Sub-sections Zinc Zinc Acetate Zinc Chloride Zinc Citrate

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Zinc
Sub-sections
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Zinc
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Zinc Acetate
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Zinc Chloride

Zinc Citrate
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Zinc Gluconate

Zinc Lactate
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Zinc Sulfate
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Adverse Effects, Treatment, and Precautions

Interactions

Pharmacokinetics

Human Requirements

Uses and Administration

Preparations
Zinc
Date of monograph review: 07-May-1998; 06-Sep-1999; 31-Oct-2001; 25May-2004; 22-Jun-2004; 08-Mar-2006; 24-Jul-2006; 18-Aug-2008; 11May-2009; 23-Aug-2010; (latest modification: 24-Sep-2013)
Drug Nomenclature (Latest modification: 23-Sep-2011)
Synonyms: Cynk; Zincum; Zink; Цинк
Molecular formula: Zn =65.38
CAS: 7440-66-6
UNII code: J41CSQ7QDS (zinc); 13S1S8SF37 (zinc ion)
Zinc Acetate
Date of monograph review: 07-May-1998; 08-Oct-1998; 06-Sep-1999; 30Oct-2001; 25-May-2004; 22-Jun-2004; 08-Mar-2006; 24-Jul-2006; 18-Aug2008; 11-May-2009; 23-Aug-2010; (latest modification: 24-Sep-2013)
Drug Nomenclature (Latest modification: 12-Feb-2013)
Synonyms: ψευδάργυρος κιτρικός; Cink-acetát-dihidrát; Cinko acetatas
dihidratas; Cynku octan; E650; Octan zinečnatý dihydrát; Sinkkiasetaatti;
Zinc (acétate de) dihydraté; Zinc, acetato de; Zinci Acetas; Zinci Acetas
Dihydricus; Zinkacetat; 酢酸亜鉛; Ацетат Цинка; Уксуснокислый Цинк
Molecular formula: (CH3CO2)2Zn,2H2O =219.5
CAS: 557-34-6 (anhydrous zinc acetate); 5970-45-6 (zinc acetate
dihydrate)
ATC code: A16AX05
ATC code (veterinary): QA16AX05
UNII code: FM5526K07A (zinc acetate dihydrate); H2ZEY72PME
(anhydrous zinc acetate)
NOTE:
Zinc Acetate, Basic is rINN.
Pharmacopoeias:
In Eur. (see
) and US.
Ph. Eur. 7 (Zinc Acetate Dihydrate; Zinc Acetate BP 2013). A white or
almost white, crystalline powder or leaflets. Freely soluble in water; soluble
in alcohol. A 5% solution in water has a pH of 5.8 to 7.0. Store in
nonmetallic containers.
USP 36 (Zinc Acetate). White crystals or granules having a slight acetous
odour. Is slightly efflorescent. Soluble 1 in 2.5 of water and 1 in 30 of
alcohol; freely soluble in boiling alcohol. pH of a 5% solution in water is
between 6.0 and 8.0. Store in airtight containers.
Zinc Chloride
Drug Nomenclature (Latest modification: 30-Jan-2013)
Synonyms: Chlorid zinečnatý; Cink-klorid; Cinko chloridas; Cynku chlorek;
Sinkkikloridi; Zinc, chlorure de; Zinc, cloruro de; Zinci chloridum; Zincum
Chloratum; Zinkchlorid; Zinkklorid; 塩化亜鉛; Хлористый Цинк; Цинка
Хлорид
Molecular formula: ZnCl2 =136.3
CAS: 7646-85-7
ATC code: B05XA12
ATC code (veterinary): QB05XA12
UNII code: 86Q357L16B
Pharmacopoeias:
In Eur. (see
), Jpn, and US.
Ph. Eur. 7 (Zinc Chloride). A white or almost white, deliquescent, crystalline
powder or cast in white or almost white sticks. Very soluble in water; freely
soluble in alcohol and in glycerol. An approximately 10% solution in water
has a pH of 4.6 to 5.5. Store in nonmetallic containers.
USP 36 (Zinc Chloride). A white or practically white, odourless, crystalline
powder, or white or practically white crystalline granules. May also be in
porcelain-like masses or moulded into cylinders. It is very deliquescent.
Soluble 1 in 0.5 of water, 1 in 1.5 of alcohol, and 1 in 2 of glycerol. Its
solution in water or in alcohol is usually slightly turbid, but the turbidity
disappears when a small quantity of hydrochloric acid is added. A 10%
solution in water is acid to litmus. Store in airtight containers.
Physicochemical Characteristics (Latest modification: 21-Mar-2004)
Turbidity
Zinc chloride almost always contains some oxychloride which produces a
slightly turbid aqueous solution. Turbid solutions, except when intended for
ophthalmic use, may be cleared by adding gradually a small amount of dilute
hydrochloric acid. Solutions of zinc chloride should be filtered through
asbestos or sintered glass, since they dissolve paper and cotton wool.
(last reviewed 2010-08-23; last modified 2005-11-07)
Zinc Citrate
Date of monograph review: 02-Oct-2007; 18-Aug-2008; 11-May-2009; 23Aug-2010; (latest modification: 24-Sep-2013)
Synonyms: Zinc Citrate Trihydrate; Цитрат Цинка
Chemical name: 2-Hydroxy-1,2,3-propanetricarboxylic acid zinc salt
Molecular formula: C12H10O14Zn3,3H2O =628.4
CAS: 546-46-3
UNII code: K72I3DEX9B (anhydrous zinc citrate); GNM26GAX7R (zinc
citrate trihydrate)
Pharmacopoeias:
In Chin. and US.
USP 36 (Zinc Citrate).
Zinc Gluconate
Date of monograph review: 07-Apr-1998; 06-Sep-1999; 30-Oct-2001; 25May-2004; 22-Jun-2004; 08-Mar-2006; 24-Jul-2006; 18-Aug-2008; 11May-2009; 23-Aug-2010; (latest modification: 24-Sep-2013)
Synonyms: Zinc, gluconate de; Zinc, gluconato de; Zinci gluconas;
Zinkgluconat; グルコン酸亜鉛; Цинка Глюконат
Molecular formula: C12H22O14Zn =455.7
CAS: 4468-02-4
ATC code: A12CB02
ATC code (veterinary): QA12CB02
UNII code: U6WSN5SQ1Z
Pharmacopoeias:
In Chin., Eur. (see
), and US.
Ph. Eur. 7 (Zinc Gluconate). A white or almost white, hygroscopic,
crystalline powder. Soluble in water; practically insoluble in absolute alcohol
and in dichloromethane. Store in non-metallic, airtight containers.
USP 36 (Zinc Gluconate). White or practically white powder or granules.
Soluble in water; very slightly soluble in alcohol. pH of a 1% solution in
water is between 5.5 and 7.5.
Zinc Lactate
Date of monograph review: 01-Nov-2010; 19-Apr-2011; (latest
modification: 24-Sep-2013)
Drug Nomenclature (Latest modification: 13-Aug-2011)
Synonyms: Zinc Dilactate; Zinc Sarcolactate (S-isomer)
Molecular formula: C6H10O6Zn =243.5
CAS: 554-05-2; 16039-53-5
UNII code: 2GXR25858Y
Zinc Sulfate
Drug Nomenclature (Latest modification: 12-Feb-2013)
Synonyms: ψευδάργυρος θειικός; ψευδάργυρος θειικός μονοϋδρικός (zinc
sulfate monohydrate); Çinko Sülfat; Cink-szulfát; Cinko sulfatas; Cynku
siarczan; Sinkkisulfaatti; Síran zinečnatý; Zinc Sulphate; Zinc, sulfate de;
Zinc, sulfato de; Zinci sulfas; Zincum Sulfuricum; Zinksulfat; 硫酸亜鉛;
Сернокислый Цинк; Цинка Сульфат
Molecular formula: ZnSO4,7H2O =287.5
CAS: 7733-02-0 (anhydrous zinc sulfate); 7446-20-0 (zinc sulfate
heptahydrate)
ATC code: A12CB01
ATC code (veterinary): QA12CB01
UNII code: 89DS0H96TB (zinc sulfate); 0J6Z13X3WO (anhydrous zinc
sulfate); PTX099XSF1 (zinc sulfate monohydrate); N57JI2K7WP (zinc sulfate
heptahydrate)
NOTE:
'White vitriol' or 'white copperas' is crude zinc sulfate.
ZSU is a code approved by the BP 2013 for use on single unit doses of eye
drops containing zinc sulfate where the individual container may be too small
to bear all the appropriate labelling information.
Pharmacopoeias:
In Chin., Eur. (see
), Jpn, and Viet.
Eur. also includes the monohydrate and the hexahydrate.
US includes the monohydrate and the heptahydrate in one monograph.
Ph. Eur. 7 (Zinc Sulfate Heptahydrate; Zinci Sulfas Heptahydricus).
Colourless, transparent, crystals or a white or almost white, crystalline
powder; efflorescent. Very soluble in water; practically insoluble in alcohol. A
5% solution in water has a pH of 4.4 to 5.6. Store in nonmetallic airtight
containers.
Ph. Eur. 7 (Zinc Sulfate Hexahydrate; Zinci Sulfas Hexahydricus).
Colourless, transparent, crystals or a white or almost white, crystalline
powder; efflorescent. Very soluble in water; practically insoluble in alcohol. A
5% solution in water has a pH of 4.4 to 5.6. Store in nonmetallic airtight
containers.
