Medically reviewed on Nov 15, 2018
(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
Generic: 1 mg/mL (10 mL [DSC]); 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
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)
55% bound to albumin; 40% bound to alpha 1-macroglobulin
Use: Labeled Indications
Trace element added to parenteral nutrition (PN) to prevent deficiency; orally as a dietary supplement.
Injection: Do not administer undiluted into peripheral vein
Dietary supplement: Oral: 50 mg (dose expressed as elemental zinc) once daily
Parenteral nutrition additive, maintenance requirement: IV (dose expressed as elemental zinc):
Acute metabolic states: 4.5 to 6 mg/day
Metabolically stable: 2.5 to 5 mg/day (ASPEN [Vanek 2012])
Replacement for small bowel fluid loss (metabolically stable): An additional 12.2 mg zinc/L of fluid lost, or an additional 17.1 mg zinc per kg of stool or ileostomy output
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.
Parenteral nutrition additive, maintenance requirement (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
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: Zinc Salts may decrease the serum concentration of Baloxavir Marboxil. Avoid combination
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. Administer the dolutegravir/rilpivirine combination product at least 4 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
PenicillAMINE: Zinc Salts may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral zinc salts 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
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: May decrease the serum concentration of Zinc Salts. Zinc Salts may decrease the serum concentration of Trientine. 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
Pregnancy Risk Factor
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.
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Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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- Drug class: minerals and electrolytes