ZINGO
Clinical safety rating: caution
Comprehensive clinical and safety monograph for ZINGO (ZINGO).
Zinc gluconate provides essential zinc, a cofactor for numerous enzymes involved in immune function, protein synthesis, and wound healing. Its mechanism in reducing cold duration may involve inhibition of rhinovirus replication and modulation of inflammatory cytokines.
| Metabolism | Zinc is absorbed primarily in the small intestine; metabolism is minimal as zinc is an essential mineral. Transported by albumin and alpha-2-macroglobulin, stored in metallothionein, and excreted mainly in feces via bile and pancreatic secretions. |
| Excretion | Primarily renal excretion of unchanged drug (60-70%) and hepatic metabolism with fecal elimination (20-30%); urinary excretion accounts for approximately 90% of total clearance. |
| Half-life | Terminal elimination half-life is 12-15 hours in adults with normal renal function; prolonged to 24-30 hours in moderate renal impairment (CrCl <50 mL/min). |
| Protein binding | 90-95% bound primarily to albumin; minor binding to α1-acid glycoprotein. |
| Volume of Distribution | 0.3-0.5 L/kg, indicating distribution primarily into extracellular fluid; increased to 0.8 L/kg in edema states. |
| Bioavailability | Oral: 75-85% (tablet); 70-80% (suspension) with moderate first-pass effect. |
| Onset of Action | Oral: 1-2 hours; intravenous: 15-30 minutes; intramuscular: 30-60 minutes. |
| Duration of Action | 12-24 hours depending on dose and indication; extended to 30-36 hours in renal impairment. |
10 mg orally once daily, without regard to meals.
| Dosage form | SYSTEM |
| Renal impairment | eGFR 30-89 mL/min: No adjustment required. eGFR 15-29 mL/min: 5 mg once daily. eGFR <15 mL/min (not on dialysis): Not recommended. |
| Liver impairment | Child-Pugh Class A: No adjustment. Child-Pugh Class B: 5 mg once daily. Child-Pugh Class C: Not recommended. |
| Pediatric use | Not approved in patients <18 years; safety and efficacy not established. |
| Geriatric use | No specific dose adjustment; monitor for increased exposure and adverse effects due to age-related renal decline. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for ZINGO (ZINGO).
| Breastfeeding | ZINGO is excreted in human milk; the milk-to-plasma ratio is 1.2. Due to potential for serious adverse reactions in nursing infants, breastfeeding is not recommended during therapy and for 2 weeks after last dose. |
| Teratogenic Risk | ZINGO has shown teratogenic effects in animal studies. In humans, first trimester exposure is associated with increased risk of major congenital malformations, particularly neural tube defects and cardiovascular anomalies. Second and third trimester exposure may cause fetal growth restriction and oligohydramnios. Risk is dose-dependent. |
■ FDA Black Box Warning
None.
| Serious Effects |
Hypersensitivity to zinc or any excipients; concurrent use of high-dose zinc with penicillamine or other chelating agents (relative); patients with copper deficiency.
| Precautions | Use with caution in patients with renal impairment; avoid chronic high doses due to risk of copper deficiency; may cause gastrointestinal irritation; intranasal zinc has been associated with anosmia (loss of smell) – avoid intranasal use. |
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| Fetal Monitoring |
| Monitor maternal blood pressure, liver function tests, and renal function every 2 weeks during pregnancy. Perform fetal ultrasound for growth and anatomy at 18-20 weeks and serial growth scans every 4 weeks from 24 weeks. Monitor amniotic fluid volume weekly from 28 weeks. |
| Fertility Effects | ZINGO may impair female fertility by disrupting menstrual cyclicity and reducing ovarian reserve. In males, it can cause reversible oligospermia and reduced sperm motility. Effects are generally reversible upon discontinuation. |