(zink SUL fate)
Zinc supplement (oral and parenteral); may improve wound healing in those who are deficient
Injection: Do not administer undiluted into peripheral vein
Recommended daily allowance (RDA): Oral (dose expressed as elemental zinc): Adults ≥19 years:
Males: 11 mg/day
Females: 8 mg/day
Pregnancy: 11 mg/day
Lactation: 12 mg/day
Parenteral TPN: IV:
Acute metabolic states: 4.5-6 mg/day
Metabolically stable: 2.5-4 mg/day
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
Refer to adult dosing.
Adequate intake (AI): Oral (dose expressed as elemental zinc): 1 " “6 months: 2.0 mg/day
Recommended daily allowance (RDA): Oral (dose expressed as elemental zinc):
7-12 months: 3 mg/day
1-3 years: 3 mg/day
4-8 years: 5 mg/day
9-13 years: 8 mg/day
14-18 years:
Males: 11 mg/day
Females: 9 mg/day
Pregnancy: 12 mg/day
Lactation: 13 mg/day
Parenteral TPN: IV:
Infants (premature, birth weight <1500 g up to 3 kg): 300 mcg/kg/day
Infants (full term) and Children ≤5 years: 100 mcg/kg/day
May be taken with food if GI upset occurs.
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).
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Capsule, Oral:
Orazinc: 220 mg
Zinc-220: 220 mg
Generic: 220 mg
Solution, Intravenous:
Generic: 1 mg/mL (10 mL [DSC]); 5 mg/mL (5 mL)
Solution, Ophthalmic:
Eye-Sed: 0.217% (15 mL) [contains benzalkonium chloride, boric acid]
Tablet, Oral:
Orazinc: 110 mg
Zinc 15: 66 mg
Generic: 220 mg
Tablet, Oral [preservative free]:
Generic: 220 mg
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
Frequency not defined.
Central nervous system: Dizziness, headache
Gastrointestinal: Abdominal cramps, diarrhea, nausea, vomiting
Disease-related concerns:
- 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.
C
Zinc crosses the placenta and can be measured in the cord blood and placenta. Fetal concentrations are regulated by the placenta (de Moraes, 2011).
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
- 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.