Ph. Eur. 7 (Zinc Sulfate Monohydrate; Zinci Sulfas Monohydricus).
Colourless, transparent, crystals or a white or almost white crystalline
powder. Very soluble in water; practically insoluble in alcohol. A 5% solution
in water has a pH of 4.0 to 5.6. Store in nonmetallic containers.
USP 36 (Zinc Sulfate). It contains one or seven molecules of water of
hydration. Colourless, transparent, prisms, or small needles. May occur as a
white, granular, crystalline powder. It is odourless and is efflorescent in dry
air. Very soluble in water (heptahydrate); freely soluble in water
(monohydrate); practically insoluble in alcohol (monohydrate); insoluble in
alcohol (heptahydrate); freely soluble in glycerol (heptahydrate). Its
solutions are acid to litmus. Store in airtight containers.
Adverse Effects, Treatment, and Precautions (Latest modification: 22Jul-2008)
The most frequent adverse effects of zinc salts (the gluconate and sulfate)
given orally are gastrointestinal and include abdominal pain, dyspepsia,
nausea, vomiting, diarrhoea, gastric irritation, and gastritis. These are
particularly common if zinc salts are taken on an empty stomach, and may
be reduced by giving them with meals.
In acute overdosage zinc salts are corrosive, due to the formation of zinc
chloride by stomach acid; treatment consists of giving milk or alkali
carbonates and activated charcoal. The use of emetics or gastric lavage
should be avoided.
Prolonged use of high doses of zinc supplements, orally or parenterally,
leads to copper deficiency with associated sideroblastic anaemia and
neutropenia; full blood counts and serum cholesterol should be monitored to
detect early signs of copper deficiency. Zinc toxicity has occurred after the
use of contaminated water in haemodialysis solutions. High serum zinc
concentrations may be reduced by using a chelating drug such as sodium
calcium edetate (
).
Metal fume fever is an occupational disease associated with inhalation of
freshly-oxidised metal fumes, most commonly from zinc, iron or copper. It is
characterised by chills, fever, cough, dyspnoea, myalgia, and chest pain, and
is generally self-limiting and does not appear to be associated with longterm sequelae.
Effects on the blood (Latest modification: 04-Mar-2006)
There have been reports1-3 of anaemia, leucopenia, and neutropenia in
patients consuming excessive amounts of zinc supplements for acne. A
patient given zinc-containing enteral feeds as well as zinc supplementation
was diagnosed with sideroblastic anaemia due to zinc toxicity.4 All patients
were copper-deficient,1-4 despite supplementation with copper in one case.4
1. 1. Porea TJ, et al. Zinc-induced anemia and neutropenia in an adolescent. J
Pediatr 2000; 136: 688–90. PubMed
2. 2. Igic PG, et al. Toxic effects associated with consumption of zinc. Mayo
Clin Proc 2002; 77: 713–16. PubMed
3. 3. Salzman MB, et al. Excessive oral zinc supplementation. J Pediatr
Hematol Oncol 2002; 24: 582–4. PubMed
4. 4. Irving JA, et al. Element of caution: a case of reversible cytopenias
associated with excessive zinc supplementation. Can Med Assoc J 2003;
169: 129–31. PubMed
Effects on the senses (Latest modification: 02-Jan-2011)
The FDA's adverse event reporting system received 131 reports of anosmia
(loss of the sense of smell) associated with the use of intranasal zinccontaining preparations (Zicam).1 These products contained zinc gluconate,
were marketed in the USA from 1999 to June 2008, and were used to
prevent and treat cold symptoms, usually for about 3 days. Loss of smell
was often associated with an initial burning sensation in the nose, and
occurred soon after intranasal use; anosmia was long-lasting or permanent
in most cases. Loss of taste was also reported in some patients.
1. 1. FDA. Zinc-containing intranasal cold products (marketed as Zicam) and
anosmia. FDA Drug Safety Newsletter 2009; 2: 26–7. Also available at:
online (accessed 04/02/10)
Hypersensitivity (Latest modification: 26-Jan-2006)
Report of a patient who developed palmoplantar pustulosis about 1 year
after receiving dental fillings containing zinc.1 Zinc hypersensitivity was
confirmed by in vitro and patch testing. Complete remission occurred on
replacing the dental fillings.
1. 1. Yanagi T, et al. Zinc dental fillings and palmoplantar pustulosis. Lancet
2005; 366: 1050. PubMed
Parenteral nutrition (Latest modification: 07-Apr-2009)
Zinc was found to be a common contaminant of various components used for
TPN, and rubber stoppers or glass may have been the source.1 Levels of zinc
found may exceed daily requirements even before the addition of
supplementary zinc. The authors suggested it may be important to routinely
monitor zinc status in patients receiving long-term TPN, particularly infants
and children.
1. 1. Hak EB, et al. Chromium and zinc contamination of parenteral nutrient
solution components commonly used in infants and children. Am J HealthSyst Pharm 1998; 55: 150–4. PubMed
Porphyria (Latest modification: 14-Nov-2011)
The Drug Database for Acute Porphyria, compiled by the Norwegian
Porphyria Centre (NAPOS) and the Porphyria Centre Sweden, classifies zinc
sulfate as not porphyrinogenic; it may be used as a drug of first choice and
no precautions are needed.1
1. 1. The Drug Database for Acute Porphyria. Available at: online (accessed
07/10/11)
Interactions (Latest modification: 08-May-2009)
The absorption of zinc may be reduced by iron supplements (see also
Absorption, under Pharmacokinetics,
), penicillamine, phosphorus-
containing preparations, and tetracyclines. Zinc supplements reduce the
absorption of copper, fluoroquinolones (see Antacids and Metal Ions, under
Interactions of Ciprofloxacin,
), iron, penicillamine, and tetracyclines (
).
Pharmacokinetics (Latest modification: 26-Jan-2006)
Absorption of zinc from the gastrointestinal tract is incomplete, and is
reduced in the presence of some dietary constituents such as phytates.
Bioavailability of dietary zinc varies widely between different sources, but is
about 20 to 30%. Zinc is distributed throughout the body with the highest
concentrations found in muscle, bone, skin, eye, and prostatic fluids. It is
primarily excreted in the faeces, and regulation of faecal losses is important
in zinc homoeostasis. Small amounts are lost in urine and perspiration.
Absorption (Latest modification: 07-Nov-2007)
Although zinc deficiency (see Deficiency States, under Uses and
Administration,
) in some cases may be due to inadequate dietary intake,
inhibitors of zinc absorption may also be causative.1 Phytates, which are
present in cereals, corn, legumes, and rice, inhibit zinc absorption. The
animal protein in beef, eggs, and cheese counteracts the inhibitory effect of
phytate, whereas the casein in milk decreases zinc absorption. Proteins also
often contain other constituents such as inorganic phosphate that can
negatively affect zinc absorption. Long-term use of calcium supplements has
no effect on zinc status, but dietary calcium may form insoluble complexes
with phytate and zinc, thus decreasing the absorption of zinc. Iron can
reduce zinc absorption, although the effect is apparent only at a very high
ratio of iron to zinc, and in aqueous solution, which suggests that iron
fortification of foods will not affect zinc absorption. Although it is possible
that iron supplementation could affect mechanisms of zinc uptake and
transport, studies have not found such an effect, and long-term iron
supplementation is not considered to impair zinc status.
Zinc can form complexes with ligands or chelators; if the complex is readily
absorbed, this can increase zinc absorption. Edetic acid has been found to
have variable effects on zinc status depending on the ratio of edetic acid to
other cations and phytate, which compete for complex formation with zinc.
Histidine also chelates with zinc and can increase plasma zinc
concentrations; however, the ratio of histidine to zinc is important because
high doses of histidine may enhance the urinary excretion of zinc.
Methionine may improve zinc absorption, although evidence is limited.
Adding organic acids such as citrate to foods can enhance zinc absorption;
zinc citrate has been used as a dietary supplement.
1. 1. Lönnerdal B. Dietary factors influencing zinc absorption. J Nutr 2000;
130: 1378S–1383S. PubMed
Human Requirements (Latest modification: 04-Mar-2006)
UK and US recommended dietary intake (Latest modification: 03-Sep-2010)
In the UK dietary reference values (DRV)1 and in the USA recommended
dietary allowances (RDA)2 (see Human Requirements,
) have been
published for zinc. In the UK the reference nutrient intake (RNI) for adult
males and females is 9.5 and 7.0 mg daily respectively; values are also
given for infants and children of varying ages and for lactating women. The
Expert Group on Vitamins and Minerals3 have established a safe upper level
(SUL) for zinc of 25 mg daily. In the USA the RDA for adults is 11 mg daily
for men and 8 mg daily for women.2 The tolerable upper intake level is
40 mg daily.
WHO recommend lower limits of the safe ranges of population mean intakes
of dietary zinc for 3 categories of diets based on high, moderate, and low
zinc bioavailability: values are 4.0, 6.5, and 13.1 mg dietary zinc daily for
women, and 5.6, 9.4, and 18.7 mg dietary zinc daily for men, respectively.4
They recommend an upper limit of the safe range of population mean
intakes of zinc of 35 mg daily for women, and 45 mg daily for men.
