Tetracyclines
Moderate
Database
Zinc chelates antibiotics in GI tract, reducing absorption of both
Separate dosing by at least 2 hours (give antibiotic first)
Source: Kimi deep-research + Cla · p1181
Drug reference
Zinc
Trace element / essential mineral / anti-diarrheal · Nutritional supplement, Immunostimulant, Anti-diarrheal
Also known as Zinc Sulfate, Zinc Gluconate, Zinc Acetate, Elemental Zinc
START
15-30 mg/day for deficiency/supplementation; 20-40 mg/day for acute diarrhea; take with food to reduce nausea
TYPICAL MAX
40 mg/day long-term; higher doses only under medical supervision with copper monitoring
STOP IF
Signs of copper deficiency (neuropathy, anemia), severe GI intolerance
WATCH
Serum zinc (baseline and periodically if deficiency), copper levels if >50 mg/day long-term, response in diarrhea
CDSCO approvedJan AushadhiATC A12CB01
KDIGO 2024 + manufacturer label
- ONSET
- 38min · absorption onset
- PEAK
- 2.5h · Peak absorption
- t½
- 4.5h · Plasma half-life
- DURATION
- 1d · Daily dosing
EXCRETION
Fecal (major); renal (minor)
route + CYP
INTERACTIONS
—
none in our sources
PREGNANCY
Safe at recommended doses; essential for fetal development; avoid excessive doses
FDA category + note
Available in India
31 branded formulations and 260 fixed-dose combinations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
Essential cofactor for over 300 metalloenzymes involved in protein synthesis, cell division, wound healing, immune function, and antioxidant defense. Anti-diarrheal effect via improved intestinal mucosal integrity, enhanced immune response to enteric pathogens, and reduced intestinal secretion.
Indications
Zinc deficiency (prevention and treatment)Acute diarrhea in children (reduces severity and duration)Wilson's disease (zinc acetate blocks copper absorption)Age-related macular degeneration (AREDS formulation)Common cold (symptom reduction)Delayed wound healing
Dosing
- Adult
- Supplementation: 15-30 mg elemental zinc/day. Acute diarrhea (adjunct): 20-40 mg/day. Wilson's disease: 50 mg TDS (zinc acetate)
- Pediatric
- Diarrhea: <6 months: 10 mg/day; >6 months: 20 mg/day for 10-14 days. Deficiency: 0.5-1 mg/kg/day
- Renal adjustment
- No adjustment needed
- Hepatic adjustment
- No adjustment needed; zinc acetate used in Wilson's disease (hepatic indication)
- Geriatric
- Standard dosing; monitor copper status with long-term high-dose use
- Max dose
- 40 mg/day elemental zinc (long-term); 150 mg/day (short-term under medical supervision)
Pharmacokinetics
Onset
Days to weeks (for deficiency correction)
Peak effect
2-3 hours (Tmax)
Duration
Variable
Half-life
4-5 hours (plasma); zinc is redistributed to tissues
Bioavailability
Variable (15-60% depending on salt, food, and zinc status)
Protein binding
~80% (bound to albumin and alpha-2-macroglobulin)
Metabolism
Not metabolized; tissue distribution and homeostasis regulated by metallothionein
Excretion
Fecal (major, unabsorbed and via pancreatic/biliary secretion); renal (minor, 2-10%)
Contraindications
- Hypersensitivity to zinc salts
- Copper deficiency (long-term high-dose zinc induces copper deficiency)
Side effects
Common
NauseaMetallic tasteAbdominal painDyspepsiaConstipation or diarrhea
Serious
- Copper deficiency (with long-term high-dose use >50 mg/day)
- Sideroblastic anemia
- Neutropenia
- Immune dysfunction (paradoxical, at very high doses)
Pregnancy & lactation
Pregnancy
Safe at recommended doses; essential for fetal development; avoid excessive doses
Lactation
Excreted in breast milk; compatible with breastfeeding at recommended doses
Drug interactions
Iron Supplements
Moderate
Database
Competitive absorption in GI tract; zinc and iron compete for divalent cation transporter
Separate dosing by 2-4 hours
Source: Kimi deep-research + Cla
Penicillamine
Moderate
Database
Zinc reduces penicillamine absorption; both used in Wilson's disease with timing separation
Separate dosing by at least 2 hours
Source: Kimi deep-research + Cla
Calcium Supplements
Mild
Database
High-dose calcium may reduce zinc absorption
Separate dosing if possible
Source: Kimi deep-research + Cla
Thiazide Diuretics
Mild
Database
Increased urinary zinc excretion; may contribute to deficiency
Monitor zinc status with long-term thiazide use
Source: Kimi deep-research + Cla
Related guidelines
Iron deficiency anaemia in pregnancy
ICMR · Obstetrics & Gynaecology · 2022
Iron deficiency anaemia in adults
ICMR · Hematology · 2023
Diabetic foot — clinical management
MOHFW · Endocrinology · 2021
Empirical antimicrobial use in common syndromes
ICMR · Infectious Diseases · 2019
Acute diarrhoea in children
IAP · Pediatrics · 2022
Ask House about Zinc
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19