Section 18 · Monograph
Zinc acetate
Reviewed Nov 2026FDA label
GalzinCopper absorption blocker
- Forms
- Cap: 25, 50mg elemental zinc
- Dose
- Wilson's disease: 50mg elemental zinc TID on empty stomach (adults); maintenance therapy per label
- MOA
- Induces intestinal metallothionein, blocking copper absorption
Indications
- Maintenance treatment of Wilson's disease in patients who have been initially treated with a chelating agentFDA-labeled
Mechanism of Action
- Induces intestinal metallothionein, which binds copper and blocks its absorption; enterocytes shed and copper is lost in stool
Full Dosing
Adult / usual
- Adults: 50mg elemental zinc three times daily on an empty stomach (1 hour before or 2 hours after food and beverages other than water)
- Do not separate doses from other copper-chelating drugs by less than about 2 hours
Pediatric
- Pediatric and pregnancy dosing per label (lower doses are used)
Contraindications
- Known hypersensitivity to zinc acetate
Drug Interactions
- Penicillamine, trientine, iron and calcium reduce zinc absorption or effect — separate by at least 2 hours
- Tetracyclines and quinolones are bound by zinc — separate dosing
Adverse Effects
- GI irritation (nausea, vomiting, epigastric pain), especially early
- Elevated serum amylase and lipase (usually asymptomatic)
- Zinc-induced copper deficiency with over-treatment (sideroblastic anemia, leukopenia, myeloneuropathy)
- Rare initial neurologic worsening
Monitoring Parameters
- 24-hour urinary copper and non-ceruloplasmin copper
- CBC and ferritin; amylase and lipase if symptomatic
- Over-treatment indicators (very low urinary copper)
Pregnancy & Lactation
- Considered an acceptable option in Wilson's pregnancy with dose adjustment under specialist guidance
- Compatible with breastfeeding at recommended doses