zinc sulfate (generic name)

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Interactions with Drugs

Hormone replacement therapy and cholestyramine may reduce zinc excretion in the urine. Amiloride (Midamor®) reduces urinary zinc excretion and increases zinc blood levels. Theoretically, concurrent use of amiloride with zinc supplementation could cause zinc toxicity. Chlorthalidone (Hygroton®) may increase serum zinc levels.

Caffeine and alcohol may decrease zinc concentrations. Birth control pills, loop and thiaide diurectics may decrease zinc absorption.

Deferoxamine (Desferal®) increases urinary zinc elimination. Captopril (Capoten®) and enalapril (Vasotec®) might increase urinary zinc excretion in patients with high blood pressure. Data on other ACE-inhibitor (ACEIs) drugs is lacking. The clinical consequence of urinary zinc loss in patients with high blood pressure is unknown.

Zinc sulfate may interact with carbenoxolone analog (BX24).

Supplementation with zinc has the potential to improve the efficacy of oral cholera vaccine in children.

Zinc may interact with LDL, HDL lipoproteins, and triglycerides, reducing HDL "good" cholesterol levels. Use cautiously with cholesterol medications, due to possible additive effects.

Zinc may increase the cytotoxicity of cisplatin (Platinol-AQ®) when in the presence of the chelate ethylenediaminetetraacetic acid (EDTA), as compared to cisplatin treatment alone.

Zinc may decrease the absorption of erythromycin. However, in a study comparing erythromycin with and without added zinc, the results showed a significant reduction in severity and number of acne vulgaris lesions (including inflamed lesions) in the zinc treated group compared to those taking erythromycin alone.

Zinc may decrease the effectiveness of fluoroquinolone antibiotics (e.g. Cipro®). Zinc decreases the absorption and serum levels of demeclocycline, minocycline, and tetracycline due to zinc binding. Doxycycline does not seem interact with zinc. Penicillamine (Cuprimine®) chelates zinc and can reduce the effects of supplemental zinc. Dosing time should be separated by at least two hours.

Zinc may improve both insulin secretion and insulin sensitivity and may exert insulin-like effects. Use cautiously with diabetes medications.

High amounts of zinc may result in the prevention of interferon release, and interact with Interferon Alfa-2B (Intron A®).

Pancreatic enzyme replacements may improve absorption of zinc compared to pancreatic insufficiency.

Zinc supplementation has been shown to alter thyroid hormone metabolism in disabled patients with zinc deficiency.

Interactions with Herbs and Dietary Supplements

Zinc may interact with LDL, HDL lipoproteins, and triglycerides, reducing HDL "good" cholesterol levels. Use cautiously with herbs and supplements taken for cholesterol, due to possible additive effects.

Zinc may interfere with copper metabolism. However, one study indicates no detrimental effects of zinc on plasma copper levels in healthy volunteers over a period of six weeks.

Non-heme iron may decrease zinc absorption. Non-heme iron and zinc compete for a common absorption pathway in the gut. However, when iron and zinc are taken with food, this interaction is not likely to occur. When taken with food, zinc absorption is facilitated by proteins in food through an alternate pathway that does not compete with iron. Protein-bound heme iron (found in red meats) does not seem to affect zinc absorption.

Zinc supplementation has been shown to alter thyroid hormone metabolism in disabled patients with zinc deficiency.

Zinc may intereact with herbs and supplements that contain caffeine or have blood pressure-altering, antibiotic, hormonal, diabetic, hypoglycemic, or diuretic effects.

Attribution

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Dawn Costa, BA, BS (Natural Standard Research Collaboration); Jenna Hollenstein, MS, RD (Natural Standard Research Collaboration); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Christine Ulbricht, BS (University of Massachusetts); Wendy Weissner, BA (Natural Standard Research Collaboration).

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