Please check your internet connection and try again.
# Zinc
## Overview
Zinc is an essential trace element required for protein synthesis, wound healing, gene expression, and immune function. It acts as a cofactor for numerous metalloenzymes. Supplemental forms include zinc sulfate, zinc gluconate, and zinc acetate.
## Primary Indications
* Treatment/prevention of zinc deficiency (e.g., malabsorption, prolonged parenteral nutrition).
* Wilson’s disease (zinc acetate).
* Adjunctive therapy for acute diarrhea (WHO/UNICEF guidelines).
## Adult Dosing
* **Deficiency Treatment:** 25–50 mg elemental zinc daily.
* **Wilson’s Disease:** 50 mg elemental zinc three times daily.
* **Dietary Supplementation:** RDA is 11 mg/day for men; 8 mg/day for women.
* **Max Limit (UL):** 40 mg elemental zinc/day (long-term). High-dose therapeutic use requires monitoring.
## Pediatric Dosing
* **Acute Diarrhea (WHO Recommendation):** 10 mg elemental zinc once daily for 10–14 days (infants <6 months); 20 mg once daily for 10–14 days (children ≥6 months).
* **Deficiency:** Dosage varies by clinical protocol and weight; consult local institutional guidelines (typically 0.5–1 mg/kg/day).
* **Max Limit (UL):** Ages 1–3 years: 7 mg; 4–8 years: 12 mg; 9–13 years: 23 mg; 14–18 years: 34 mg.
## Dose Adjustments
* **Renal Impairment:** No specific adjustment; however, use with caution as zinc is excreted renally.
* **Hepatic Impairment:** No specific guidelines available.
## Contraindications
* Hypersensitivity to zinc salts.
* Avoid excessive dosing in patients with copper deficiency.
## Adverse Effects
* **Common:** Nausea, vomiting, abdominal pain, diarrhea, metallic taste.
* **Serious (Chronic/High-dose):** Copper deficiency (manifesting as anemia or neutropenia), sideroblastic anemia, immunosuppression, neurological symptoms from copper depletion.
## Key Drug Interactions
* **Quinolones/Tetracyclines:** Zinc reduces absorption of these antibiotics. Separate administration by at least 2–4 hours.
* **Copper:** Zinc and copper compete for absorption; high-dose chronic zinc supplementation leads to copper deficiency.
* **Penicillamine:** Zinc decreases absorption of penicillamine.
## Monitoring
* **Short-term:** Baseline and periodic serum zinc levels (if on high-dose therapy).
* **Long-term:** Serum copper levels and ceruloplasmin levels to screen for drug-induced copper deficiency. CBC to monitor for anemia or neutropenia.
## Clinical Pearls
* **Elemental Zinc Content:** Products vary by salt. Zinc gluconate (~14% elemental), zinc sulfate (~23%), zinc acetate (~30%). Always verify the elemental content on the label.
* **Administration:** May be taken with food to decrease GI upset, though absorption may be slightly reduced by phytates/fiber in food.
* **Topical Use:** Used in various barrier creams for diaper rash and skin irritation (e.g., zinc oxide).
***
**Educational Disclaimer:** This information is for educational purposes only. Clinical guidelines and dosing protocols vary by institution and patient-specific factors. Always verify current prescribing information, laboratory reference ranges, and institutional policies before initiating therapy.
