Zinc
Sulphate {BP. Eur.P) Zinc Sulph.; Zinci Sulfas {I.P.: Zincum Sulfuricum.
ZnSO4,.7H2,O = 287.5.
Dose: 220 mg thrice daily; 0.6 to 2g as an emetic.
NOTE. 220 mg of zinc sulphate is approximately equivalent
to 50 mg of zinc.
Odorless, colorless, transparent, efflorescent crystals or
white crystalline powder with an astringent metallic taste. Each
9 represents 15.3 mmol (30.6mEQ) of zinc. It loses 5 molecules
of water of crystallization, or 31.2% of its weight, when slowly
heated to 50° and a further molecule at 100°.
Soluble 1 in less than 1 of water, 1 in 0.2 of boiling
water, and 1 in 2.5 of glycerol; insoluble in alcohol. A 5%
solution in water has a pH of 4.4 to 5.6. A 7.65% solution in
water is iso-osmotic with serum. Solutions are sterilized
by autoclaving or by filtration. Incompatible with lead,
calcium, and strontium salts, borax, alkali carbonates and
hydroxides, silver protein, and tannins. Store in
airtight containers.
Toxic Effects. Low doses of zinc sulphate may cause mild
gastro-intestinal disturbances. Doses of 0.6 to 2 g are emetic.
In overdosage it has corrosive effects similar to those of Zinc
Chloride.
Treatment of Toxic Effects. As for Zinc Chloride.
Absorption and Fate. Zinc sulphate is partially absorbed
from the gastro-intestinal tract.
Uses. Zinc sulphate has been given internally in doses of
up to 220 mg thrice daily to assist wound healing and in the
treatment of acrodermatitis enteropathica. It was formerly used
as a reflex emetic in a dose of up to 2 g as a 1% solution.
Externally, zinc sulphate is used as an astringent lotion for
indolent ulcers and to assist granulation. It is used in
conjunction with zinc chloride as an astringent mouth-wash.
Solutions usually containing 0.25% of zinc sulphate are applied
locally to relieve chronic inflammation of the cornea in
conjunctivitis. Higher zinc concentrations were measured in
serum than in plasma due to release from disintegrating
platelets. There was also a diurnal variation in plasma-zinc
concentrations.- R. G. Burr [letter). Lancet, i/1974,879.
In a double-blind study of 30 geriatric patients with senile
dementia 16 received zinc sulphate capsules. 220 mg thrice daily
for 24 weeks, while 14 received placebo.
Although psychological testing and psychiatric rating did not
demonstrate any advantage of zinc sulphate over placebo some
behavioral tests indicated that the patients receiving zinc
sulphate deteriorated less rapidly. Diarrhea occurred with zinc
sulphate therapy.- A. W. Czerwinski et al., Clin. Pharmac
Ther., 1974,15, 436.
A study of the effects of foodstuffs on the absorption of
zinc sulphate. - A. Pẻcoud et al., Clin Pharmac Ther.
1975, 17.469. See also J.L. Schelling et al., (letter) Lancet.
ii/1973, 968.
ACRODERMATITIS ENTEROPATHICA. Acrodermatitis
enteropathica was considered to be a zinc-deficiency disorder.
Nine children treated with zinc sulphate were completely free
from symptoms. A small dose - 35 mg of zinc sulphate daily -
might suffice but the optimum daily dose appeared to be 150 mg
daily. - E.J.Moynahan (letter). Lancet, ii/1974,399.
Mention of a further patient responding favourably. - B.Portnoy
and M.Molokhia (letter). ibid., 663. Impaired zinc absorption
might not be the primary defect in acrodermatitis enteropathica.
The urinary excretion of 65Zn 24 hours following a
small dose was proportional to the absorption.- R.I. Henkin and
R.L. Aamodt (letter). ibid., i/1975, 1379.
