Zicam™ Information
Description: Zinc is a trace element. Zinc is distributed throughout the plant and animal kingdoms, second in abundance only to iron. As a trace element, zinc is essential for biologic functions and, in animals, is important in growth, appetite, testicular maturation, skin integrity, mental activity, wound healing, and immunocompetence. Zinc deficiency, first identified clinically in 1963 in young males in Iran and Egypt, is associated with diets high in unrefined cereal and unleavened bread, total parenteral nutrition (TPN), intestinal disease (i.e., Crohn's disease, pancreatic insufficiency), alcoholism, pregnancy, or in acrodermatitis enteropathica, an autosomal recessive disease characterized by zinc malabsorption. Commercially available zinc salts include zinc acetate, zinc chloride, zinc gluconate, zinc oxide, and zinc sulfate. Zinc sulfate, administered orally or parenterally, is the most common form of zinc used when a nutritional supplement is needed; it is the salt found in zinc-containing multivitamin preparation. Zinc sulfate is also used as an ophthalmic solution for mild ocular irritation. Zinc chloride is sometimes also used for IV nutritional supplementation; oral administration of zinc chloride is associated with significant nausea. Recently, zinc lozenges and zinc nasal spray have gained attention; these formulations are purported to treat symptoms of the common cold. Zinc oxide is a mild astringent with weak antiseptic properties and is applied topically as a sunblocking agent and to treat dermatologic conditions such as abrasions, burns, chafing, diaper rash, and minor skin irritations. Additionally, the antifungal compound zinc undecylenate and the antibacterial agent bacitracin zinc contain zinc as an astringent. Zinc is also used to stabilize insulin preparations such as protamine insulin. Zinc acetate is used topically as a non-prescription agent to treat poison ivy and related Rhus dermatitis. Most recently, oral zinc acetate (Galzin(R)) was granted FDA approval on January 29, 1997 for the oral treatment of Wilson's disease (hepatolenticular degeneration) and is the only prescription-only zinc product.
Mechanism of Action: Zinc is a component of many metalloenzymes in the human body. Serving as a cofactor, zinc is involved in such functions as synthesis or degradation of major metabolites (i.e., carbohydrates, lipids, proteins, nucleic acids), stabilization of protein and nucleic acid structure, transport processes, immune function, and expression of genetic information. Zinc is abundant in the nucleus of cells where it serves to stabilize RNA and DNA structure and is required for the activity of RNA polymerases important in cell division. Zinc is also present in the crystalline structure of bone, in bone enzymes, and at the zone of demarcation where it is thought to be important for adequate osteoblastic activity, formation of bone enzymes (i.e., alkaline phosphatase), and calcification. Topically administered zinc acts as an astringent and weak antiseptic. These actions are thought to be mediated by precipitation of proteins by zinc ions. Topical zinc salts include zinc chloride, zinc stearate, zinc oxide, zinc acetate, and zinc sulfate. In addition to its astringent and antiseptic effects, zinc sulfate administered as an ophthalmic solution also aids in the clearance of mucous from the outer surface of the eye and produces mild vasodilatation, however, it does not have any decongestant activity. To reduce the duration of symptoms of the common cold, oral lozenges of zinc gluconate have been beneficial.[1219] It is thought that zinc prevents rhinovirus particles from entering cells by combining with the carboxyl termini of rhinovirus coat proteins.[1219] This inhibits further virus reproduction. Zinc may also exert its antiviral effects, in part, by stabilizing and protecting cellular membranes. Cold symptom relief may be explained by an inhibitory effect of zinc ions on prostaglandin metabolism. There is still much debate on the mechanism and efficacy of zinc in treating the common cold. Zinc deficiency is manifest in a variety of organ systems signifying the importance of the mineral for biological function and development. Clinical characterization of zinc deficiency includes growth retardation, hypogonadism and hypospermia, delayed sexual maturation, alopecia, impaired wound healing, skin lesions, immune deficiencies, behavioral disturbances, night blindness, and hypogeusia (impaired taste). Some biochemical markers of zinc deficiency include decreased plasma zinc, reduced alkaline phosphatase, low plasma testosterone, decreased retinal alcohol dehydrogenase, and decreased RNA polymerase activity in some tissues. Also, there is impaired T-lymphocyte function and decreased collagen synthesis. Zinc supplementation and adequate nutrition usually results in noticeable clinical improvement in zinc deficient patients. Non-enzymatic proteins called metallothioneins contain large amounts of zinc. The exact role of zinc in metallothionein function is not known, however, administration of zinc stimulates the production of metallothioneins. Metallothioneins are believed to have a role in cellular antioxidant protection by scavenging free radicals. Metallothioneins bind copper with a much higher affinity than zinc, hence, the use of zinc acetate in treating Wilson's disease and the occurrence of copper deficiency with high dose zinc therapy. In treating Wilson's disease, zinc acetate interferes with copper absorption/reabsorption from the gut by inducing the production of metallothionein in the enterocyte, thereby preventing the serosal transfer of copper into the blood. The protein-bound copper is then excreted in the stool following desquamation of intestinal cells.