1. 1. DoH. Dietary reference values for food energy and nutrients for the
United Kingdom: report of the panel on dietary reference values of the
committee on medical aspects of food policy. Report on health and social
subjects 41. London: HMSO, 1991. PubMed
2. 2. Standing Committee on the Scientific Evaluation of Dietary Reference
Intakes of the Food and Nutrition Board. Dietary Reference Intakes for
vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron,
manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington
DC: National Academy Press, 2001. Also available at: online (accessed
21/07/08)
3. 3. Expert Group on Vitamins and Minerals. Safe Upper Levels for vitamins
and minerals (May 2003). Available at: online (accessed 14/11/05)
4. 4. WHO. Zinc. In: Trace elements in human nutrition and health. Geneva:
WHO, 1996: 72–104.
Uses and Administration (Latest modification: 07-Nov-2011)
Zinc is an essential element of nutrition and traces are present in a wide
range of foods. It is a constituent of many enzyme systems and is present in
all tissues. Features of zinc deficiency include growth retardation and defects
of rapidly-dividing tissues such as the skin, the immune system, and the
intestinal mucosa. Water-soluble zinc salts are used as supplements to
correct zinc deficiency; for example, in malabsorption syndromes, during
parenteral feeding, in conditions with increased body losses (trauma, burns,
and protein-losing states), and in acrodermatitis enteropathica (a rare
genetic disorder characterised by severe zinc deficiency). They have been
tried in the treatment of a large number of conditions that may be related to
zinc deficiency.
Doses of zinc salts are usually expressed in terms of elemental zinc, and the
following salts contain about 50 mg of zinc:
zinc acetate (dihydrate) 168 mg
zinc chloride 104 mg
zinc citrate (trihydrate) 160 mg
zinc gluconate 348 mg
zinc lactate 186 mg
zinc sulfate (heptahydrate) 220 mg
The approximate number of millimoles of zinc contained in these salts are:
4.6 mmol in 1 g zinc acetate (dihydrate)
7.3 mmol in 1 g zinc chloride
4.8 mmol in 1 g zinc citrate (trihydrate)
2.2 mmol in 1 g zinc gluconate
4.1 mmol in 1 g zinc lactate
3.5 mmol in 1 g zinc sulfate (heptahydrate)
In deficiency states, zinc is usually given orally as the sulfate, the sulfate
monohydrate, or the gluconate, in doses of up to 50 mg of elemental zinc
three times daily. When intravenous supplements are required, zinc chloride
or zinc sulfate may be given; a suggested dose for parenteral nutrition is
6.5 mg of elemental zinc (100 micromoles) daily.
Oral zinc salts, commonly the acetate, may be used as copper absorption
inhibitors in Wilson's disease (
). The usual adult dose is 50 mg three
times daily up to a maximum of five times daily. An effective dose in
pregnant women is usually 25 mg three times daily; however, dosage is
adjusted based on copper concentrations.
For doses in children, see Administration in Children,
under Deficiency States,
and Diarrhoea,
.
Zinc sulfate is used topically in a variety of skin conditions mainly for its
astringent properties. The insoluble zinc salts, commonly the oxide (
),
are used similarly. A 1.2% solution of zinc acetate is used topically with
erythromycin in the treatment of acne vulgaris (
). Zinc sulfate is also
used as an astringent in eye drops. Zinc chloride has been used for its
powerful caustic and astringent properties, usually in very dilute solution, in,
for example, mouthwashes. Zinc citrate and zinc lactate are used in
preparations for oral care and as a dietary supplement.
Polaprezinc (
Homoeopathy
) is also used as a source of zinc.
Zinc and its salts have been used in homoeopathic medicines.
Administration in children (Latest modification: 24-Sep-2013)
Zinc can be given to children to prevent and treat deficiency or as a copper
absorption inhibitor in Wilson's disease (
). The following doses are
expressed as elemental zinc.
In deficiency states, zinc can be given orally according to weight:
less than 10 kg, 22.5 mg daily
10 to 30 kg, 22.5 mg once to three times daily
over 30 kg, 45 mg once to three times daily
The BNFC suggests an oral dose of zinc 1 mg/kg daily for neonates.
When intravenous supplements are required, suggested doses of zinc for
children vary between countries. UK licensed product information
recommends a dose of 250 micrograms/kg (up to a maximum of 3.75 mg)
daily for children weighing 40 kg or less; children weighing more than 40 kg
should receive the adult dose (see
). In the USA, licensed product
information recommends a dose of 300 micrograms/kg daily for preterm
neonates weighing up to 3 kg, and 100 micrograms/kg daily for full term
infants and children up to 5 years. Adult doses may be used in older
children.
In Wilson's disease, zinc is given orally according to age:
1 to 6 years, 25 mg twice daily
6 to 16 years and body-weight under 57 kg, 25 mg three times daily
over 16 years or body-weight above 57 kg, 50 mg three times daily
For acrodermatitis enteropathica, the BNFC suggests an initial oral dose
of zinc 0.5 to 1 mg/kg twice daily for all ages (the total daily dose may
alternatively be given in 3 divided doses).
For oral zinc doses recommended in the management of acute diarrhoea in
children, see
Administration
. Zinc sulfate may also be applied topically, see Uses and
.
Age-related macular degeneration (Latest modification: 26-Jan-2006)
High doses of dietary supplements such as betacarotene, vitamin C, vitamin
E, and zinc are being promoted for preservation of vision in the elderly but
there are no data to suggest any benefit for patients who do not have agerelated macular degeneration or have only mild disease and such treatment
is not necessarily harmless.1 For further details, see under Betacarotene,
.
1. 1. Anonymous. Antioxidant vitamins and zinc for macular degeneration.
Med Lett Drugs Ther 2003; 45: 45–46. PubMed
Common cold (Latest modification: 07-Dec-2011)
Zinc salts have been tried (orally or intranasally) in the treatment of the
common cold (
) with variable results.1-9 A systematic review of
randomised studies (conducted in upper-middle and high-income countries,
where zinc deficiency is uncommon) found that oral zinc reduced the
duration and severity of common cold symptoms when used therapeutically,
and that it reduced the incidence of the common cold in healthy children
when used prophylactically. However, no firm recommendations could be
made regarding the dose, formulation, and duration that should be used.10
1. 1. Mossad SB, et al. Zinc gluconate lozenges for treating the common cold:
a randomized, double-blind, placebo-controlled study. Ann Intern Med
1996; 125: 81–8. PubMed
2. 2. Macknin ML, et al. Zinc gluconate lozenges for treating the common cold
in children: a randomized controlled trial. JAMA 1998; 279: 1962–7.
PubMed
3. 3. Prasad AS, et al. Duration of symptoms and plasma cytokine levels in
patients with the common cold treated with zinc acetate: a randomized,
double-blind, placebo-controlled trial. Ann Intern Med 2000; 133: 245–52.
PubMed
4. 4. Turner RB, Cetnarowski WE. Effect of treatment with zinc gluconate or
zinc acetate on experimental and natural colds. Clin Infect Dis 2000; 31:
1202–8. PubMed
5. 5. Eby GA. Zinc lozenges as cure for the common cold—a review and
hypothesis. Med Hypotheses 2010; 74: 482–92. PubMed
6. 6. Turner RB. Ineffectiveness of intranasal zinc gluconate for prevention of
experimental rhinovirus colds. Clin Infect Dis 2001; 33: 1865–70. PubMed
7. 7. Hirt M, et al. Zinc nasal gel for the treatment of common cold
symptoms: a double-blind, placebo-controlled trial. Ear Nose Throat J
2000; 79: 778–82. PubMed
8. 8. Mossad SB. Effect of zincum gluconicum nasal gel on the duration and
symptom severity of the common cold in otherwise healthy adults. Q J Med
2003; 96: 35–43. PubMed
9. 9. Belongia EA, et al. A randomized trial of zinc nasal spray for the
treatment of upper respiratory illness in adults. Am J Med 2001; 111:
103–8. PubMed
10.10. Singh M, Das RR. Zinc for the common cold. Available in The Cochrane
Database of Systematic Reviews; Issue 2. Chichester: John Wiley; 2011
(accessed 20/10/11). PubMed
Deficiency states (Latest modification: 22-Jul-2008)
General references.
1. 1. Hambidge M. Human zinc deficiency. J Nutr 2000; 130 (suppl): 1344S–
1349S. PubMed
2. 2. Prasad AS. Zinc deficiency: has been known of for 40 years but ignored
by global health organisations. BMJ 2003; 326: 409–10. PubMed
3. 3. Shrimpton R, et al. Zinc deficiency: what are the most appropriate
interventions? BMJ 2005; 330: 347–9. PubMed
4. 4. Mason P. Physiological and medicinal zinc. Pharm J 2006; 276: 271–4.
Diagnosis and testing
A loss of taste acuity is a sign of zinc deficiency (see Taste Disorders,
)
and this has been used as a test for the condition: patients who do not
immediately perceive a strong flavour on tasting a dilute (typically 0.1 or
0.2%) solution of zinc sulfate are considered likely to benefit from
supplementation. However, a study in pregnant women failed to confirm that
the ability to taste such a solution was related to zinc deficiency.1
Authors of a small study of Japanese children with short stature evaluated
body zinc clearance, and considered those patients with high clearance
values but normal serum zinc concentrations to have marginal zinc
deficiency.2
1. 1. Mahomed K, et al. Failure to taste zinc sulphate solution does not
predict zinc deficiency in pregnancy. Eur J Obstet Gynecol Reprod Biol
1993; 48: 169–75. PubMed
2. 2. Kaji M, et al. Studies to determine the usefulness of the zinc clearance
test to diagnose marginal zinc deficiency and the effects of oral zinc
supplementation for short children. J Am Coll Nutr 1998; 17: 388–91.