A 22-year-old woman with acrodermatitis enteropathica, who
had been maintained on di-iodohydroxyquinoline 650 mg 3 or 4
times daily, showed complete remission within 4 days of starting
zinc sulphate 220 mg thrice daily. Plasma-zinc concentrations
rose to high-normal values. Zinc sulphate was discontinued after
10 days and a remission of 5 weeks obtained. When restarted,
di-iodohydroxyquinoline was less effective, requiring a longer
time and higher dose to achieve incomplete remission.
After a period without medication zinc sulphate 50 mg twice
daily was given and the clinical response was excellent although
slightly slower than with the higher dose. K.H. Neldner and K.M.
Hambidge, New Engl. J Med., 1975, 292,879.
A report of complete and rapid remission of 5 children with
acrodermatitis enteropathica after treatment with zinc sulphate
80 to 120 mg daily, without immediate change in the
ultrastructural lesions of the Paneth cells. I. Polanco et al.
(letter). Lancet, i/1976, 430.
Further reports of zinc sulphate in the treatment of
acrodermatitis enteropathica:J.M. Gartside and B.R. Allen. Br
med. J., iii/1975, 521;E. Guiraldes et al., Lancet,ii/1975,
710.
EFFECT ON WOUND HEALING. Zinc sulphate. 660 mg daily in 3
divided doses, equivalent to 150 mg of elemental zinc, was found
to increase the rate of healing of granulating wounds in a
controlled study in 20 young men. Treated and control groups had
comparable diets and their wounds received the same
postoperative treatment. On average, wounds took 45.8 days to
heal in-patients receiving zinc sulphate and 80.1 days for the
controls. The average rate of wound healing was nearly 3 times
greater in the treated group. There was no evidence of toxicity
from the administration of zinc sulphate in capsules. - W.J.
Pories et al., Lancet. i/1967,121 and Ann. Surg.,
1967,165. 432. Criticisms and comments. - G.G. Power (letter).
Lancet, i/1967.440; see alsoR. Simpson-White
(letter). ibid. 278;B. Williams and C.B. Heald (letters). ibid.,
330.
In a controlled trial in 104 patients, zinc sulphate 220 mg
thrice daily after meals produced healing of leg ulcers in an
average of 32 days compared with 77 days for patients given
placebos. - S.L. Husain. Lancet, i/1969, 1069.
Delay in healing of wounds and ulcers could be caused by
delay in migration of the granulating epithelium. This could be
due to zinc deficiency. Since administration of zinc salts by
mouth resulted in healing at normal rates. Among 17 patients
with chronic indolent wounds, the 12 who had serum-zinc
concentrations below 1 mg per litre progressed rapidly when
given zinc salts. - W.J. Pories and W.H. Strain.
Trace Element Metabolism in Animals. Proceedings of
International Symposium by World Association for Animal
Production/International Biological Programme,Aberdeen, July
1969, Edinburgh, Livingstone. 1970, p. 75.
In a double-blind trial in 25 patients with large burns. The
administration of zinc sulphate 220 mg thrice daily reduced the
time for complete epithelialisation of burns and the length of
hospital admission, but this was not significant for the numbers
involved. - A.J.M. Brodribb and C.R. Ricketts, Injury. 1971, 3,
25.
In a controlled study of 27 patients with venous leg ulcers
where 13 were treated with zinc sulphate 200 mg thrice daily and
14 with a placebo for 18 weeks. The 7 patients with an initial
serum-zinc concentration of less than 1.1 mg per litre had a
significantly greater increase in healing-rate when given zinc
sulphate than did the 7 patients with similar serum-zinc
concentrations given placebo. There was no difference in the
response to placebo or zinc sulphate in the group of 13 patients
who had initial serum concentrations. greater than 1.1 mg per
litre. - T. Hallböök and E. Lanner. Lancet, ii/1972, 780.
Comment. - M.M. Molokhia and B. Portnoy [letter), ibid., i/1973,
41.
In a double-blind study in 36 patients with chronic leg
ulceration chiefly due to venous stasis and unresponsive to
other treatment the mean linear healing-rate in those given zinc
sulphate 220 mg. thrice daily was 0.9 mm per week and 3 achieved
complete healing compared with 0.6 mm per week and 2 achieving
complete healing in those given a placebo. The difference was
not significant. - M.W. Greaves and F.A. Ive. Br. J. Derma,
1972,87,632.
