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BLOOD AND BLOOD FORMING ORGANS › BLOOD SUBSTITUTES AND PERFUSION SOLUTIONS › I.V. SOLUTION ADDITIVES › Electrolyte solutions
zinc sulfate
B05XA18
Forms & Strengths
- Injectable solution: 1 mg/mL, 3 mg/mL, 5 mg/mL (as elemental zinc)
- Oral capsules/tablets: various strengths (e.g., 220 mg zinc sulfate heptahydrate providing 50 mg elemental zinc)
- Oral syrup/drops: various concentrations
Adult Dosing
- Intravenous supplementation in parenteral nutrition: 2.5 to 4 mg elemental zinc daily for stable adult with trace element deficiency
- Additional 2 mg elemental zinc daily for acute catabolic states
- Oral deficiency treatment: 50 mg elemental zinc (approx. 220 mg zinc sulfate) 1 to 3 times daily
Pediatric Dosing
- Term infants and children up to 5 years: 100 mcg elemental zinc/kg/day IV
- Premature infants (birth to 3 kg): 300 mcg elemental zinc/kg/day IV
- Pediatric oral supplementation for deficiency: 0.5 to 1 mg elemental zinc/kg/day divided in 1-2 doses
Indications
- Prevention and treatment of zinc deficiency in patients receiving total parenteral nutrition (TPN)
- Adjunctive treatment of acute diarrhea in children (WHO recommendation)
- Wilson's disease (historical or alternative maintenance therapy)
Mechanism of Action
- Functions as an essential trace element and cofactor for numerous enzymatic reactions (e.g., carbonic anhydrase, RNA polymerase)
- Plays a critical role in DNA synthesis, cell division, protein synthesis, and immune function
- In the gastrointestinal tract, induces intestinal metallothionein, which binds copper and reduces its absorption (utilized in Wilson's disease)
Contraindications
- Hypersensitivity to zinc sulfate or any component of the formulation
- Presence of fully developed acute renal failure prior to institution of dialysis (risk of accumulation)
- Do not administer undiluted via direct intravenous injection
Adverse Reactions
- Gastrointestinal: nausea, vomiting, epigastric pain, diarrhea (primarily with oral administration)
- Injection site reactions: local irritation, phlebitis (with high osmolality solutions)
- Long-term high-dose toxicity: copper deficiency, secondary hypocupremia, sideroblastic anemia, leukopenia, and altered immune function
Drug Interactions
- Quinolone and tetracycline antibiotics: oral zinc decreases absorption of these antimicrobials via chelation; separate administration by at least 2 to 4 hours
- Penicillamine and trientine: bind zinc and reduce its absorption; oral zinc and copper-chelating agents should be separated by at least 2 hours
- Iron and calcium supplements: may interfere with gastrointestinal absorption of zinc when taken concomitantly
Curated Content: Needs Vetting Before Put to Clinical Use