PubMed
Diarrhoea
Chronic diarrhoea can be a sign of zinc deficiency, and diarrhoea can lead to
excessive zinc losses and zinc deficiency when dietary zinc is inadequate.
Zinc supplements have been shown to reduce the incidence, intensity, or
duration of acute diarrhoea (
) in children in developing countries.1-5
Beneficial effects have also been seen with zinc supplementation for
persistent diarrhoea.4,5 A WHO report concluded that zinc supplementation is
efficacious in significantly reducing the severity and duration of diarrhoea;
the type of zinc salt does not appear to influence efficacy, although the best
formulation should be determined to minimise adverse effects such as
vomiting.6 A further report7 concluded that there was sufficient evidence to
recommend the inclusion of zinc as adjunctive therapy to oral rehydration
salts in the standard management of both dysenteric and non-dysenteric
acute diarrhoea. WHO guidelines on the management of acute diarrhoea
recommend 10 to 14 days of oral zinc supplementation at a dose of 10 mg
daily for infants under 6 months of age, and 20 mg daily for older children.8
It has been suggested that HIV-infected children should also receive zinc
supplementation for diarrhoea, see HIV infection and AIDS,
.
For a report of increased efficacy in reducing persistent diarrhoea and
dysentery when zinc is used with vitamin A, see Diarrhoea, under Deficiency
states,
. For suggestions that zinc potentiates the effect of vitamin A, see
Vitamin A deficiency,
.
1. 1. Bhutta ZA, et al. Zinc Investigators' Collaborative Group. Prevention of
diarrhea and pooled analysis of randomized controlled trials. J Pediatr
1999; 135: 689–97. PubMed
2. 2. Bhutta ZA, et al. Therapeutic effects of oral zinc in acute and persistent
diarrhea in children in developing countries: pooled analysis of randomized
controlled trials. Am J Clin Nutr 2000; 72: 1516–22. PubMed
3. 3. Aggarwal R, et al. Role of zinc administration in prevention of childhood
diarrhea and respiratory illnesses: a meta-analysis. Pediatrics 2007; 119:
1120–30. PubMed
4. 4. Fischer Walker CL, Black RE. Micronutrients and diarrheal disease. Clin
Infect Dis 2007; 45 (suppl 1): S73–S77. PubMed
5. 5. Lukacik M, et al. A meta-analysis of the effects of oral zinc in the
treatment of acute and persistent diarrhea. Pediatrics 2008; 121: 326–36.
PubMed
6. 6. Fontaine O. Effect of zinc supplementation on clinical course of acute
diarrhoea. J Health Popul Nutr 2001; 19: 338–46. PubMed
7. 7. Robberstad B, et al. Cost-effectiveness of zinc as adjunct therapy for
acute childhood diarrhoea in developing countries. Bull WHO 2004; 82:
523–31. PubMed
8. 8. WHO/UNICEF. WHO/UNICEF joint statement: clinical management of
acute diarrhoea (issued May 2004). Available at: online (accessed
22/07/10)
Growth retardation
Growth retardation in a group of short Japanese children without endocrine
abnormalities was found to be associated with mild to moderate zinc
deficiency; supplementation with oral zinc sulfate 5 mg/kg daily over 6
months resulted in an improvement in growth velocity despite unchanged
growth hormone production.1 Similarly, supplementation with 10 mg zinc
daily for 6 days of each week, for 6 months, increased the growth rate of
stunted Ethiopian infants; weight also increased in both stunted and nonstunted children, and the authors commented that these effects were at
least partly due to improvements in appetite, and reduced morbidity from
infection.2 Results from a meta-analysis of these 2 studies and 31 others
indicated that zinc supplementation resulted in a highly significant increase
in both linear growth and weight gain of prepubertal children; weight-for-
height index was not affected. Significant increases in serum zinc
concentrations were also noted with supplementation, but additional studies
were considered necessary in order to determine whether mean serum zinc
concentration could accurately predict response to supplementation.3
1. 1. Nakamura T, et al. Mild to moderate zinc deficiency in short children:
effect of zinc supplementation on linear growth velocity. J Pediatr 1993;
123: 65–9. PubMed
2. 2. Umeta M, et al. Zinc supplementation and stunted infants in Ethiopia: a
randomised controlled trial. Lancet 2000; 355: 2021–6. PubMed
3. 3. Brown KH, et al. Effect of supplemental zinc on the growth and serum
zinc concentrations of prepubertal children: a meta-analysis of randomized
controlled trials. Am J Clin Nutr 2002; 75: 1062–71. PubMed
HIV infection and AIDS
A systematic review1 found that zinc supplements reduced diarrhoeal
morbidity in HIV-infected children in a single study, without causing adverse
effects on disease progression; it was considered that children with HIV
should receive zinc supplements in the management of diarrhoea (
) or
severe malnutrition in the same way as uninfected children.
1. 1. Irlam JH, et al. Micronutrient supplementation in children and adults
with HIV infection. Available in The Cochrane Database of Systematic
Reviews; Issue 12. Chichester: John Wiley; 2010 (accessed 22/12/10).
PubMed
Pneumonia
A pooled analysis1 of 10 studies performed in developing countries found
that zinc supplementation reduced the incidence of pneumonia in children by
41%. A randomised study in Bangladesh, in 270 children aged 2 to 23
months, found that 20 mg daily of elemental zinc, given orally and adjuvant
to standard antimicrobial therapy, accelerated recovery from pneumonia
when compared with placebo; children aged 12 months or older resolved
their respiratory illness earlier than younger infants.2 Another study in
Bangladesh,3 involving 1621 children 2 to 12 months old, found that
prophylaxis with 70 mg of oral zinc acetate [about 20 mg of zinc] given
weekly reduced the incidence of pneumonia compared with placebo and also
reduced subsequent pneumonia-related mortality; a small reduction in the
incidence of diarrhoea was also seen.
However, a later systematic review4 including 15 randomised controlled
studies concluded that on balance the evidence suggested no additional
benefit of oral zinc supplementation in children with community-acquired
pneumonia who were receiving antimicrobial therapy; there was also no
evidence of benefit in preventing pneumonia, and one study had suggested a
possible increased incidence and prevalence in children given the
supplement.
1. 1. Bhutta ZA, et al. Prevention of diarrhea and pneumonia by zinc
supplementation in children in developing countries: pooled analysis of
randomized controlled trials. J Pediatr 1999; 135: 689–97. PubMed
2. 2. Brooks WA, et al. Zinc for severe pneumonia in very young children:
double-blind placebo-controlled trial. Lancet 2004; 363: 1683–8. PubMed
3. 3. Brooks WA, et al. Effect of weekly zinc supplements on incidence of
pneumonia and diarrhoea in children younger than 2 years in an urban,
low-income population in Bangladesh: randomised controlled trial. Lancet
2005; 366: 999–1004. PubMed
4. 4. Mathew JL. Zinc supplementation for prevention or treatment of
childhood pneumonia: a systematic review of randomized controlled trials.
Indian Pediatr 2010; 47: 61–6. PubMed
Pregnancy
Zinc requirements are increased in pregnancy. Although it is unclear to what
extent this has clinical consequences, some have suggested that
supplementation with modest doses of zinc (less than 45 mg daily) during
pregnancy may have beneficial effects on fetal growth and development, and
lead to improved pregnancy outcomes.1 A controlled study in Peru found that
addition of oral zinc (25 mg of zinc daily as zinc sulfate) to iron and folate
supplementation improved fetal bone growth, as measured by femur length.2
A systematic review3 concluded that, while zinc supplementation during
pregnancy appears to reduce preterm delivery, there was no convincing
evidence that it resulted in other useful benefits. Since the association with
preterm birth might reflect poor nutrition, improvement in the overall
nutritional status of impoverished populations would be more beneficial than
zinc supplementation in isolation.
1. 1. Favier M, Hininger-Favier I. Zinc et grossesse. Gynecol Obstet Fertil
2005; 33: 253–8. PubMed
2. 2. Merialdi M, et al. Randomized controlled trial of prenatal zinc
supplementation and fetal bone growth. Am J Clin Nutr 2004; 79: 826–30.
PubMed
3. 3. Mahomed K, et al. Zinc supplementation for improving pregnancy and
infant outcome. Available in The Cochrane Database of Systematic
Reviews; Issue 2. Chichester: John Wiley; 2007 (accessed 05/03/08).
PubMed
Taste disorders
Zinc appears to be effective for the treatment of taste disturbances (
)
associated with zinc deficiency but there is insufficient evidence to determine
its efficacy for taste dysfunction secondary to conditions that do not involve
low serum zinc concentrations.1 Zinc picolinate was found to significantly
improve objective measurement of taste when compared with placebo, both
in patients with zinc deficiency and in those with idiopathic taste disorders
(and normal serum zinc concentrations); there were no differences in
subjective assessment of taste.2 A later study3 also found oral zinc gluconate
140 mg daily [about 20 mg of zinc] to be of benefit in idiopathic dysgeusia.