Pharmacokinetics: Zinc supplementation may be administered orally or parenterally. Following oral administration, zinc is absorbed by diffusion and a carrier-mediated process regulated by metallothionein. The amount absorbed is controlled by the level of zinc in the diet and the presence of substances that interfere with zinc absorption. Zinc absorption is promoted by a diet rich in protein due to the formation of zinc-amino acid chelates which present zinc in a more absorbable form. High levels of zinc decrease the absorption of copper by displacing copper from metallothionein. Once in the systemic blood circulation, zinc is primarily bound to albumin and is transported to the liver where some is stored and the rest delivered to extrahepatic tissues. In the plasma, zinc is localized in erythrocytes and leukocytes. Plasma concentrations tend to correspond with dietary intake and physiologic factors (i.e., injury or inflammation) and drop by 50% in the acute phase response to injury probably due to the sequestering of zinc by the liver. Tissue distribution of zinc is highest for the liver, pancreas, kidney, bone, and voluntary muscles. High concentrations also occur in parts of the eye, skin, hair, fingernails, toenails, prostate gland, and spermatozoa. Up to 25% of the daily loss is via biliary and pancreatic secretions.
Drug Form
Zinc Salts tablets or capsules
What are zinc tablets or capsules? ZINC SALTS are needed by the body to maintain normal structure and function. Zinc supplements treat or prevent zinc deficiency in patients whose zinc needs are not supplied by a normal diet or who are receiving intravenous feeding. Zinc acetate (Galzin(R)) is also used to reduce the amount of copper in patients who have too much copper in their body (Wilson's disease). Generic preparations of zinc capsules or tablets are available.
Common Questions
What should my health care professional know before I take zinc salts? They need to know if you have any of these conditions: -too little copper in the blood -an unusual or allergic reaction to zinc salts, other medicines, foods, dyes, or preservatives -pregnant or trying to get pregnant -breast-feeding
How should I take this medicine? Take zinc tablets or capsules by mouth. Follow the directions on the prescription label. Swallow the tablets with a full glass of water. Take on an empty stomach, at least 1 hour before or 2 hours after meals, unless your prescriber or health care professional tells you otherwise. Do not take within 2 hours of iron, copper, or phosphorus supplements. Take your doses at regular intervals. Do not take more than the prescribed dose. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.
What if I miss a dose? If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
What drug(s) may interact with zinc salts? -caffeine -certain antibiotics (quinolones or tetracyclines) -copper supplements -iron supplements -phosphorus supplements Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What should I watch for while taking zinc salts? Zinc is a normal part of a regular diet. Foods that contain significant amounts of zinc include: lean red meats, seafoods (especially herring and oysters), peas, and beans. Zinc is also in whole-grains, however, do not use large amounts of whole-grain foods because this may cause a decrease in amount of zinc taken into the body. Ask your prescriber or health care professional about the need to take extra zinc. The absorption of zinc can be reduced if you take it with high-fiber foods, large amounts of alcohol or drinks containing caffeine. Do not take zinc salts within 2 hours of any other medication taken by mouth.
What side effects may I notice from taking zinc salts? Side effects that you should report to your prescriber or health care professional as soon as possible: -anemia -chest pain -fever, chills, or sore throat -dizziness or fainting -shortness of breath, wheezing -ulcers or sores in mouth that do not heal -unusual tiredness or weakness -yellowing of the eyes or skin Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome): -abdominal pain -heartburn -stomach upset Let your prescriber or health care professional know about this side effect if it does not go away or if it annoys you.
Where can I keep my medicine? Keep out of the reach of children in a container that small children cannot open. Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Store in a tight container. Throw away any unused medicine after the expiration date.
Drug Form
Zinc salts lozenges
What are zinc salts lozenges? ZINC (Cold-Eeze and others(R)) lozenges are nutritional mineral supplements promoted for the supportive treatment of cold symptoms. Some studies suggest zinc lozenges may shorten the duration of cold symptoms, but the FDA has not approved zinc for this purpose. Generic zinc lozenges are available.
Common Questions
What should my health care professional know before I take zinc salts? They need to know if you have any of these conditions: -too little copper in the blood -an unusual or allergic reaction to zinc salts, other medicines, foods, dyes, or preservatives -pregnant or trying to get pregnant -breast-feeding
How should I take this medicine? Let a zinc lozenge dissolve in the mouth slowly and completely; do not swallow whole and do not chew. Follow the directions on the package. Do not use zinc lozenges more often than directed. If this medicine has been recommended by your health care prescriber, finish the full course prescribed even if you think your condition is better. Do not stop using except on your prescriber's advice. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. Lozenges may be a choking hazard to young children.
What if I miss a dose? If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
What drug(s) may interact with zinc salts? -caffeine -certain antibiotics (quinolones or tetracyclines) -copper supplements -iron supplements -phosphorus supplements Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What should I watch for while taking zinc salts lozenges? Tell your prescriber or health care professional if your cold symptoms do not improve or if you get a high fever, sinus pain, or a cough that does not go away.
