Zinc%2520dt

# Zinc (supplement) ## Overview Zinc is an essential trace mineral available as oral supplements (e.g., zinc gluconate, zinc sulfate, zinc acetate). The notation "dt" is not a standard abbreviation; assume elemental zinc. ## Primary Indications - Treatment and prevention of zinc deficiency - Adjunctive therapy for Wilson disease (blocks copper absorption) - Acute diarrhea in children (WHO recommendation) - Acrodermatitis enteropathica - Age-related macular degeneration (in AREDS2 formulation) ## Adult Dosing - **Zinc deficiency:** 30–50 mg elemental zinc daily, typically for 3–6 months - **Wilson disease:** 50 mg elemental zinc three times daily, given 1 hour before or 2 hours after meals - **Maintenance (mild deficiency):** 15–25 mg elemental zinc daily - **Upper tolerable limit:** 40 mg/day from all sources (including diet); higher doses require monitoring ## Pediatric Dosing - **Acute diarrhea (≥6 months):** 10–20 mg elemental zinc daily for 10–14 days (per WHO) - **Zinc deficiency:** 0.5–1 mg/kg elemental zinc per day, max 15–20 mg/day (age-dependent) - **Wilson disease (children):** 25–50 mg three times daily, titrate by response - **Pediatric upper limit:** 4–8 years: 12 mg/day; 9–13 years: 23 mg/day; 14–18 years: 34 mg/day (includes dietary) ## Dose Adjustments - **Renal impairment:** No adjustment needed - **Hepatic impairment:** No specific adjustment; monitor copper if high-dose long-term ## Contraindications - Hypersensitivity to zinc or any component - Wilson disease: do not use concurrently with chelating agents (e.g., penicillamine) without specialist guidance (give zinc at least 1 hour apart) ## Adverse Effects - **GI upset:** nausea, metallic taste, vomiting (common at doses >50 mg) - **Chronic high doses:** copper deficiency, anemia, neutropenia, lowered HDL - **Nasal irritation:** if intranasal (not recommended) ## Key Drug Interactions - **Copper:** zinc reduces copper absorption; avoid high-dose zinc without copper supplementation - **Iron, calcium, magnesium:** co-administration reduces zinc absorption; separate by 2 hours - **Tetracyclines, quinolones:** zinc reduces absorption; administer 2–4 hours apart - **Penicillamine, trientine:** for Wilson disease, separate zinc by at least 1 hour ## Monitoring - Serum zinc levels (deficiency: <70 µg/dL; toxicity: >150 µg/dL) - Copper levels if on long-term high-dose zinc (especially >50 mg/day) - CBC and neutrophil count with chronic high doses ## Clinical Pearls - Take zinc on an empty stomach for best absorption (minimal GI upset often manageable with food) - With food, phytates (grains, legumes) reduce absorption; meat enhances absorption - For Wilson disease, zinc is a maintenance therapy; acute toxicity requires chelation - Zinc lozenges (≥9 mg) started within 24 hours may shorten common cold duration in adults - Always use products labeled with “elemental zinc” content to ensure correct dosing *Educational disclaimer: This summary is for educational purposes and does not replace current clinical judgment. Verify dosing, safety, and indications with up-to-date prescribing information and local protocols.*