Parenteral nutrition (PN) contains zinc sulphate as a trace ingredient to prevent zinc insufficiency. Orally, it is consumed as a dietary supplement.

Zinc sulfate Dose in Adults

Dose as a Dietary supplement:

• Once day, take 50 mg of elemental zinc orally.

Dose in the treatment of Parenteral nutrition additive as a maintenance requirement:

• (Dosage expressed as elemental zinc) intravenously
  • Metabolically stable:
    • 5 to 5 mg/day (ASPEN [Vanek 2012])
  • Acute metabolic states:
    • 5 to 6 mg/day

Dose in the treatment of Replacement for small bowel fluid loss (metabolically stable):

• 12.2 mg more zinc per litre of fluid loss, or 17.1 mg more zinc per kilogramme of stool or ileostomy output

Dose in the treatment of Zinc deficiency:

• Some medical professionals recommend zinc doses for a mild deficit of 2-3 times the RDA and for moderate to severe deficiency of 4-5 times the RDA for 6 months.

Zinc sulfate Dose in Children

Dose in the therapy of Parenteral nutrition as a supervision requirement:

Note:

• Patients who have burns, high-output intestinal fistulas, excessive, persistent diarrhoea, or limited intestinal absorption may need greater doses.
• Zinc atoms are used to express dosage.
   

• Age-directed dosing:

  • Infants less than 3 months:
    • 250 mcg/kg intravenously per day.
  • Infants over 3 months:
    • 50 mcg/kg intravenously per day.
  • Children:
    • intravenous administration of 50 mcg/kg/day with a daily dosage cap of 5,000 mcg

• Weight-directed dosing:

  • Infants less than 10 kg:
    • 50 to 250 mcg/kg intravenously each day.
  • Children between 10 to 40 kg:
    • To a daily dose limit of 5,000 mcg, administer 50 to 125 mcg/kg intravenously each day.
  • Children and Adolescents over 40 kg:
    • 2,000–5,000 mcg intravenously per day.

Dose in the therapy of Diarrhea in malnourished individuals:

Key point:

• Represented as a dosage in terms of elemental zinc
  At the first symptom of diarrhoea, it should be begun along with oral rehydration treatments.
• infants less than 6 months:
  • For 10 to 14 days, take 10 mg orally once daily.
• Infants over 6 months and kids:
  • For 10 to 14 days, take 20 mg orally once daily.

Dose in the therapy of Zinc shortage:

Note: represented as a dosage in terms of elemental zinc

• Acquired:

  • Infants, young children, and teenagers
    • 5 to 1 mg/kg/day orally.

• Acrodermatitis enteropathica:

  • Infants, young children, and teenagers
    • 3 mg/kg/day orally.

Pregnancy Risk Factor C

• Zinc can be detected in the placenta and cord blood after it has crossed the placenta.
• The placenta regulates fetal concentrations.

Use of zinc sulfate during breastfeeding

• Breast milk contains zinc.
• During the first six months of lactation, concentrations decrease.
• Dietary supplementation does not generally affect concentrations.

Zinc sulfate Dose in Renal impairment:

• Patients with renal problems should not have their dosage changed.

Zinc sulfate Dose in Liver impairments:

• Patients with liver problems should not have their dosage changed.

Side effects of Zinc sulfate

• Gastrointestinal:

  • Abdominal cramps
  • Vomiting
  • Diarrhea
  • Nausea

• Central nervous system:

  • Headache
  • Dizziness

Contraindication to Zinc sulfate includes:

• Do not administer bolus injections undiluted into peripheral veins

Caution and alerts

• Renal impairment
  • It must be used with caution by patients with impaired renal function.

Zinc sulfate: Drug Interaction

Monitor:

• Patients on chronic therapy and parenteral nutrition should have periodic serum copper and serum zinc levels measured.
• Monitor alkaline phosphatase
• Taste acuity
• Mental depression

How to administer Zinc sulfate?

• It should be administered orally with food if a gastrointestinal upset occurs

Parenteral:

• It should be diluted as a component of daily parenteral nutrition or maintenance fluids.
• Because of the potential for phlebitis and tissue irritation, it should not be given undiluted by direct injection into a peripheral vein as a bolus.

Mechanism of action of Zinc sulfate:

• Zinc sulfate can be used as a dietary supplement.

Absorption is low pH is more acidic and can be enhanced (pH less than 3). Food can reduce absorption.

distribution is found in the liver and skeletal muscle. The whole-body status of zinc is not accurately represented by serum levels.

Protein binding: 55% is bound to albumin, and 40% to alpha 1-macroglobulin

Excretion: Primarily in the faeces.

International Brands of Zinc sulfate:

• Afazol Z
• Ascazin
• Dalidome
• Daribur
• Daryazinc
• Exastrin
• L-Zinc
• Litezinc
• Solvazinc
• Solvezink
• Vytral
• Z Span
• Zimor
• Zincaps
• Zinchydra
• Zincocet DT
• Zincol
• Zincteral
• Zine
• Eye-Sed
• Orazinc
• Zinc 15
• Zinc-220

Zinc sulfate brands in Pakistan: