Are there any risks connected with zink supplement (Solvezink) given to children?

Fråga: Are there any risks connected with zink supplement (Solvezink) given to children?

Sammanfattning: Zinc supplemention is generally considered safe. Allergic reactions to oral preparations have been reported sporadically. High doses (well above the recommended) can cause gastrointestinal symptoms. The absorption of zinc may compete with that of copper and induce copper deficiency.

Svar: Zink deficiency was connected to disease in man as late as in the 1960´s. Acrodermatitis enteropathica was recognised as a form of zink malabsorption in 1973. Since then much has been written about the concequences of zink deficiency, but we have found little information concerning the possible risks of zink intake and no information specifically concerning the risks to children. Recommended daily dietary intake is 3-5 mg in infants, 10 mg in children, 15 mg in adults and 20 mg in pregnant women (1). The recommended dose of zink sulphate in acrodermatitis enteropathica is 20-135 mg daily, depends on weight and age (2).

Zink toxicity is generally considered low. Large doses (at least ten times the recommended intake) cause nausea and vomiting. This is probably due to the formation of errosive zinc chloride (3).

Inhalation of zinc-containing dust can cause metal fume fever with nausea, dyspnoea and chest pain.

Zink sulphate may interfere with copper absorption and induce copper deficiency with anemia and neutropenia as a consequence. HDL cholesterol concentrations may also be adversely affected. These effects have been suggested to occur even at relatively low levels of zinc intake (100-300 mg daily) (4).

The files of SADRAC contain 11 reports concerning side-effects of oral zink sulphate, including 6 cases of urticaria or exanthema and one case of an SLE-like (systemic lupus erythematosus) reaction. The latter has also been published as a case report (5). None of the reports concern children.

On Drugline we have had one question concerning a 53-year-old woman who became "red as a crayfish" after every dose of Solvezink (6) and one question concerning a 12-year-old boy who reacted with vomiting to adult doses of zinc and selenium (7). 1 Bryce-Smith D: Zinc deficiency - the neglected factor. Chem Br 1989; 783-786

2 FASS 1995
3 Martindale, The extra pharmacopoeia. 1993; 30th ed: 1064
4 Fosmire GJ: Zinc toxicity. Am J Clin Nutr 1990; 51: 225-227

5 Fjellner B: Drug-induced lupus erythematosus. Aggravated by oral zinc therapy. Acta Derm Venereol (Sthlm) 1979; 59: 368-370 6 Drugline nr 06612 (year 1989) 7 Drugline nr 05559 (year 1987)