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# Zinc (Dispersible Tablets)
## Overview
Zinc is an essential trace element involved in numerous enzymatic processes, DNA synthesis, and immune function. Dispersible tablets (DT) are designed to be dissolved in a small volume of water or breast milk immediately before administration to facilitate easier dosing in pediatric and geriatric populations.
## Primary Indications
* Treatment of acute diarrhea (as an adjunct to oral rehydration therapy).
* Prevention and treatment of zinc deficiency.
* Supportive care for Wilson's disease (acetate salt).
## Adult Dosing
* **Zinc Supplementation:** 15–30 mg elemental zinc daily.
* **Acute Diarrhea:** 20 mg elemental zinc daily for 10–14 days.
* **Maximum:** Tolerable Upper Intake Level (UL) is 40 mg of elemental zinc daily for long-term use. Higher doses (up to 150 mg/day) may be used for specific conditions like Wilson's disease under strict specialist supervision.
## Pediatric Dosing
* **Acute Diarrhea (WHO/UNICEF Guideline):**
* **Age <6 months:** 10 mg elemental zinc daily for 10–14 days.
* **Age ≥6 months:** 20 mg elemental zinc daily for 10–14 days.
* **Maintenance/Deficiency:** 0.5–1 mg/kg/day (varies by local protocol and specific deficiency severity).
## Dose Adjustments
* **Renal/Hepatic Impairment:** No standard adjustment, but use caution; monitor serum zinc levels in patients with chronic organ dysfunction.
## Contraindications
* Hypersensitivity to zinc or any components of the formulation.
* Avoid in patients with copper deficiency (long-term high-dose zinc induces copper deficiency).
## Adverse Effects
* **Gastrointestinal:** Nausea, vomiting, abdominal pain, dyspepsia.
* **Long-term High Dose:** Copper deficiency (manifesting as anemia, neutropenia), sideroblastic anemia, and potential immune suppression.
## Key Drug Interactions
* **Antibiotics:** Zinc reduces absorption of fluoroquinolones and tetracyclines (separate administration by at least 2–4 hours).
* **Chelating Agents:** Penicillamine or trientine (efficacy of both may be reduced).
* **Iron:** High doses of supplemental iron can inhibit zinc absorption.
* **Bisphosphonates:** Zinc may decrease absorption; space doses.
## Monitoring
* Serum zinc levels for long-term therapy.
* Copper levels (ceruloplasmin) if high-dose zinc is required long-term.
* Hemoglobin/Hematocrit for signs of anemia.
## Clinical Pearls
* **Administration:** Ensure the tablet is fully dispersed in a small amount of liquid before swallowing.
* **Absorption:** Best absorbed on an empty stomach, but administration with meals is often necessary if gastrointestinal distress occurs.
* **Source:** Verify the salt form (e.g., gluconate, sulfate, acetate). Dosing is based on **elemental** zinc; ensure content is checked on the label.
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**Educational Disclaimer:** This information is for educational purposes and does not replace medical judgment. Always verify current prescribing information, institutional protocols, and patient-specific factors with a reliable clinical database (e.g., Lexicomp, UpToDate) before prescribing or administering medication.