In contrast, loss of taste has been reported in some patients using zinc
gluconate intranasally, see
Polaprezinc (
.
) is also being investigated as a treatment for taste
disorders.
1. 1. Heyneman CA. Zinc deficiency and taste disorders. Ann Pharmacother
1996; 30: 186–7. PubMed
2. 2. Sakai F, et al. Double-blind, placebo-controlled trial of zinc picolinate for
taste disorders. Acta Otolaryngol 2002; (suppl 546): 129–33. PubMed
3. 3. Heckmann SM, et al. Zinc gluconate in the treatment of dysgeusia—a
randomized clinical trial. J Dent Res 2005; 84: 35–8. PubMed Correction.
ibid.; 382.
Vitamin A deficiency (Latest modification: 07-Nov-2005)
It has been proposed1 that the inconsistent effects on morbidity of vitamin A
supplementation (see Diarrhoea, under Deficiency States,
) may be due
to co-existing micronutrient deficiencies, such as zinc deficiency, that affect
the bioavailability of vitamin A. The authors found combined zinc and
vitamin A supplementation to be more effective in reducing persistent
diarrhoea and dysentery than either zinc or vitamin A alone. There is also
some suggestion that zinc may potentiate the effects of vitamin A in the
treatment of night blindness,2 but only in those patients already deficient in
zinc. A study in Bangladesh3 found that the proportional improvement in
vitamin A status in vitamin A-deficient children was larger in those given zinc
with vitamin A than in those given vitamin A or zinc alone, suggesting a
synergistic effect. Similarly, a study in Indonesia4 of supplementation in
pregnant women found that betacarotene with zinc, but not betacarotene or
zinc alone, improved vitamin A status in both mothers and infants at 6
months postpartum; the authors suggested that zinc may have a specific
role in the conversion of betacarotene to retinol.
1. 1. Rahman MM, et al. Simultaneous zinc and vitamin A supplementation in
Bangladeshi children: randomised double blind controlled trial. BMJ 2001;
323: 314–18. PubMed
2. 2. Christian P, et al. Zinc supplementation might potentiate the effect of
vitamin A in restoring night vision in pregnant Nepalese women. Am J Clin
Nutr 2001; 73: 1045–51. PubMed
3. 3. Rahman MM, et al. Synergistic effect of zinc and vitamin A on the
biochemical indexes of vitamin A nutrition in children. Am J Clin Nutr 2002;
75: 92–8. PubMed
4. 4. Dijkhuizen MA, et al. Zinc plus β-carotene supplementation of pregnant
women is superior to β-carotene supplementation alone in improving
vitamin A status in both mothers and infants. Am J Clin Nutr 2004; 80:
1299–1307. PubMed
Wilson's disease (Latest modification: 05-Dec-2011)
References.
1. 1. Anderson LA, et al. Zinc acetate treatment in Wilson's disease. Ann
Pharmacother 1998; 32: 78–87. PubMed
2. 2. Brewer GJ, et al. Treatment of Wilson's disease with zinc: XV long-term
follow-up studies. J Lab Clin Med 1998; 132: 264–78. PubMed
3. 3. Brewer GJ, et al. Treatment of Wilson's disease with zinc: XVII:
treatment during pregnancy. Hepatology 2000; 31: 364–70. PubMed
4. 4. Brewer GJ. Zinc acetate for the treatment of Wilson's disease. Expert
Opin Pharmacother 2001; 2: 1473–7. PubMed
Preparations (Latest modification: 17-Oct-2013)
Single-ingredient Preparations (Latest modification: 17-Oct-2013)
The symbol ¤ denotes a preparation which is discontinued or no longer
actively marketed.
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Solvezink¤; Virudermin¤; Wilzin; Belgium: Wilzin; Brazil: Dermezil;
Zincopan; Canada: Anu-Aide¤; Anusol; Anuzinc¤; Bio Statol; Egozinc;
Fisherman's Friend Zinc¤; Flavo-Zinc¤; Men Formula¤; Micro Zn; PMSEgozinc¤; Rivasol; Shaklee DR; Chile: Altazinc; Cleanance; Num-Zit;
China: Likexin (利可欣); Ping An (屏安); Wei Er (威尔); Xing Rui Ling (星瑞灵
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Denmark: BiOrto Zink; Solvezink¤; Wilzin; Finland: Solvezink¤; France:
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Ophtal Z¤; Ophtopur-Z¤; Solvezink¤; Tussamag Zink¤; Unizink; Virudermin;
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Zinkbrause; Zinkit; Zinkorot; Zinkotase; Greece: Solvazinc; Wilzin; Hong
Kong: Anuzinc¤; Egozinc¤; Eye Glo Relief; Zincaps; Hungary: FeroglobinB12; India: Adrovit-Z; Aquasol Ceezed; Ascazin; Gludel; Infladase Forte;
Keeper; Indonesia: Interzinc; Orezinc; Zidiar; Zincare; Zincpro; Zn-Diar;
Ireland: Solvazinc¤; Wilzin; Israel: Avazinc; Micro Zn; Zincol; Italy:
Pontefix; Troca Flu Rino¤; Wilzin; Mexico: Metazinc¤; Tersaken¤; Unguento
del Bebe; Z-Crim¤; Zn-Fusin¤; Netherlands: Wilzin; Norway: Solvezink;
Wilzin; New Zealand: Elemental Zinc¤; Zincaps; Philippines: E-Zinc;
Immuzinc; Lipactin; Nutrizinc; Orazinc; Prozinc; Zinbee; Poland: Wilzin;
Zincas; Zincteral; Portugal: Wilzin; Russia: Zincteral (Цинктерал); South
Africa: ZN 220¤; Spain: Wilzin; Sweden: Solvezink; Wilzin; Switzerland:
Collazin; Virudermin; Zink Verla; Thailand: Z-G; Zinc Tab; Zincaps;
Zincate; Zinctab; Turkey: Medizinc; Nutri-Zinc; Zinco; Zincobest; Zincover;
Zinvital; United Kingdom: Cold-Gard¤; Flavo-Zinc; Solvazinc; Sootheye¤;
Tartar Control Listerine; Wilzin; Z Span¤; Zincomed; Zincosol; Ukraine:
Zincteral (Цинктерал); Zinkit (Цинкит); United States: Dermadrox; EyeSed¤; Galzin; Halls Zinc Defense; Ivy Dry; Orazinc; PeleVerus Clear;
Verazinc; Zinca-Pak¤; Zincate; Venezuela: Cicalfate;
Multi-ingredient Preparations (Latest modification: 15-Nov-2013)
actively marketed.
Argentina: Adelgazar; ADX; Agua D'Alibour; Berocca Plus; Caladryl
Incoloro; Callicida; Cicalfate; Cistidac; Cistimax; Citrovita; Clean-AC;
Cleanance; Cleanance; Cleanance; Cleanance; Copelia; Crema de Ordene;
Crema Para Paspaduras¤; CTabs-Magnesio; Dermalibour; Excelentia
Antihemorroidal; Fotoral¤; Gingeron; Ginkgo Biloba Forte; Glucobefol¤;
Herbaccion Antioxidante; Imedeen; Ipri V Plus; Ipri V Total; Kelual Zinc;
Lacto-Cev Zn; Lagrimas de Santa Lucia¤; Litiofarm¤; Magnesio 102 Plus;
Megaplus; Negacne; Prostafit; Prostamen; Redoxon Doble Accion; Selder;
Senexon Plus; Sigma CE¤; Sigmace Plus; Stress with Zinc; Tonovital
Antioxidante; Tonovital Plus Antioxidante; Total Magnesiano Sport;
Tricomax; Troxac; Valcatil Max; Valcatil Plus; Vitalfort Antioxidante; XLS; ZClindacin; Zinc Antioxidante + Guarana; Zinc for Acne; Zineryt; Australia:
