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# Zinc Sulfate ## Overview Zinc sulfate is an essential mineral supplement used to treat or prevent zinc deficiency. ## Primary Indications * Treatment and prevention of zinc deficiency. * Adjunctive therapy in Wilson's disease (high dose, specific protocols). * Management of diarrhea in children in developing countries. ## Adult Dosing * **Dietary Supplementation (Prevention of deficiency):** 10-22 mg elemental zinc per day. * **Treatment of Deficiency:** 50-150 mg elemental zinc per day, often divided into 2-3 doses, for 3-6 months. Subsequent maintenance dose is typically 10-30 mg elemental zinc per day. * **Wilson's Disease (Adjunctive):** 50 mg elemental zinc three times daily. *Note: Zinc sulfate heptahydrate (ZnSO₄·7H₂O) contains 22.45% elemental zinc by weight. Zinc sulfate monohydrate (ZnSO₄·H₂O) contains 39.34% elemental zinc by weight. Doses are typically expressed as elemental zinc.* ## Pediatric Dosing * **Dietary Supplementation (Prevention of deficiency):** * Infants < 6 months: 3 mg elemental zinc per day. * Infants 6-12 months: 5 mg elemental zinc per day. * Children 1-3 years: 5 mg elemental zinc per day. * Children 4-8 years: 5 mg elemental zinc per day. * Children 9-13 years: 8 mg elemental zinc per day. * Adolescents 14-18 years: Males 11 mg/day, Females 9 mg/day. * **Treatment of Deficiency:** 1 mg/kg/day of elemental zinc, divided into 2-3 doses, not to exceed 5 mg/kg/day or adult doses. Duration varies based on severity and response. * **Diarrhea (WHO recommended):** * Infants < 12 months: 10 mg elemental zinc once daily for 10-14 days. * Children ≥ 12 months: 20 mg elemental zinc once daily for 10-14 days. ## Dose Adjustments No dose adjustment is typically needed for renal or hepatic impairment, but caution is advised in severe cases. ## Contraindications * Hypersensitivity to zinc sulfate or any component of the formulation. ## Adverse Effects * **Common:** Nausea, vomiting, abdominal pain, diarrhea, metallic taste. * **Less Common/Rare:** Fever, headache, dizziness, lethargy, changes in blood counts (rare). ## Key Drug Interactions * **Antibiotics (Quinolones, Tetracyclines):** Zinc can decrease absorption of these drugs. Separate administration by at least 2-4 hours. * **Penicillamine:** Zinc can decrease absorption and increase excretion of penicillamine. Separate administration by at least 2 hours. * **Thiazide Diuretics:** Can increase urinary zinc excretion. * **Iron Supplements:** High doses of iron can interfere with zinc absorption. ## Monitoring * Monitor for signs and symptoms of zinc deficiency (e.g., skin lesions, hair loss, impaired wound healing, diarrhea). * Monitor for adverse effects. * Serum zinc levels can be monitored, though they may not always reflect intracellular status. ## Clinical Pearls * Elemental zinc content varies by salt form; always confirm the percentage of elemental zinc in the product. * Administer oral zinc supplements with food to minimize gastrointestinal upset. * Zinc absorption is significantly reduced when taken with high-fiber foods, phytates, or certain medications. * Long-term high-dose zinc supplementation can lead to copper deficiency anemia and neutropenia. *** **Disclaimer:** This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult the most current prescribing information and your institution's protocols before making any treatment decisions.