Zinc Sulfate 220mg Tablets
It is used to help growth and good health.
Drug Class
Trace element supplement
Pharmacologic Class
Essential mineral
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Zinc sulfate is a mineral supplement used to treat or prevent zinc deficiency. Zinc is important for your immune system, wound healing, and many other body functions.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. You can take this medication with or without food. If it causes stomach upset, taking it with food may help.
Storing and Disposing of Your Medication
Keep your medication at room temperature in a dry place, avoiding storage in bathrooms. Ensure all medications are stored safely and out of reach of children and pets. When disposing of unused or expired medications, do not flush them down the toilet or pour them down the drain unless instructed to do so. Instead, consult your pharmacist for guidance on proper disposal. Many areas have drug take-back programs that can also assist with safe disposal.
Missing a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
To use this medication correctly, follow your doctor's instructions and read all the information provided. You can take this medication with or without food. If it causes stomach upset, taking it with food may help.
Storing and Disposing of Your Medication
Keep your medication at room temperature in a dry place, avoiding storage in bathrooms. Ensure all medications are stored safely and out of reach of children and pets. When disposing of unused or expired medications, do not flush them down the toilet or pour them down the drain unless instructed to do so. Instead, consult your pharmacist for guidance on proper disposal. Many areas have drug take-back programs that can also assist with safe disposal.
Missing a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
Lifestyle & Tips
- Take with food if stomach upset occurs, but be aware that food (especially dairy, whole grains, and high-fiber foods) can reduce absorption. If possible, take 1 hour before or 2 hours after meals.
- Avoid taking zinc supplements at the same time as iron, calcium, tetracycline antibiotics, or fluoroquinolone antibiotics. Separate doses by at least 2-4 hours.
- Do not exceed the recommended dose without consulting your doctor, as too much zinc can be harmful and lead to copper deficiency.
Available Forms & Alternatives
Available Strengths:
- Zinc Sulfate 220mg Capsules
- Zinc Trace 1mg/ml Inj, 10ml
- Zinc Oxide 20% Ointment 56.7gm
- Zinc Oxide 20% Ointment 28.4gm
- Zinc Sulfate 5mg/ml Inj, 5ml
- Zinc 50mg Tablets
- Zinc Sulfate 220mg Tablets
- Zinc Oxide 20% Ointment 30gm
- Zinc Oxide 20% Ointment 425gm
- Zinc Oxide Ointment 454gm
- Zinc Oxide 20% Ointment 60gm
- Zinc Sulfate 10mg/10ml Inj, 10ml
- Zinc Sulfate 220mg Capsules
- Zinc Sulfate 5mg/ml Inj, 5ml
- Zinc Sulfate 10mg/10ml Inj, 10ml
- Zinc Chloride 10mg/10ml Inj, 10ml
- Zinc Sulfate 3mg/ml Inj, 10ml
- Zinc Sulfate 3mg/ml Inj, 10ml
Dosing & Administration
Adult Dosing
Standard Dose:
220 mg (equivalent to 50 mg elemental zinc) once daily or as directed for zinc deficiency.
Dose Range:
220 - 660 mg
Condition-Specific Dosing:
zinc_deficiency:
220 mg (50 mg elemental zinc) 1 to 3 times daily, typically for 1-3 months. Higher doses may be used for specific conditions under medical supervision.
Pediatric Dosing
Neonatal:
Not established for routine use; specific dosing for acrodermatitis enteropathica or severe deficiency under specialist guidance.
Infant:
Not established for routine use; specific dosing for acrodermatitis enteropathica or severe deficiency under specialist guidance (e.g., 0.5-1 mg elemental zinc/kg/day).
Child:
For zinc deficiency: 0.5-1 mg elemental zinc/kg/day, up to 220 mg (50 mg elemental zinc) daily. Dosing should be based on elemental zinc content.
Adolescent:
For zinc deficiency: 220 mg (50 mg elemental zinc) once daily or as directed.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment needed.
Moderate:
No specific adjustment needed.
Severe:
Use with caution; monitor zinc levels. Accumulation may occur in severe renal failure. Adjustment may be needed if zinc levels are elevated.
Dialysis:
Monitor zinc levels. Supplementation may be needed due to losses during dialysis, but excessive accumulation should be avoided.
Hepatic Impairment:
Mild:
No specific adjustment.