Advanced Prostate Care; APR Cream¤; Arctium & Zinc Compound; Berocca;
Bilberry Plus Eye Health¤; Caprilate¤; Cold and Flu Relief¤; Echinacea &
Antioxidants¤; Extralife Eye-Care¤; Extralife Flow-Care¤; Full Motion;
Goodnight Formula¤; Horse Radish and Garlic Tablets¤; In A Wink¤; Joint
Mobility¤; Lemsip First Signs Cold & Flu Day + Night; Lemsip First Signs
Cold & Flu; Logicin Natural Lozenges¤; Macro C + Garlic with Zinc¤; Methyl
Transfer; Min-Detox-C¤; Nervatona Calm; Nervatona Focus; Nutribone; Nyal
Cough, Cold & Flu Day + Night; Nyal Nasal Spray; Odourless Garlic¤; Olive
Leaf Plus; Optazine A¤; Osteoapatite with Boron¤; Prefrin Z¤; Prosta
Balance; Prostate Health Formula; Proyeast¤; Redoxon Double Action;
Strepsils Zinc Cold Relief¤; Throat-Clear; Tribulus & Epimedium Compound;
Urapro¤; Visine Allergy¤; Vita-Minis Cold & Flu¤; Vita-Zinc¤; Zinc
Supplement¤; Zincfrin¤; Zinvit C¤; Zinvit G¤; Zinvit; Austria: Berocca plus
Zink; Efalith¤; Lipactin; Ophtaguttal; Zeller-Augenwasser¤; Belgium:
Efalith; Lipactin; Ostrin Q10; Redoxon + Zink; Zincfrin Antihistaminicum¤;
Zincfrin¤; Zineryt; Brazil: Alivbaby; Antiseptin¤; Babyglos¤; Babymed;
Belagin¤; Beroccal; Borato de Sodio¤; Cariderm¤; Cebion Zinco; Cenevit
Zinco; Colirio Blumen¤; Colirio Helios¤; Colirio Legrand; Colirio Moura Brasil;
Colirio Teuto; Colirio Vima¤; Dermil; Dermostatin; Dexa-Vastrictol¤;
Efederm¤; Eximia Fortalize; Fluo-Vaso; Hemodase; Limpele Ginecologico;
Maxibell; Minesol; Mirabel; Mirorroidin¤; Neo Vastrictol¤; Ocuvite Lutein;
Olig-Trat; Pomada Blumen¤; Pomada Martel¤; Pratiderm; Redoxon Zinco;
Rhamiglos; Sensibaby; Stilux; Stresstabs; Suavebaby; Suavederm;
Vastrictol¤; Verlin¤; Visiplex; Visolon; Visual; Zincolok; Zincovit; Canada:
Adeks; Allergy Cream¤; Allergy Eye Drops; Anodan-HC; Anugesic-HC;
Anusol Plus; Anusol-HC; Anuzinc HC Plus; Anuzinc HC; Anuzinc Plus; AOEncap¤; Beminal Z¤; Benadryl Bug Bite Relief; Benadryl Spray; Bio-Gyn¤;
Cal-Mag Citrate with Zinc and Vitamin D; Cal-Mag Complete; Cal-Mag
Vitamin C & Zinc¤; Cal-Mag with Vitamin D & Zinc; Clear Eyes Allergy;
Combac¤; Cortrex; Dermagran Moisturizing Spray¤; Dermagran Ointment¤;
EC + Complex¤; Echina-B-C¤; Egozinc-HC; Ester C EVC¤; Formula CDC;
Formula O¤; Formula Ultra Pro¤; Formula-4 SX¤; Hemorrhoid Ointment;
Hemorrhoidal Ointment; High Potency Cal-Mag Plus¤; Lipactin; Listerine
Antiseptic Tartar Control; Munit-E¤; Neo-Bex Forte¤; Nutrol E plus Zinc &
Selenium¤; One A Day Cold Season¤; Onguent Hemorrhoidal¤; OptiBiostim; Optibiol¤; Orajel Mouth Sore Medicine; Osteo-Logic¤; Polysporin
Itch Relief; Procozin; Proctodan-HC; Prostaplex; ProstGard¤; Prozma¤;
ratio-Hemcort-HC; Rectogel HC; Rectogel; Rivasol HC; Shelly's HC¤; Stress
Plex C¤; Stress Tab with Zinc¤; Super AO Factors; Super AO Formula¤;
Surbex plus Zinc¤; T-MA; TAD+; TFE; TIM¤; Upro; Visine Allergy; Vita-Cal
Mag with Zinc and Vitamin D¤; Watkins Vision¤; Z-Bec¤; Zinc Plus¤;
Zincfrin-A¤; Zincfrin¤; Chile: Agua Sulfatada Picrica¤; Astrijesan; Berocca
Plus; Berocca Vit; Biofax¤; Biogenol; Biorgan¤; Brolin; Caladryl Clear;
Capilet Locion Capilar; Caprimida D Balance; Carotenoplos¤; Cellvital¤;
Cicalfate; Cicaplast; Clean-AC; Cleanance; Cleanance; Deltisan;
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(正大维他); Diweijia (迪维佳); Kang Bi De (康必得); Zaikang (再康); Czech
Republic: Acne Lotio¤; Curiosin¤; Dermabion¤; Feroglobin B12; Osteocare;
Redoxon Double Action¤; Zineryt; Denmark: Zincfrin¤; Finland: Berocca;
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Emlac Forte-BZ; Energy Plus; Enerzip; Enhance; Ep-Iron Fol; Eramet;
Erysia; Ev-Cal-CT; Ev-Cal; Ev-Syl-XT; Evaglow Plus; Evepearl-PMS; Evica;
Evovit; Exerge; Eyevital; Fabulae; Facicap; Familykair; Familykair; Fancal;
Faroo-XT; Fe-Glow; Fe-Z; Fearo; Fecontin-Z¤; Feday; Fefol-Z; Fejet-OD;
Fejet; Fekair; Femena-Z; Femicontin; Fenna; Fenora; Fenotec-Z; Fenserr;
Feonat-Z; Fephar; Feranid; Fered-C; Fered-C; Fereg-Z; Ferid-C; Ferid-C;
Ferimax; Feripro-Z; Ferisafe; Ferisan; Feristar; Feritol; Ferizest; Ferobid-Z;
Ferofast; Ferolact; Ferolact; Feromax; Feronez; Feronez; Feronyl; Ferose
Tab; Ferose; Ferox; Ferozinc; Ferricos; Ferritop-Z; Ferritop; Ferro Hepatine;
Ferro-Plan Kit; Ferrochelate-Z; Ferrocin C B12 Plus; Ferrocin C B12;
Ferrogen-Z; Ferrolac; Ferycare; Ferywel; Ferz; Fesofor-Z; Fesoft; Feton-ZTR; Fevovit; Fexid-Z; Fexid; Fezec; Fezee; Fezlina; Fezocaps; Fezocar;
Fezon; Fezys-SM; Fezys-Z; Fiesta-Z; Fifa-AD; Fifa; Fifa; Fista; Fizol; Fizol;
Fleefer; Flintoff; Focal-CZ; Fol-G2; Folinz; Foncal; Forbone; Forhem; Frednil;
Freecad; Fresco; Frezep; FRS; Furtipil-L; Gatdor; Gefer; Gemcal; Genprot;
Geocal; Glace; Globac-Z; Globac-Z; Globac; Globex Forte; Globiron-C;
Globiron-Z; Glocal; Glohar-C; Glohem TR; Glowcarb-Z; Glowcarb; Glubex-Z;
Glubex-Z; Glucorich; Glyciron; GMab Plus; Gromet-Z; GSComb; HAA; Haem
Up-Z; Haem Up; Haemaze; Haemflow-Z; Haemglow-Z; Haemo-Z;
Haemocare; Haemrise; Haems; Haemup-C; Hamozen-Z; HB Fast-Z; HB-4;
HB-Forte; HB-Nova; HB-Orange; HB-Orange; HB-Plan Kit; HB-Up; Hefovin;
Hem-12; Hemacor; Hemadex; Hemadex; Hemcap; Hemex; Hemfer;
Hemfer; Hemfer; Hemglob-Z; Hemifolin-Z; Hemofer-Z; Hemral-CB;
Hepasules-F; HG Cal; Hi-Mom; Hi-Q Plus; Hi-Q Plus; Hi-Q; Huntred-Z;
Hycal; Hycibex-Z; Hydent; Hyrase; Hyton; I-Lute; I-Top; Ibelac-TR; Ifcit;
Ifcit; Ifyasco-Z; Ifycal-C; Ifycarb-Z; Ifycarb; Ilyx; Imax; Imferon Forte;
Incal; Incal; Indical; Infaglobin; Infer-Z; Inox; Inpro; Inprovit; Insiron-AD;
Iolebate; Ionic-Z; Irex-TR; Irex; Iro-Life; Irocid-Z; Irodate-FA; Irofol-AZ;
Irolar; Iromost; Ironac-S; Ironac; Ironate; Ironeed; Ironifol-Z; Irossgold;
Irossgold; Irotel; Irum; Jalcium-T; Jectocos; Joyce; JP Tone-TR¤; Jstat;
Kairfee; Kairfee; Kalzin-C; Kalzin; Kaniz; Kazifer-Z; Keep-Top; Kelcer; KfolZ; Kibocal-M; Klinit; Kolq; Kudamin; Kufol-Z; Kurecal-CZ; L-Beplex; L-Bex;
L-Vit-Z; Lacsil; Lancitone-CS; Lancitone-CZ; Layo; Leobet-GZ; Lephos;
Lephos; Levical; Levicarb; Levifer; Lexfer-Z; Liquiron; Liquiron; Litcal Forte;
Litcal; Literate-CT; Literate; Liton-Z; Litron; Litron; Livogen-XT; Livogen-Z;
Lizace; Logical-M; Lozee-GM; Lozee-M; Lozee; Lycodric; Lycostar-CM;
Lysicon-V c Zinc; Lyto; M Trol-Z; Macuchek; Magnical; Magtrate; Maltviron;
Mapratone-Z; Max Pluse; Maxo-FE; Maxoza; Me-Fresh; Medineuron;
