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Dear Readers! I started this blog when my daughter was in the NICU. She had ventriculitis. Her CSF report grew E.coli. But, she was injected Teicoplanin directly into her brain. The doctors made two errors here:

Teicoplanin is for gram-positive bacteria only. It does not treat E.coli.
Teicoplanin is not for intraventricular use. The manufacturer strongly discourage injecting Teicoplanin into the brain.

My daughter bled into the brain. She lived for another two years and ultimately died.

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Zinc gluconate (For Common Cold) - Drug Information

Zinc gluconate interferes with the adhesion and cleavage of rhinoviruses (when used to treat the common cold) and protects the plasma membrane from destruction by complement and microbial toxins.

It is used to treat patients with the following conditions:

Dietary supplement:
- It is used as a dietary supplement.
Common cold:
- It reduces the severity and duration of signs of the typical cold.

Zinc acetate is used to treat patients with Wilson's disease. Zinc chloride is used in patients on total parenteral nutrition.

Zinc gluconate Dose in Adults

Dose in the treatment of Common cold:

Note: Treatment should begin 24 - 48 hours before the onset of symptoms
- As needed, dissolve one 13.3 mg lozenge in your mouth every 2 to 4 hours.
- Daily maximum: 6 lozenges.

Dose in the treatment of Dietary supplements:

One capsule or tablet orally daily or as advised by a health care provider.

Zinc gluconate Dose in Children

Zinc gluconate dose in the treatment of Common cold:

Treatment should begin 24 to 48 hours before the onset of the symptoms:

Cold-Eeze Lozenge:

Children ≥12 years and Adolescents:
- Every two to four hours, or as needed, dissolve a lozenge in your mouth.
- The maximum daily dose is age-dependent:
  - 12 -17 years: 4 lozenges/day;
  - 18 years or more: 6 lozenges/day.

Dose in the treatment of Zinc deficiency:

Note: Dosage is expressed in terms of elemental zinc.

Acquired:
- Infants, Children, and Adolescents:
  - 5 to 1 mg/kg/day orally.
Acrodermatitis enteropathica:
- Infants, Children, and Adolescents:
  - 3 mg/kg/day orally.

Pregnancy Risk Factor C

The placenta regulates the fetal zinc concentrations and increases the RDA during pregnancy.
Zinc passes across the placental barrier.
It can also be measured in cord blood and placenta.

Zinc gluconate use during breastfeeding:

Breast milk contains zinc.
Supplements to maternal diets do not affect the zinc content of breastmilk.
After 6 months of lactation, it tends to decrease in quantity.
The maternal requirement (RDA), is higher than that of non-lactating females.

Zinc gluconate Dose in Renal Disease:

The manufacturer has not recommended any dose adjustment in patients with kidney disease.

Zinc gluconate Dose in Liver Disease:

The manufacturer has not recommended any dose adjustment in patients with liver disease.

Side effects of zinc gluconate:

Endocrine & metabolic:
- Decreased HDL Cholesterol
- Copper Deficiency
- Decreased LDL Cholesterol
Central nervous system:
- Headache
Hematologic & oncologic:
- Immunodeficiency
Gastrointestinal:
- Diarrhoea
- Epigastric Pain
- Gastrointestinal Distress
- Abdominal Cramps
- Decreased Appetite
- Nausea
- Vomiting

Contraindication to Zinc gluconate Include:

The manufacturer's labelling does not contain any contraindications.

Warnings and precautions

Malabsorption syndromes:
- Zinc absorption may be reduced and urine excretion may be increased in patients with malabsorption conditions such as Crohn's disease, short bowel syndrome, and sprue.