Moderate:
No specific adjustment.
Severe:
No specific adjustment, but monitor zinc levels in severe liver disease as metabolism and excretion may be altered.
Pharmacology
Mechanism of Action
Zinc is an essential trace element required for the catalytic activity of approximately 100 enzymes and plays a role in immune function, protein and DNA synthesis, wound healing, and cell division. It is critical for normal growth and development during pregnancy, childhood, and adolescence, and for proper sense of taste and smell. Zinc sulfate provides a source of zinc ions to correct or prevent zinc deficiency.
Pharmacokinetics
Absorption:
Bioavailability:
20-40% (highly variable, influenced by diet and other minerals)
Tmax:
1-3 hours
FoodEffect:
Food, especially phytates (found in whole grains, legumes), fiber, and certain proteins (e.g., dairy), can significantly decrease zinc absorption. Best absorbed on an empty stomach, but may be taken with food to reduce GI upset.
Distribution:
Vd:
Not available (widely distributed throughout the body, with highest concentrations in muscle, bone, skin, hair, and prostate)
ProteinBinding:
Approximately 60% bound to albumin, 30% to alpha-2 macroglobulin, and 10% to other proteins and amino acids.
CnssPenetration:
Limited
Elimination:
HalfLife:
125 days (whole body turnover), but plasma half-life is much shorter (hours)
Clearance:
Not available
ExcretionRoute:
Primarily fecal (90%), with small amounts excreted in urine and sweat.
Unchanged:
100% (as elemental zinc)
Pharmacodynamics
OnsetOfAction:
Days to weeks for clinical improvement in deficiency symptoms.
PeakEffect:
Weeks to months for repletion of body stores.
DurationOfAction:
Dependent on continued intake and underlying deficiency.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek immediate medical attention:
* Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, discuss them with your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek immediate medical attention:
* Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, discuss them with your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe nausea or vomiting
- Severe diarrhea
- Unusual fatigue or weakness
- Pale skin (signs of anemia)
- Numbness or tingling in hands or feet (signs of neuropathy)
- Dizziness or lightheadedness
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor and pharmacist assess potential interactions between this medication and other substances.
* Any existing health problems, as this medication may interact with certain conditions.
To ensure your safety, it is crucial to verify that this medication can be taken with all your current medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor and pharmacist assess potential interactions between this medication and other substances.
* Any existing health problems, as this medication may interact with certain conditions.
To ensure your safety, it is crucial to verify that this medication can be taken with all your current medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood tests will be necessary, as directed by your doctor, to monitor your condition. Be sure to discuss any concerns or questions with your doctor. If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor immediately. You and your doctor will need to carefully weigh the benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe nausea
- Vomiting
- Diarrhea
- Abdominal pain/cramps
- Metallic taste in mouth
- Dizziness
- Lethargy
- Headache
- Irritability
- Anemia (due to copper deficiency with chronic overdose)
- Neurological symptoms (due to copper deficiency with chronic overdose)
What to Do:
Seek immediate medical attention or call Poison Control at 1-800-222-1222. Treatment is supportive; gastric lavage may be considered if ingestion is recent. Chelation therapy is generally not recommended for zinc overdose.
Drug Interactions
Major Interactions
- Tetracyclines (e.g., doxycycline, minocycline): Zinc can chelate tetracyclines, reducing their absorption. Separate administration by at least 2-4 hours.
- Fluoroquinolones (e.g., ciprofloxacin, levofloxacin): Zinc can chelate fluoroquinolones, reducing their absorption. Separate administration by at least 2-4 hours.
Moderate Interactions
- Iron supplements: High doses of iron can interfere with zinc absorption. Separate administration by at least 2 hours.
- Copper supplements: High doses of zinc can induce copper deficiency by increasing metallothionein synthesis, which binds copper. Monitor copper levels with long-term high-dose zinc.
- Penicillamine: Zinc can decrease the absorption of penicillamine. Separate administration by at least 2 hours.
- Diuretics (thiazide and loop): May increase urinary excretion of zinc, potentially leading to deficiency with long-term use.
Minor Interactions
- Calcium supplements: High doses of calcium may slightly reduce zinc absorption.
- Phytates (in whole grains, legumes): Reduce zinc absorption. Take zinc supplements away from meals high in phytates.
