zinc (Rx, OTC)

Brand and Other Names:Galzin, ZnCl2

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule (zinc gluconate)

  • 50mg

capsule (zinc acatate)

  • 25mg
  • 50mg

tablet (zinc gluconate)

  • 15mg
  • 30mg
  • 50mg
  • 100mg

tablet extended release (zinc gluconate)

  • 100mg

lozenge (zinc gluconate)

  • 10mg
  • 13.3mg

gum

  • 13.3mg

IV solution (zinc sulfate)

  • 1mg/mL
  • 5mg/mL

IV solution (zinc chloride)

  • 1mg/mL

RDA

RDA expressed as elemental zinc

Males (>14 years): 11 mg/day

Females (>19 years): 8 mg/day

Pregnancy: (14-18 years old): 12 mg/day; (>19 years): 11 mg/day

Lactation: (14-18 years): 13 mg/day; (>19 years): 12 mg/day

UL: (14-18 years): 34 mg/day; (>19 years old): 40 mg/day

Common Cold

Dose expressed as elemental zinc

4.5-23.7 mg zinc gluconate lozenge PO q2hr

Wilson Disease

Dose expressed as elemental zinc

Zinc acetate (Galzin): 50 mg PO three times daily

During pregnancy: 25 mg PO three times daily; may increase to 50 mg three times daily if inadequate response

TPN

Acute catabolic state: 4.5-6 mg/day added to TPN IV if metabolically stable

Metabolically stable: 2.5-4 mg/day; additional 12.2 mg per liter of small bowel fluid lost, or 17.1 mg per kilogram of stool or ileostomy recommended

Administration

Take Galzin capsules on empty stomach; swallow whole

Dosage Forms & Strengths

capsule (zinc gluconate)

  • 50mg

capsule (zinc acetate)

  • 25mg
  • 50mg

tablet (zinc gluconate)

  • 15mg
  • 30mg
  • 50mg
  • 100mg

tablet extended release (zinc gluconate)

  • 100mg

lozenge (zinc gluconate)

  • 10mg
  • 13.3mg

gum

  • 13.3mg

IV solution (zinc sulfate)

  • 1mg/mL
  • 5mg/mL

IV solution (zinc chloride)

  • 1mg/mL

RDA

RDA expressed as elemental zinc

0-6 months: 2 mg/day

6-12 months: 3 mg/day

1-3 years: 3 mg/day

3-8 years: 5 mg/day

8-13 years: 8 mg/day

13-18 years: 11 mg/day

TPN

<5 years: 100 mcg/kg/day added to TPN IV  

Premature infants (<1500 g birth weight-3 kg): 300 mcg/kg/day added to TPN IV

Wilson's Disease

Zinc acetate

Manufacturer's dosing

  • >10 years: 25 mg PO three times daily, may increase to 50 mg three times daily if inadequate response

AASLD dosing

  • American Association for the Study of Liver Diseases
  • >5 years and <50 kg: 25 mg PO three times daily
  • >50 kg and adolescents: 50 mg PO three times daily
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Adverse Effects

Frequency Not Defined

Nausea/vomiting

Gastric irritation

Elevations of serum alkaline phosphatase, amylase, and lipase that may return to high normal within 1-2 years of therapy

Neurologic deterioration

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Warnings

Contraindications

Hypersensitivity

Cautions

Not for direct injection into peripheral vein (may cause infusion phlebitis)

Injection contains aluminum, which may cause toxicity in prolonged parenteral administration if renal function impaired

Do not use zinc intranasally (as in Zicam)-risk of permanent loss of smell

Lozenges sweetened with citric acid, mannitol, or sorbitol have decreased efficacy; should only be sweetened with glycine

Wilson disease

  • Not recommended for initial therapy of symptomatic patients with because of the delay required for zinc-induced increase in enlerolyhc metallothionein and blockade of copper uptake; may be used as maintenance therapy after patient has stabilized on initial chelation therapy
  • Symptomatic patients should be treated initially, using chelating agents for initial therapy; neurological deterioration may occur as copper stores are mobilized
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Pregnancy & Lactation

Pregnancy Category: A (Galzin); C (injction or gluconate)

Lactation: Present in breast milk, use caution

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

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Nutrition

Source: shellfish, fish, red meat; plant sources (whole grains, legumes, nuts) less bioavailable d/t phytic acid binding

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Pharmacology

Mechanism of action

Cofactor in over 100 enzymes; plays a role in DNA synthesis; supports a healthy immune system; helps maintain a sense of smell and taste; may assist in porper function of insulin

Pharmacokinetics

Half-life: 11 days following cessation of therapy (inhibition of copper uptake)

Absorption: pH dependent (enhanced at pH<3); impaired by food

Excretion: Feces (primarily)

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Administration

IV Info

Do NOT give undiluted as a bolus injection- acidic, may cause phlebitis & tissue damage

Dilute in at least 100 mL

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Images

No images available for this drug.
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Patient Handout

A Patient Handout is not currently available for this monograph.
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Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.