Drug Interaction with Zinc Gluconate

Risk factor X (Avoid combination)

Bisphosphonate Derivatives

Products containing polyvalent cations may lower the level of bisphosphonate derivatives in the serum. The following oral drugs should not be used within the following time frames: 2hrs prior to or after tiludronate/clodronate/etidronate; 60 mins after oral ibandronate; or 30 mins after alendronate/risedronate. Exceptions: Zoledronic Acid; Pamidronate

Bictegravir

Products containing polyvalent cations may lower bictegravir's serum levels. Treatment: Bicategravir should be administered while fasting at least two hours before or six hours after using products containing polyvalent cations. It is not advised to take bictegravir at the same time as or two hours after most polyvalent cation products.

Ceftibuten

Ceftibuten's serum levels may drop if you take zinc salts. Treatment: Take into account giving oral zinc salts at least 3hrs after taking ceftibuten.

Deferiprone

Products containing polyvalent cations may lower the level of deferiprone in the serum. Treatment: Give deferiprone at least four hours apart from oral drugs or dietary supplements containing polyvalent cations.

Cephalexin

Cephalexin may be less readily absorbed if you take zinc salts. Treatment: Take into account giving zinc salts orally at least 3hrs after cephalexin.

Dolutegravir

Dolutegravir's serum levels may be lowered by zinc salts. Treatment: Dolutegravir should be administered at least 2hrs prior to or 6hrs after oral zinc salts. When taking oral zinc salts, provide the dolutegravir/rilpivirine mixture product at least 4hrs prior to or 6hrs after.

PenicillAMINE

Products containing polyvalent cations may lower the level of penicillAMINE in the serum. Treatment: Give oral medications containing polyvalent cations and penicillamine at least an hour apart.

Quinolones

Quinolones' serum concentration may be lowered by zinc salts. Treatment: Oral quinolones should be administered at least a few hours before or after oral zinc salts (4hrs for lome-, 8hrs for moxi-, 3hrs for gemi-, 6hrs for cipro/dela-, and 2hrs for levo-, nor-, or peor ofloxacin or nalidixic acid). Other than LevoFLOXacin (Oral Inhalation).

Eltrombopag

Eltrombopag should be administered at least two hours prior to or four hours following the administration of any oral drug containing polyvalent cations. Eltrombopag's serum levels may be decreased by products containing polyvalent cations.

Tetracyclines

Tetracyclines may be less readily absorbed if you take zinc salts. Only a problem if both medications are taken orally. Management: Take doxycycline into account as a tetracycline derivative that does not interact. To reduce interaction, administer oral zinc salts and tetracycline derivatives at least 2hrs apart. Doxycycline and eravacycline are exceptions.

Raltegravir

Products containing polyvalent cations may lower the level of raltegravir in the blood. Treatment: Give raltegravir 2hrs prior to or 6hrs following the polyvalent cations. The impact of this interaction might not be sufficiently reduced by dose separation.

Trientine

Products containing polyvalent cations may lower the level of trientine in the serum. Management: Steer clear of combining the use of oral medications containing polyvalent cations with trientine. If you need to take oral iron supplements, space out the administration by 2hrs. Separate administration of other oral polyvalent cations by one hour if necessary.

Risk factor X (Avoid combination)

Baloxavir Marboxil

Products containing polyvalent cations may lower the level of baloxavir marboxil in the serum.

Monitor:

No monitoring is required.

How to administer Zinc gluconate?

It is administered with food orally to avoid stomach upset.
The lozenges are dissolved in the mouth.
Chewing should be avoided.
Patients should be advised to avoid drinking and eating for at least 15 minutes after its administration.

Mechanism of action of Zinc gluconate:

Zinc is vital for our bodies. Zinc is found in nearly every cell of the body and is necessary for the proper functioning of more than 100 enzymes.
Zinc deficiency may lead to an increase in the incidence of infections.
It prevents the adhesion or cleavage by rhinoviruses (when it is used to treat the common cold) and protects plasma membranes from damage by complement and microbial toxicants.

Absorption: Small intestine.

Excretion: Feces and urine.

Distribution: Stored primarily in skeletal muscle and bone.

Protein binding: Primarily to albumin.