.217% (15 mL [DSC]) [contains benzalkonium chloride, boric acid]
Orazinc: 110 mg
Zinc 15: 66 mg
Generic: 220 mg
Tablet, Oral [preservative free]:
Generic: 220 mg [DSC]
Brand Names: U.S.
- Eye-Sed [OTC] [DSC]
- Orazinc [OTC]
- Zinc 15 [OTC]
- Zinc-220 [OTC]
- Trace Element
pH-dependent; enhanced at lower pH; (pH <3); impaired by food (Anderson 1998)
Storage sites are liver and skeletal muscle; serum levels do not adequately reflect whole-body zinc status
Primarily in feces (Anderson 1998)
~80% bound to albumin; ~20% bound to alpha 1-macroglobulin
Use: Labeled Indications
Trace element added to parenteral nutrition (PN) to prevent deficiency; orally as a dietary supplement.
Injection: Hypersensitivity to zinc or any component of the formulation.
Dietary supplement: Oral: 50 mg (dose expressed as elemental zinc) once daily.
Parenteral nutrition additive, maintenance requirement: IV (dose expressed as elemental zinc): Note: Individualize dose based on the patient's clinical condition, nutritional requirements, and the contribution of oral or enteral zinc intake.
Acute metabolic states: Optimal dose not determined; monitor and replace as clinically indicated (Blaauw 2019).
Metabolically stable: 3 to 5 mg/day (ASPEN 2019).
Replacement for small bowel fluid loss (metabolically stable): Additional zinc replacement may be required for patients with intestinal fistula, ostomy effluent, or severe diarrhea due to excessive zinc losses. Estimated losses range from up to 12 mg zinc/L for GI fluid loss and up to 17 mg zinc/L for stool or ileostomy output (Blaauw 2019; Vanek 2012).
Zinc deficiency (Saper 2009): Oral: Some clinicians recommend daily doses of 2 to 3 times the zinc RDA for mild deficiency and 4 to 5 times the RDA for moderate to severe deficiency for 6 months.
Refer to adult dosing.
Note: Dosages may be presented in units of mcg or mg; use caution to ensure correct units.
Parenteral nutrition, maintenance requirement: IV: Note: Dosage expressed in terms of elemental zinc; higher doses may be needed if impaired intestinal absorption or an excessive loss of zinc (eg, excessive, prolonged diarrhea, high-output intestinal fistula, burns)
Age-directed dosing (ASPEN [Vanek 2012]):
Infants <3 months: 250 mcg/kg/day
Infants ≥3 months: 50 mcg/kg/day
Children: 50 mcg/kg/day; maximum daily dose: 5,000 mcg/day
Weight-directed dosing (ASPEN [Mirtallo 2004]):
Infants <10 kg: 50 to 250 mcg/kg/day
Children 10 to 40 kg: 50 to 125 mcg/kg/day; maximum daily dose: 5,000 mcg/day
Children and Adolescents >40 kg: 2,000 to 5,000 mcg/day
Diarrhea, treatment; malnourished patient (WHO/UNICEF 2004): Note: Dosage expressed in terms of elemental zinc; Note: Zinc should be started in conjunction with oral rehydration solutions at first sign of diarrhea:
Infants <6 months: Oral:10 mg once daily for 10 to 14 days
Infants ≥6 months and Children: Oral: 20 mg once daily for 10 to 14 days
Zinc deficiency; treatment: Limited data available (Kliegman 2016): Note: Dosage expressed in terms of elemental zinc
Acquired: Infants, Children, and Adolescents: Oral: 0.5 to 1 mg/kg/day
Acrodermatitis enteropathica: Infants, Children, and Adolescents: Oral: 3 mg/kg/day
IV: Not for direct IV infusion; must be prepared and used as an admixture in parenteral nutrition solutions only.
May be taken with food if GI upset occurs.
Dietary adequate intake (AI) (IOM 2001):
1 to 6 months: 2 mg/day
Dietary recommended daily allowance (RDA) (IOM 2001):
7 to 12 months: 3 mg/day
1 to 3 years: 3 mg/day
4 to 8 years: 5 mg/day
9 to 13 years: 8 mg/day
14 to 18 years: Females: 9 mg/day; Males: 11 mg/day; Pregnancy 12 mg/day; Lactation: 13 mg/day
Adults ≥19 years: Females: 8 mg/day: Males: 11 mg/day; Pregnancy: 11 mg/day; Lactation: 12 mg/day
Capsule: Store at 15°C to 30°C (59°F to 86°F).
Tablet (Orazinc®): Store at 13°C to 24°C (55°F to 76°F).
Injection: Prior to use, store at room temperature of 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F).
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
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 least 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 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. 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
Frequency not defined.
Central nervous system: Dizziness, headache
Gastrointestinal: Abdominal cramps, diarrhea, nausea, vomiting
• Renal impairment: Use with caution in patients with renal impairment.
Concurrent drug therapy issues:
• Copper: IV administration of zinc without copper may cause a decrease in copper serum concentrations.
Dosage form specific issues:
• Aluminum: The parenteral product may contain aluminum; toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources. Parenteral aluminum exposure of >4 to 5 mcg/kg/day is associated with CNS and bone toxicity; tissue loading may occur at lower doses (Federal Register, 2002). See manufacturer's labeling.
Patients on parenteral nutrition or chronic therapy should have periodic serum copper and serum zinc levels; alkaline phosphatase, taste acuity, mental depression
Zinc crosses the placenta and can be measured in the cord blood and placenta. Fetal concentrations are regulated by the placenta (de Moraes 2011).
• 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 healthcare 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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- Drug class: minerals and electrolytes