What side effects may I notice from taking zinc salts? Side effects that you should report to your prescriber or health care professional as soon as possible: -chest pain -fever, chills, or sore throat -shortness of breath, wheezing -ulcers or sores in mouth that do not heal -unusual tiredness or weakness Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome): -abdominal pain -change in taste or an unpleasant taste -heartburn -stomach upset
Where can I keep my medicine? Keep out of the reach of children in a container that small children cannot open. Store at room temperature below 30 degrees C (86 degrees F); do not freeze. Throw away any unused medicine after the expiration date.
Drug Form
Zinc Salts injection
What are injections of zinc salts? ZINC SALTS are needed by the body to maintain normal structure and function. Zinc supplements treat or prevent zinc deficiency in patients whose zinc needs are not supplied by a normal diet or who are receiving intravenous feedings. Generic injections of zinc salts are available.
Common Questions
What should my health care professional know before I receive zinc salts? They need to know if you have any of these conditions: -too little copper in the blood -an unusual or allergic reaction to zinc salts, other medicines, foods, dyes, or preservatives -pregnant or trying to get pregnant -breast-feeding
How should I use this medicine? Zinc salts injections are for addition to intravenous feedings. It is usually added to the injection solution by a health-care professional when it is not possible for you to take zinc by mouth. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.
What if I miss a dose? This does not apply.
What drug(s) may interact with zinc salts? -certain antibiotics (quinolones or tetracyclines) -copper supplements -iron supplements -phosphorus supplements Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What should I watch for while taking zinc salts? Zinc is a normal part of a regular diet. Foods that contain significant amounts of zinc include: lean red meats, seafoods (especially herring and oysters), peas, and beans. Zinc is also in whole-grains, however, do not use large amounts of whole-grain foods because this may cause a decrease in amount of zinc taken into the body. Ask your prescriber or health care professional about the need to take extra zinc. Avoid using galvanized cookware or storage containers because zinc present in them may enter the food causing too much zinc. Also, foods stored in unlacquered tin containers may decrease the amount of zinc available for absorption. The absorption of zinc can be reduced if you eat large amounts of high-fiber foods, alcohol, or drinks containing caffeine.
What side effects may I notice from receiving zinc salts? Side effects that you should report to your prescriber or health care professional as soon as possible: -anemia -chest pain -fever, chills, or sore throat -dizziness or fainting -shortness of breath, wheezing -ulcers or sores in mouth that do not heal -unusual tiredness or weakness -yellowing of the eyes or skin Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome): -abdominal pain -heartburn -stomach upset Let your prescriber or health care professional know about this side effect if it does not go away or if it annoys you.
Where can I keep my medicine? Keep out of the reach of children. Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F); do not freeze. Throw away any unused medicine after the expiration date.
Drug Form
Zinc Salts eye solution
What is zinc sulfate eye solution? ZINC SULFATE (Eye-Sed(R)) is a weak antiseptic. It can precipitate protein and clear mucus from the surface of the eye. Zinc sulfate eye solution is used as an astringent for relief of mild eye irritation. Generic zinc sulfate eye solution is available.
Common Questions
What should my health care professional know before I use zinc sulfate? They need to know if you have any of these conditions: -an unusual or allergic reaction to zinc sulfate, or other eye products
How should I use this medicine? Zinc sulfate solution is only for use in the eye. Do not take by mouth, Follow the directions on the prescription label. Wash hands before and after use. Tilt your head back slightly and pull down your lower eyelid with your index finger to form a pouch. Try not to touch the tip of the dropper to your eye, fingertips, or other surface. Squeeze the prescribed number of drops into the pouch. Close the eye for a few moments to spread the drops. Do not use more often than directed. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.
What if I miss a dose? If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose. Do not use double or extra doses.
What drug(s) may interact with zinc sulfate? -lead, barium, strontium and calcium salts -silver or mercury -methylcellulose Tell your prescriber or health care professional: about all other eye products you are using, including non-prescription medicines. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What should I watch for while taking zinc sulfate? Only use as directed for a limited period. If your eye problems are not resolved or if they get worse, contact your prescriber or health care professional for advice. Zinc sulfate can form insoluble compounds with some other salts. It can also precipitate methylcellulose from solution. Do not use other eye products at the same time, especially Artificial Tears (these contain methylcellulose).
What side effects may I notice from using zinc sulfate? Side effects that you should report to your prescriber or health care professional as soon as possible: -continued eye irritation, redness, or inflammation -eye pain -visual changes Stop using the eye solution and call your prescriber or health care professional if you get any of these effects.
Where can I keep my medicine? Keep out of the reach of children. Store at room temperature between 8 and 25 degrees C (46 and 77 degrees F); do not freeze. Throw away any unused medicine after the expiration date.
Authors: Clinical Pharmacology Editorial Team
Last Modified: 2002-05-20
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