Zinc

Zinc is a mineral supplement (trace element) medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Adjunct to ORS in acute and persistent childhood diarrhoea
• Prevention and treatment of zinc deficiency
• Nutritional support in malnutrition and recurrent infections
• Support of wound healing and skin conditions linked to zinc deficiency, per doctor
• Loss of taste or appetite associated with zinc deficiency
• Supplementation in pregnancy and lactation when advised by a doctor

The dose of Zinc should be decided by a registered doctor. In childhood diarrhoea, the standard WHO-recommended schedule is zinc once daily for 10-14 days together with ORS — commonly 20 mg daily for children above six months and 10 mg daily for younger infants, given as a dispersible tablet dissolved in a little water or breast milk; exact dosing for any child is weight- and age-based, per doctor.

For adults with deficiency, commonly used elemental zinc doses range from about 10 to 40 mg daily, often after food to limit stomach upset. Do not exceed the prescribed dose or duration of Zinc, as excess zinc causes harm.

Zinc supplements are generally well tolerated at recommended doses. The most common side effects are mild stomach upset, nausea, occasional vomiting shortly after a dose, a metallic taste, and loose stools or constipation. Taking it after food reduces these problems for most people.

High doses or prolonged excessive use can cause copper deficiency leading to anaemia and low white cells, reduced HDL cholesterol and weakened immunity — the opposite of the intended benefit. Very large single doses cause abdominal pain and vomiting. Allergic reactions are rare. Seek medical advice for persistent vomiting, unusual tiredness or any severe reaction.

In childhood diarrhoea, zinc is an adjunct — ORS and continued feeding (including breastfeeding) remain the mainstay. Watch for danger signs such as sunken eyes, very little urine, lethargy, blood in stool or high fever, which need urgent medical care. Give the dispersible tablet fully dissolved; do not force a vomiting child repeatedly without advice.

Avoid taking zinc long term above recommended amounts, as copper deficiency can develop silently. People with kidney disease should use it only under medical guidance. Separate zinc from tea, coffee, bran-rich meals and from iron or calcium supplements by about two hours, since these reduce its absorption.

Zinc reduces the absorption of several antibiotics — tetracyclines (doxycycline) and quinolones (ciprofloxacin, levofloxacin) — so take these at least two hours before or four to six hours after zinc. It also lowers absorption of penicillamine and some osteoporosis medicines; spacing is required.

Iron, calcium and copper supplements compete with zinc for absorption, and high-dose zinc depletes copper. Thiazide diuretics increase zinc loss in urine during long-term use. Foods rich in phytates (bran, some cereals) and tea reduce zinc uptake. Tell your doctor or pharmacist about all your medicines and supplements so timings can be arranged.

Zinc preparations should not be used by anyone with known hypersensitivity to zinc salts or any component of the formulation. They are not a treatment for diarrhoea on their own and must not replace ORS and medical care in a dehydrated child.

High-dose zinc should be avoided in people with copper deficiency or unexplained anaemia until assessed. Those with significant kidney impairment should not take zinc supplements without medical supervision, as excretion is reduced. If symptoms such as vomiting, abdominal pain or rash follow each dose, stop and consult a doctor before continuing.

Pregnancy: Zinc at recommended supplemental doses is considered safe in pregnancy and is sometimes prescribed, since zinc needs rise while expecting. High doses should be avoided. Take it as part of doctor-advised antenatal care rather than self-prescribing multiple supplements that may overlap.

Lactation: Zinc passes into breast milk and normal supplemental doses are compatible with breastfeeding; requirements are slightly higher while nursing. Avoid exceeding recommended amounts, as chronic excess can affect copper balance in both mother and baby. Discuss your total intake from all supplements with your doctor.

Store below 30°C in a dry place away from direct sunlight and moisture. Keep dispersible tablets in their blister until the moment of use, as they absorb humidity quickly. Keep syrup bottles tightly closed and use within the period stated after opening. Keep out of the reach and sight of children, and do not use after the expiry date.