Brief reviews of the use of zinc sulphate to promote healing
- R. Craters,Drugs, Basle, 1973,6, 161; RI Heineken. New Engl.
J. Med., 1974, 291,675.
GASTRIC ULCER. In a double-blind trial in-patients with
benign gastric ulcers. 10 were given zinc sulphate 220 mg thrice
daily by mouth and 8 placebo. After 3 weeks patients taking zinc
sulphate had an ulcer healing rate three times that of patients
taking placebo, and more patients in the zinc sulphate group
achieved complete healing. There was no evidence of zinc
deficiency in any of the patients.- D.J. Frommer., Med.J. Aust.,
ii/1975, 793.
PORPHYRIA. Zinc sulphate 220 mg every 8 hours by mouth
relieved abdominal pain in a patient with acute intermittent
porphyria. - W. Roman et a1., Med. J.Aust., i/1969, 633. A
similar report - W. Roman et a1., (letter). Lancet,
ii/1967, 716.
ZINC DEFICIENCY. The mean concentration of zinc in the
plasma was 960 Ųg per litre
for healthy adults and 890
Ųg per litre
for healthy children. Abnormally low concentrations were found
in-patients with alcoholic cirrhosis, other types of liver
disease, active tuberculosis, indolent ulcers, and uraemia,
before and after a single haemodialysis, cardiac infarct.
Pulmonary infection, Down’s syndrome, cystic fibrosis with
growth retardation, in pregnancy, in women taking oral
contraceptives, and in growth-retarded Iranian villagers.- J.A.
Halsted and J.C. Smith.Lancet, i/1970, 322. See also
Chronica1 Wld Hlth Org., 1973,27,534.
A greater effect on height increase and onset of sexual
function was noted in a group of Iranians who, in addition to a
well-balanced diet, were given zinc sulphate equivalent to 27 mg
zinc daily than in a group who were given the diet alone. -
J.A.Halsted et al. Am J.Med., 1972,53,277,per J. Am. med. Ass.,
1972.222.1200.
A discussion of zinc deficiency and the use of zinc sulphate.
- per Lancet, i/1973, 299. See also Drug & Ther.
Bull., 1973, 11, 45; A.S. Prasad and D.Oberleas (letter).Lancet,
i/1974. 463; ibid., ii/1975, 351.
In a review of the role of zinc deficiency in retarded growth
and sexual development of children, treatment with zinc was not
found to increase growth or sexual development; retardation was
considered to be due to protein malnutrition. - J.E.Caughey
[letter). Lancet, i/1973. 993; treatment with zinc 40 mg
daily as carbonate for 1 year produced a significant increase in
height, weight, and bone-age in 20 boys. - J.G. Reinhold and H.A.
Ronaghy (letter). ibid.. ii/1973, 50. See also H.A. Ronaghy et
a1., Am J clin Nutr,. 1974,27,112. per Trop. Dis. Bull,.
1974,71,943.
In rats deficient in zinc and vitamin A, plasma
concentrations of vitamin A were not restored to normal until
zinc supplements were also added to the diet.- J.C.Smith et al.
Science, Wash., 1973,181,954. per J. Am. med. Ass.
1974,228,1669.
In 103 patients with diminished or disorted taste perception
(hypogeusia, dysgeusia) and diminished or disorted smell
perception (hyposmia, dysosmia) serum-zinc concentrations were
significantly lower than in controls; the symptoms were
alleviated by zinc supplements given by mouth - per J.Am. med.
Ass. 1974,228,1669.
Review of the pregnancies of 3 women with acrodermatitis
enteropathica. a condition associated with zinc deficiency.
Suggested a correlation between zinc deficiency and foetal
malformations. - K.M. Hambidge et a1., (letter). Lancet,
i/1975, 577.
Zincomed {Medo-Chemiculs) Zinc sulphate.
ORAZINC 220
(USA)
Courtesy of:
Mericon
Industries, Inc.
