Zinc Trace 1mg/ml Inj, 10ml

Manufacturer HOSPIRA Active Ingredient Zinc Chloride(zink KLOR ide) Pronunciation Zink KLOR ide
It is used to help growth and good health.
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Drug Class
Trace element, Nutritional supplement
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Pharmacologic Class
Essential mineral
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Pregnancy Category
C
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FDA Approved
Jan 1970
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DEA Schedule
Not Controlled

Overview

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What is this medicine?

Zinc Chloride Injection is a medicine given through a vein (intravenously) to provide your body with zinc, an essential mineral. Zinc is crucial for many body functions, including healing wounds, fighting infections, and proper growth. It's used when you can't get enough zinc from food, often in people receiving nutrition through an IV.
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How to Use This Medicine

To use this medication correctly, follow your doctor's instructions and carefully read all accompanying information. Take this medication exactly as directed, and adhere to all guidelines provided. This drug is administered as an intravenous infusion, which involves slowly injecting the medication into a vein over a specified period of time, typically after it has been mixed with other fluids.

If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.

If you miss a dose, contact your doctor immediately to receive guidance on the appropriate course of action.
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Lifestyle & Tips

  • Follow all instructions from your healthcare provider regarding your nutrition plan.
  • Report any new or worsening symptoms immediately.

Dosing & Administration

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Adult Dosing

Standard Dose: 2.5 to 4 mg zinc/day (for stable patients on parenteral nutrition)
Dose Range: 2.5 - 12.5 mg

Condition-Specific Dosing:

acuteCatabolicStates: Up to 12.5 mg zinc/day
intestinalLosses: Additional 2 mg zinc/day for each liter of small bowel fluid loss
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Pediatric Dosing

Neonatal: 300 mcg zinc/kg/day (for premature infants up to 3 kg)
Infant: 100 mcg zinc/kg/day (for term infants and children up to 5 years)
Child: 100 mcg zinc/kg/day (up to 5 years); 2.5 to 5 mg zinc/day (over 5 years)
Adolescent: 2.5 to 5 mg zinc/day
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Dose Adjustments

Renal Impairment:

Mild: Monitor zinc levels; dose adjustment may be needed based on levels and clinical status.
Moderate: Monitor zinc levels closely; reduced dose may be needed due to decreased excretion.
Severe: Monitor zinc levels closely; reduced dose is typically required. Avoid excessive accumulation.
Dialysis: Zinc requirements may vary; monitor plasma zinc levels and adjust dose accordingly. Dialysis can remove some zinc.

Hepatic Impairment:

Mild: Monitor zinc levels; dose adjustment may be needed.
Moderate: Monitor zinc levels closely; dose adjustment may be needed due to altered metabolism and excretion.
Severe: Monitor zinc levels closely; dose adjustment is typically required. Patients with cholestasis may have increased zinc excretion.

Pharmacology

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Mechanism of Action

Zinc is an essential trace element vital for numerous biological processes. It acts as a cofactor for over 300 enzymes involved in metabolism, DNA and RNA synthesis, protein synthesis, cell division, and gene expression. It plays a crucial role in immune function, wound healing, growth, and sensory functions (taste and smell). Zinc also has structural roles in proteins and cell membranes, contributing to their stability and function.
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Pharmacokinetics

Absorption:

Bioavailability: 100% (intravenous administration)
Tmax: Not applicable (IV administration)
FoodEffect: Not applicable (IV administration)

Distribution:

Vd: Not well-defined for a single dose; widely distributed throughout the body, with high concentrations in bone, muscle, skin, hair, prostate, and eye. Total body zinc is approximately 1.5-3 grams.
ProteinBinding: Approximately 80% of plasma zinc is bound to albumin, 15% to alpha-2 macroglobulin, and 5% to amino acids (e.g., histidine, cysteine).
CnssPenetration: Limited, but essential for normal brain function and development.

Elimination:

HalfLife: Complex; plasma half-life is biphasic, with an initial rapid phase (minutes to hours) and a slower phase (days to weeks) reflecting tissue turnover and redistribution.
Clearance: Primarily via fecal excretion (biliary and pancreatic secretions); minor renal excretion.
ExcretionRoute: Fecal (major), Renal (minor)
Unchanged: 100% (as it is an element)
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Pharmacodynamics

OnsetOfAction: Not applicable in the typical pharmacological sense; effects are related to maintaining or restoring physiological zinc levels, which can take days to weeks to correct deficiency.
PeakEffect: Not applicable; continuous supply maintains steady-state levels.
DurationOfAction: Continuous as long as administered; body stores can maintain function for a period after cessation.

Safety & Warnings

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Side Effects

Urgent Side Effects: Seek Medical Attention Immediately
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 medical help right away:
- 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, or 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 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. Your doctor is available to provide medical advice about side effects.
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Seek Immediate Medical Attention If You Experience:

  • Signs of too little zinc: new skin rashes (especially around mouth, hands, feet), hair loss, poor wound healing, frequent infections, changes in taste or smell.
  • Signs of too much zinc: nausea, vomiting, stomach pain, diarrhea, feeling tired, dizziness, headache, fever, chills, or yellowing of skin/eyes (signs of copper deficiency).
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Before Using This Medicine

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about any allergies you have, including:
- An allergy to this medication or any of its components
- An allergy to other medications, foods, or substances
When discussing your allergy, be sure to describe the symptoms you experienced.

This medication may interact with other medications or health conditions. To ensure safe use, it is crucial to:
- Inform your doctor and pharmacist about all medications you are taking, including prescription and over-the-counter drugs, natural products, and vitamins
- Share information about any health problems you have
You must verify that it is safe to take this medication with all your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
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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. Discuss any concerns or questions you have with your doctor.

This medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. This risk is particularly higher if you have kidney problems or if you are a premature infant. It is crucial to discuss this potential risk with your doctor.

If you are pregnant, planning to become pregnant, or are breastfeeding, you must notify your doctor. You and your doctor will need to weigh the benefits and risks of taking this medication to ensure the best possible outcome for you and your baby.
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Overdose Information

Overdose Symptoms:

  • Nausea
  • Vomiting
  • Abdominal pain
  • Diarrhea
  • Lethargy
  • Dizziness
  • Headache
  • Fever
  • Chills
  • Copper deficiency (manifesting as anemia, neutropenia, neurological symptoms)

What to Do:

Seek immediate medical attention. Management is supportive. In severe cases of acute toxicity, chelation therapy (e.g., with EDTA) may be considered, but is rarely needed for chronic excess. Copper supplementation may be required if copper deficiency is induced.

Drug Interactions

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Moderate Interactions

  • Copper (high zinc intake can induce copper deficiency by interfering with absorption and ceruloplasmin synthesis)
  • Iron (high oral iron intake can interfere with oral zinc absorption, less relevant for IV)
  • Chelating agents (e.g., penicillamine, EDTA - can increase zinc excretion and lead to deficiency)

Monitoring

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Baseline Monitoring

Plasma Zinc Levels

Rationale: To assess baseline status, especially if deficiency is suspected or patient is at high risk (e.g., malabsorption, high GI losses).

Timing: Prior to initiation of therapy, if indicated.

Clinical Signs of Zinc Deficiency

Rationale: To identify symptoms such as dermatitis, alopecia, impaired wound healing, immune dysfunction, or growth retardation.

Timing: Prior to initiation and throughout therapy.

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Routine Monitoring

Plasma Zinc Levels

Frequency: Weekly initially, then monthly or as clinically indicated (e.g., in long-term PN, renal/hepatic impairment, or high-output GI losses).

Target: 70-120 mcg/dL (adults)

Action Threshold: Below target range (consider increasing dose); above target range (consider decreasing dose or investigating toxicity).

Clinical Status (e.g., wound healing, immune function, skin integrity)

Frequency: Daily/Weekly

Target: Improvement or maintenance of normal function

Action Threshold: Worsening symptoms or new signs of deficiency/toxicity.

Copper Levels (if high zinc doses or long-term therapy)

Frequency: Periodically (e.g., every 3-6 months)

Target: Normal range

Action Threshold: Low copper levels (may indicate zinc-induced copper deficiency).

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Symptom Monitoring

  • Signs of zinc deficiency (e.g., acrodermatitis enteropathica-like rash, alopecia, impaired wound healing, immune dysfunction, growth retardation, diarrhea, impaired taste/smell)
  • Signs of zinc toxicity (e.g., nausea, vomiting, abdominal pain, diarrhea, lethargy, dizziness, headache, fever, chills, copper deficiency, anemia, neutropenia)

Special Patient Groups

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Pregnancy

Zinc is an essential nutrient during pregnancy for fetal growth and development. Deficiency can lead to adverse outcomes. However, excessive zinc intake can also be harmful. IV zinc should be administered to meet physiological requirements, especially in women on parenteral nutrition, with careful monitoring of levels.

Trimester-Specific Risks:

First Trimester: Essential for early embryonic development; deficiency can impair organogenesis.
Second Trimester: Continued need for fetal growth and maternal tissue expansion.
Third Trimester: High demand for rapid fetal growth; deficiency can impact birth weight and neurological development.
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Lactation

Zinc is an essential component of breast milk. IV zinc supplementation is generally considered compatible with breastfeeding when administered to meet maternal nutritional needs. Monitor infant for any adverse effects, though unlikely with appropriate maternal dosing.

Infant Risk: Low risk with appropriate maternal dosing; essential for infant growth and development.
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Pediatric Use

Pediatric patients, especially premature infants, have specific and higher per-kilogram zinc requirements due to rapid growth. Dosing must be carefully calculated based on weight and age to prevent both deficiency and toxicity. Close monitoring of plasma zinc levels is crucial.

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Geriatric Use

No specific dose adjustments are typically required for geriatric patients beyond those for renal or hepatic impairment. However, older adults may have altered nutritional status or comorbidities that affect zinc requirements or excretion, necessitating careful monitoring.

Clinical Information

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Clinical Pearls

  • Zinc is a critical trace element for patients on long-term parenteral nutrition, especially those with high gastrointestinal losses (e.g., high-output ostomies, short bowel syndrome).
  • Monitor plasma zinc levels regularly, particularly in patients with renal or hepatic dysfunction, or those with significant fluid losses, to guide appropriate dosing and prevent both deficiency and toxicity.
  • Excessive zinc supplementation can induce copper deficiency, leading to anemia and neutropenia. Monitor copper levels if high zinc doses are used or for prolonged periods.
  • Administer zinc chloride injection as part of a complete parenteral nutrition solution, not as a standalone bolus, due to its concentration and potential for irritation.
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Alternative Therapies

  • Oral zinc supplements (e.g., zinc sulfate, zinc gluconate, zinc acetate) for patients who can tolerate enteral nutrition and have less severe deficiency or lower requirements.
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Cost & Coverage

Average Cost: Highly variable; typically low for the raw material, bundled within parenteral nutrition solutions. per 10ml vial
Generic Available: Yes
Insurance Coverage: Typically covered as part of medically necessary parenteral nutrition or trace element supplementation by most health insurance plans.
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General Drug Facts

If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed otherwise, do not flush medications down the toilet or pour them down the drain. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the quantity, and the time of ingestion.