Monitoring
Baseline Monitoring
Serum Zinc Levels
Rationale: To confirm deficiency and establish baseline for treatment efficacy.
Timing: Prior to initiation of therapy.
Serum Copper Levels
Rationale: To assess for pre-existing copper deficiency and establish baseline, especially if high-dose or long-term zinc therapy is anticipated, due to risk of zinc-induced copper deficiency.
Timing: Prior to initiation of therapy.
Routine Monitoring
Serum Zinc Levels
Frequency: Every 1-3 months initially, then every 3-6 months for maintenance.
Target: 70-120 mcg/dL (or 11-18.4 micromol/L)
Action Threshold: If levels remain low despite therapy, assess adherence or absorption issues. If levels become excessively high, reduce dose or discontinue to avoid toxicity.
Serum Copper Levels
Frequency: Every 3-6 months, especially with high-dose or long-term therapy.
Target: 70-140 mcg/dL (or 11-22 micromol/L)
Action Threshold: If levels fall below normal range, consider reducing zinc dose or adding copper supplementation.
Clinical Symptoms of Zinc Deficiency (e.g., skin lesions, impaired wound healing, immune dysfunction)
Frequency: Ongoing clinical assessment.
Target: Resolution or improvement of symptoms.
Action Threshold: Lack of improvement may indicate inadequate dosing, poor absorption, or alternative diagnosis.
Symptom Monitoring
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Headache
- Metallic taste
- Fatigue (signs of copper deficiency with prolonged high-dose zinc)
- Anemia (signs of copper deficiency with prolonged high-dose zinc)
- Neuropathy (signs of copper deficiency with prolonged high-dose zinc)
Special Patient Groups
Pregnancy
Zinc is an essential nutrient during pregnancy. Zinc sulfate is generally considered safe when used at recommended doses to treat or prevent deficiency. High doses should be avoided unless specifically indicated and monitored by a healthcare provider.
Trimester-Specific Risks:
First Trimester:
Adequate zinc is crucial for early fetal development. Deficiency can lead to adverse outcomes. Supplementation at recommended doses is generally safe.
Second Trimester:
Continued need for zinc for fetal growth. No specific risks with appropriate supplementation.
Third Trimester:
Continued need for zinc for fetal growth. No specific risks with appropriate supplementation.
Lactation
Zinc is naturally present in breast milk and is essential for infant growth and development. Zinc sulfate supplementation at recommended doses is generally considered safe during lactation. High doses should be avoided.
Infant Risk:
L2 (Safer - limited data, no adverse effects reported in infants; risk of adverse effects is possible but unlikely).
Pediatric Use
Essential for growth and development. Dosing must be carefully calculated based on elemental zinc content and the child's weight and age. High doses can be toxic and lead to copper deficiency. Use under medical supervision.
Geriatric Use
No specific dose adjustments are typically needed. Elderly patients may be at higher risk for zinc deficiency due to dietary factors, malabsorption, or polypharmacy. Monitor for interactions and potential copper deficiency with long-term use.
Clinical Information
Clinical Pearls
- Zinc sulfate 220 mg provides 50 mg of elemental zinc, which is a common therapeutic dose for deficiency. Always clarify elemental zinc content when comparing products.
- Absorption of zinc is highly variable and significantly reduced by food, especially phytates. Advise patients to take it on an empty stomach if tolerated, or with a small, non-dairy meal to minimize GI upset.
- Long-term high-dose zinc supplementation (e.g., >50 mg elemental zinc/day) can induce copper deficiency, leading to anemia and neurological symptoms. Monitor copper levels in these patients.
- Educate patients about separating zinc from certain medications (tetracyclines, fluoroquinolones, iron) to prevent absorption issues.
- Zinc supplements can cause GI upset (nausea, vomiting, abdominal pain). Taking with food may help, but may reduce absorption.
Alternative Therapies
- Dietary modification (foods rich in zinc like red meat, poultry, seafood, nuts, legumes, dairy)
- Other trace element supplements (e.g., copper, selenium, manganese, if deficiencies are multiple)
Cost & Coverage
Average Cost:
$5 - $20 per 30 tablets
Generic Available:
Yes
Insurance Coverage:
Often covered as a generic or over-the-counter, but coverage varies by plan. May require prior authorization for higher doses or specific indications.
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.