Medofer; Megacal; Megagin; Megashelcal; Melan; Memi-LB; Mepyvit-CT;
Merical; Metacal-DMZ; Metalin-Z; Metro Plus; Microsol; Mighty Plus; Mighty;
Mil; Milical XP; Milkcal; Minadex; Minigadine; Mintcal; Miproten; Miracal;
Mishcal; Momkair; Mostcal; Mufe; Mufe; Mulmin Plus; Mulmin-F; Mulmin;
Multilipius; Multiphar; Multiphar; Multoxid; Mumcal; Mumfer-Z; Myglo-CS;
Myglo; Mytifer; N-Rich; Naflin; Nam Cold-Z; NCZ; Neogadine SG; NerwinMD; Netfer; Neufer-Z; Neufer-Z; Neuractin Forte; Neurobex-Z; Neurogard;
Neuromin-EA; Neurotrat; Neuvital; New Eye Lotion¤; Newtromin-Z; NicoferXT; Nikotriol; Nitizest; Nitizest; Nitrodent-R; Nofro; Nurifier; Nurokind-More;
Nutra; Nutrex; Nutribone Plus; Nutrifil; O2-Fresh-GP; Ob-Cal; Ob-Cal; Ocal;
Ocium-M; Ocuclear; Ocufree; Ocurest-Z; Og-Lac; Olgacal; Omegachek;
Optifer; Optisulin; Optivision; Orbone Tab; Oriro; Ortocal-CT; Osex Forte;
Osfer; Osiron; Osoferon; Ospical-M; Ossidos-T; Ossofez; Osteo-G; Osteobel;
Osteochek; Osteoz Plus; Osti-Rich; Ostium; Osto-3; Ostocare; Ostocrat;
Ostonex; Ostriol Forte; Ostrobit-CZ; Ovista; Oxi-Red; Oxi-Red; Oxibet;
Oxidon; Oxipre; Oxired; Oxitra; Oxy-V; Oxyban; Oxydex; Oxyglobin; OxylaAL; Oxytret; Oxyvit; Pabatab-BZ; Pamagin C; Pamagin C; Pedic; Protone;
Sioplex-Z; Trinergic; Winofit; Zad-G; Zevit; Zicomplex; Zinco Sulpha¤;
Indonesia: Antox; Artovit; Artriox¤; Artro Plus; Artro; Aviter; Azvit; BdGARD; Becom-Zet; Befozi; Bevizil; Bexicom-Z; Biocal-95; Biostrum; Cado;
Cal-95; Calcium-Sandoz Junior Growth; Calciviton; Calplex; Caltron;
Calvitos; Calvitran; Cerebrovit Active; Cerebrovit X-Cel; Cetop Zink;
Climadan; Colaskin; Coldizo; Danzet; Diasulin; Echinox; Eftian; Elanos Kids;
Elanos; Enerbex¤; Enfavit; Entrap; Erphacea; Ever Ost¤; Eyebright; Eyevit;
Ezygard; Farmabex Plus; Ferofort; Feroglobin; Feroglobin; Formuno; Fripos;
GCM; Glimunos; Hemaviton Action; Hemaviton Brain Nutrient¤; Hemaviton
C; Hemaviton Skin Nutrient; Hepachol; Heparviton NF; Hical; Ilefrin;
Imboost Force; Imboost; Imforce Plus; Imforce; Immu-cea; Immu-cea;
Imodul; Imodul; Imudator; Imufor; Imumax; Imunal Plus; Imunogard;
Imunos; Imunos; Imunvit Plus; Imustrum; Indofrin-A¤; Indofrin¤; Isofem¤;
Isotic Frizin; Joint Care Plus; Joint Care; Jointace; Kidimun; Lactacin;
Lanavision Plus; Lavarix; Livercare; Lubire; Lutevision Extra; Lutevit;
Lycoten; Lycoxy; Matoflam; Matovit AX; Maxirex; Maxivit; MD-Cal;
Megazing; Muveron; My Caps; Naturema; Neo Hormoviton; Neoboost Kids;
Neoboost; Noros; Nufit; Nufit; Nuvision; OA Forte; OA Plus; OA; Ocu-V;
Oculex; Oculosan; Opinacea; Opinacea; Optha-LL; Optimax Plus; Optimax;
Osamin; Osfit; Ossovit Plus; Ossovit; Oste; Ostela; Osteocal Plus;
Osteocare; Osteoflam; Osteokom Forte; Osteokom; Osteonic; Osteor Plus;
Osteor; Ostine; Ostrimix; Osvion Plus; Oxcal; Oxypen; Proza; Proza; Qutan10; Radiblock; Radivit; Ratax; Rebone; Redoxon Double Action; Reticopen;
Retivit Plus; Retivit; Retop; Rheumatin Forte; Rheumatin; Risteon; Scaven;
Seleca; Selefit Plus; Seloxy AA; Seloxy; Solvitron; Soprost¤; Stacare;
StarMuno; StarMuno; Steopor; Surbex-Z; Tetris; Tonikum Bayer; Univoxy;
Vantiz; Vialyn; Vionin NF; Viopor-M Forte; Viopor-M; Viopor; Vioxy-fm;
Vioxy; Vipro-G; Vistrum; Vitanox; Vitazet; Vitner-Z; Viusid; Vizibex;
Vossecal; Xepavit; Ximun; Zegavit; Zevibex; Zevit Grow; Zevit Grow;
Zeviton; Zinc Pharmacore; Zincopto; Zinone; Zivon; Ireland: Caltrate
Plus¤; Efalith¤; Lypsyl Cold Sore Gel¤; Ocuvite¤; Redoxon Double Action;
Zineryt; Israel: Caltrate Plus¤; Hemo; Stresstabs with Zinc¤; Visine AC;
Italy: Acnesan; Adrenosin Composto¤; Allercalm¤; Argidam; Artrosulfur;
Assist; Astar; Bagno Oculare¤; Caresel; Chiton; Cuprosodio Plus;
Cuprosodio; Deproctol; Deroidal; Dicotuss; Emmenoiasi; Emoform Alifresh;
Euretin Duo; Eutears; Flogovis; Forbrand; Formedico; Gemiol Plus; Ginsana
Ton; Immun-up Junior; Imoviral Junior; Indaco; Inflamase; Influ-Zinc Gola;
Influ-Zinc; Linfoflu; Linfonorm; Listerine Tartar Control; Lozione Same AS¤;
Meziv¤; Neosulfur¤; Nevril; Novostatin; Opti-Mag¤; Osteo Complex;
Periogard Plus; Ramno Fix; Ramnoflor Plus; Rinotrofina C; Rodopsin Plus¤;
Rubrojunior; Rubrovital; Salovit; Sametrix; Selemax¤; Serilact; Spm-OK;
Traumaven; Troca Cationi; Troca Flu; Video Capsule con Mirtillo¤; Virman
Plus; Visu-len; Vitreolux; Zinc-Imizol; Zincoimidazyl¤; Zincometil; Zincoral;
Zineryt; Malaysia: Adult Citrex; Caltrate Plus; Eurobio Bio-Vizmax; Evelle;
Oculosan¤; Surbex with Zinc; Visionex¤; Zincfrin¤; Mexico: Afazol Z;
Alfavit-Eoxi¤; Alpharexin¤; Caladryl Clear; Dalidome; Daribur; Drusen;
Exastrin; Gripaleta¤; Hemoinfant; Hierrocal Z-Plus; Micostatin Baby;
Oleomed A¤; Optima IFX; Periodentyl; Periodentyl; Soyaloid Apruri;
Tokolirio; Unguento Cruz; Unguento de la Madre; Unguento Sulfatiazol
Rojtier; Z Frin; Zinc Ofteno; Zincfrin-A; Zincfrin; Netherlands: Zincfrin¤;
Zineryt; Norway: Berocca; New Zealand: Caltrate Plus; Clear Eyes ACR;
Efalith¤; Listerine Tartar Control¤; Prefrin Z¤; Redoxon Double Action¤;
Strepsils Zinc Defence; Zincfrin¤; Philippines: Ad-C Plus; Bo-D-Fense¤;
Caltrate Plus; Carofit; Ceegeefer¤; Ceelin Plus; CeeZinc; Conzace; Cristane;
Dayzinc; Diamaxin; Dreamvite; Ener A Plus; Enervon with E & Zinc; Folium
OB; Hi-Smart Teens; Hi-Smart; Listerine Tartar Control; Memorx IQ Plus;
Neurosmart; Nutrafem; Nutrazinc; Nutricaire; Nutrigrow Plus; Nutrof¤;
Oculosan; Omnimune; Optigrow; Osteocare¤; Pedzinc Plus C; Regeron Vita
with Chlorella; Regeron Vita with Chlorella; Restor-F; Restor; Vigor-ACE;
Vita SL Plus; Vitaplex; Vitazinc; Z-Vita; Zeeplus; Zeman; Zimuvite; Poland:
Biherpan¤; Caltrate Plus; Cincol; Hemcort HC¤; Hemkortin-HC; Naturapia
Prostata¤; Oculosan; Rutinoscorbin Plus; Zincuprin¤; Zineryt; Portugal:
Bioclin Kera¤; Bioclin Sebo Care; Caltrate Plus Mastigavel¤; Caltrate Plus¤;
Cystinex¤; Ecophane¤; Ever-Fit Dermo; Fortal Vision; Hexaphane¤;
Hipersex¤; Kemphor; Mentofenol¤; Neuroftal¤; Oralbiotico¤; Oratol; Rilastil
Anti-Oxidante; Vitace; Vitacrecil¤; Zineryt; Russia: Anusol (Анузол);
Berocca Plus (Берокка Плюс); Complivit Oftalmo (Компливит Офтальмо);
Diacine (Диацин); Fenules Zinc (Фенюльс Цинк); Novosept (Новосепт
Форте); Ocumethyl (Окуметил); Oftalmol (Офтальмол); Osteocare
(Остеокеа); Reddyvit (Реддивит); Relief Ultra (Релиф Ультра); Zineryt
(Зинерит); South Africa: Hepavite¤; Nazene Z; Neurotone; Oculoforte¤;
Oculosan; Tartar Control Listerine¤; Vitamag; Zincfrin-A¤; Zincfrin¤;
Zineryt; Singapore: Berocca Boost; Berocca Performance; Biogaia Protectis
ORS; Bios Life; Calmag Zn¤; Caltrate Plus; Chitosano; Enerbolis; Evelle;
Glutamine Plus; Immunped Zinc Plus; Listerine Bright & Clean; Listerine
Tartar Control¤; Manhae; Multitrace-5; New Daigaku¤; Nutrivision¤; Ocuvite
Adult 50+; Optibiol; Proza; Raricap Combi; Redoxon All Day Defence;
Redoxon Double Action; Redoxon Kids; Regulator; Robovites Multivitamins;
Seven Seas Zinc Plus Vitamin C; Surbex with Zinc; Vigor-Ace; Visionex¤;
Vita Calmag Zn; Zeman; Spain: Acnosan¤; Astringen¤; Astringente¤; Buco
Regis; Cilinavagin Neomicina¤; Clo Zinc¤; Cloram Zinc¤; Coliriocilina Adren
Astr¤; Dexa Vasoc¤; Faderma¤; Fluo Vasoc¤; Mirantal¤; Odamida;
Odontocromil c Sulfamida¤; Regal Tirotricina¤; Regal¤; Vasocon Ant¤;
Vasoconstr¤; Vasoconstricto¤; Zincfrin¤; Zineryt; Sweden: Mezinc¤;
Zincfrin¤; Switzerland: Acne Lotion; Acnidazil¤; Berocca calcium,
magnesium + zinc; Bonactin¤; Cadmiofrine¤; Collypan; Eau pour les yeux¤;
Efalith; Hima-Pasta; Lipactin; Oculosan forte¤; Oculosan; Redoxon + Zinc;
Rocanal Permanent Gangrene¤; Rocanal Permanent Vital¤; Zincfrin-A¤;
Zincfrin¤; Thailand: B-Z Vit; Beplex-Zee¤; Berocca; Bio-Selenium Zinc;
Biotrat; Calplus MZ; Caltrate Plus; Calvin Plus; Diavit; Enervon-MV¤; Mac-Q-
Vis; Oculosan; Ocuvite; Opplin; Redoxon Zinc; Surbex-Zinc¤; Visotone; ZBec; Zinc B, E & C¤; Zincfrin¤; Turkey: Alkagin; Eser Metaller; Ferrozinc;
Immuzinc; Magnezinc; Osteocare; Piyraleks; Sena-Oil; Zinco C; United
Kingdom: Amino PG¤; Antioxidant Nutrients¤; Betaimune; Brushtox;
Caltrate Plus; CB12; Ceezinc¤; Dencyl¤; Dispello; Ditemic¤; Efalith¤; Fefol
Z¤; Feospan Z¤; Feroglobin; Fesovit Z¤; Lacrima; Lypsyl Cold Sore Gel;
Nutrideen; Ocusol¤; Osteocare; Ostron; Pennine¤; Redoxon Double Action;
Se-Power; Selene-Activ; Selenium Bonus; Strepsils Zinc Defence¤; Tri-Ac¤;
Vicks Vital¤; Vitalux Plus; Zinc Plus¤; Zinc-ACE; Zineryt; Ukraine: Berroca
Plus (Берокка Плюс)¤; Calcemin (Кальцемин); Calcemin Silver (Кальцемин
Сильвер); Cliran Zinc (Клиран Цинк); Curiosin (Куриозин); Fersinol-Z
(Ферсинол-З); Fitoval Capsules (Фитовал капсулы); Gentaxan (Гентаксан);
Kuriosin (Куриозин); Livonorm (Ливонорм); Ocuvite Complete (Окювайт
Комплит); Ocuvite Lutein Forte (Окювайт Лютеин форте); Optix (Оптикс);
Osteocare (Остеокеа)¤; Ranferon-12 (Ранферон-12); Relief Ultra (Релиф
Ультра); Revalid (Ревалид); Vitrum Cardio (Вітрум Кардио); Vitrum Foreyes
Forte (Вітрум Форайз Форте); Vitrum Memory (Витрум Мемори); Zineryt
(Зинерит); United States: Adeks¤; AKEDamins; Amerigel; Anti-Itch;
Antioxidant Formula; AquADEKS; Astring-O-Sol¤; Benadryl Itch; Better
Prostate¤; Biotene with Calcium; Blood Sugar Balance; Calaclear; Caladryl
Clear; Calagel; Callergy Clear; Caltrate Plus; CF Vite¤; Cholesterol Support;
Clear Eyes Seasonal Relief; Clearly Cala-gel¤; Corvite FE; Corvite; Cro-ManZin; Dentiva; Dermadrox; Dermasept Antifungal; Ester-C Plus Multi-Mineral;
Gets-It; Herpetrol; I-Vite Protect; Invites RX; Macular Vitamin Benefit;
MacuTrition; Mineral Zinc; Nasal-Ease; Nasal-Ease; Neotic¤; Obstetrix;
Oncovite; One A Day Vitacraves; Orajel Mouth Aid; Otozin; PNV-Iron¤;
Prena1 with Quatrefolic; Prenatal 1; Prenatal Plus; Prenatal; Preservision
Eye Vitamin; Prostate Support; Salese; Select-OB + DHA; Sucrets Defense
Kids Formula; Sulpho-Lac; Super Ivy Dry; Tri-zel; Udamin SP; Udamin;
VasoClear A; Visine Allergy Relief¤; Visine Totality Multi-Symptom Relief;
VitaMedMD One Rx; VP-Zel; Wound Cleanser; Ze Caps¤; Zincfrin¤; Zinotic¤;
Venezuela: Calasyl Transparente; Dermagran; Dermagran; Diamel;
Ferronorm; Ocoxin; Oxi-Cell Plus¤; Sebium AKN; Terace Zinc; Uvagen;
Vitalux; Viusid;
Pharmacopoeial Preparations (Latest modification: 23-Oct-2013)
BP 2013: Erythromycin and Zinc Acetate Lotion; Zinc Sulphate Capsules;
Zinc Sulphate Eye Drops; Zinc Sulphate Injection; Zinc Sulphate Lotion; Zinc
Sulphate Tablets; USP 36: Calcium and Vitamin D with Minerals Tablets;
Minerals Capsules; Minerals Tablets; Oil- and Water-soluble Vitamins with
Minerals Capsules; Oil- and Water-soluble Vitamins with Minerals Oral
Solution; Oil- and Water-soluble Vitamins with Minerals Tablets; Oil-Soluble
Vitamins with Minerals Capsules; Oil-Soluble Vitamins with Minerals Oral
Solution; Oil-Soluble Vitamins with Minerals Tablets; Water-soluble Vitamins
with Minerals Capsules; Zinc Acetate Oral Solution; Zinc and Vitamin C
Lozenges; Zinc Chloride Injection; Zinc Citrate Tablets; Zinc Gluconate
Tablets; Zinc Sulfate Injection; Zinc Sulfate Ophthalmic Solution; Zinc
Sulfate Oral Solution; Zinc Sulfate Tablets; Zinc Sulfide Topical Suspension;
Homoeopathic Preparations (Latest modification: 26-Sep-2013)
actively marketed.
Australia: Nervatona Calm; Nervatona Focus; Snore Eze; Stress Relief¤;
Austria: Gracil; Schlaftropfen Nr 30¤; Canada: Cold Tablets with Zinc¤;
Constipation L106¤; Echinacea Compositum; Formula PC 223¤; Serenol¤;
Weight Loss Kit¤; Chile: Ikoplex No 9; Czech Republic: Vita C-R15 forte¤;
Vita C-R15¤; France: Abbe Chaupitre no 23¤; Acidum Phosphoricum
Complexe No 5; Dolidermil¤; Granules Boripharm no 24¤; Germany:
Corallium I/ 02 B¤; Discus compositum¤; Dormi-cyl L Ho-Len-Complex;
Gelsemium Comp; Hypotonex¤; Infi-China; NeyArthros-Liposome
(Revitorgan Lp Nr 83)¤; NeyArthrosome (Revitorgan-Dilution)¤; NierenElixier ST¤; Pasivital h¤; Phonix Antitox¤; Phonix Cuprum I/0178A¤; Phonix
Ferrum O32 A¤; Phonix Lymphophon¤; Phonix Phonohepan¤; Phonix
Phonomigral¤; Phonix Plumbum 024 A¤; Phonix Silybum spag; Phonix
Spongia 013 B¤; Phonix Tartarus III/020¤; Phonix Thuja-Lachesis spag;
Phonix Urtica-Arsenicum spag; Presselin Nervenkomplex; Presselin
Nervennahrung N¤; Ranocalcin HM; Rufebran regeno¤; Secale (Hevertoplex
147)¤; Vita-C R15¤; Zerosorin SN¤; Zincum Hevert N; Zinkokehl; Zinkorell;
Netherlands: Emvita 15; Portugal: Sportenine¤; Russia: Passidorm
(Пассидорм); Ukraine: Echinacea Comositum S (Эхинацея Композитум
С)¤;
Martindale: The Complete Drug Reference © 2013 The Pharmaceutical Press.
MedicinesComplete © The Pharmaceutical Press 2014

Sub-sections Zinc Zinc Acetate Zinc Chloride Zinc Citrate

Transcription

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