Zinc Citrate 90c

Orthoplex

Zinc may help to support healthy immune function and assist with wound healing.

Gluten Free
Egg Free
Dairy Free
Vegan
Vegetarian
    Product Details

    Pack Size
    90 Capsule

    Adult Dose
    Take 1 capsule daily, or as recommended by your registered healthcare practitioner.

    BIO

    Storage
    Store below 30°C in a cool, dry place, away from direct sunlight.

    Indications

      Zinc is:

      • Involved in more than 200 enzymes in the body
      • Involved in DNA, RNA and protein synthesis
      • Necessary for ovulation, fertilisation, the metabolism of reproductive hormones in both males and females
      • A component of the antioxidant enzyme superoxide dismutase
      • Supports the health and function of the nervous system
      • Supports healthy vision and eye health

      *All Zincs listed on the ARTG meet Pharmacopeia requirements for levels of heavy metals. We have found a Zinc that meets and exceeds these regulatory requirements because we understand that you will only accept the best.

      Contraindications

      • Cephalexin (Keflex)
      • Suitable for use in pregnancy and lactation

      Contraindications are taken from Natural Medicines database and are correct as of March 2019.

    Excipients
    Glycine, leucine, colloidal anhydrous silica, vegetable capsule (Vcaps®).

    Warning
    Contains zinc, which may be dangerous if taken in large amounts or for a long period. Vitamin and mineral supplements should not replace a balanced diet. All Zincs listed on the ARTG meet Pharmacopeia requirements for levels of heavy metals. We have found a Zinc that meets and exceeds these regulatory requirements because we understand that you will only accept the best.

    Ingredients

    Each capsule contains

    Zinc citrate dihydrate 95.8mg
    equiv. Zinc 30.0mg
    Drug Interactions
    Significance
    Ingredient
    Interaction Descriptions
    Moderate
    ZINC
    (Polaprezinc (Zinc carnosine), Zinc, Zinc amino acid chelate, Zinc citrate, Zinc citrate dihydrate, Zinc gluconate, Zinc picolinate, Zinc sulfate heptahydrate)
    Be cautious with this combination.
    View Interactions:
    Moderate

    RITONAVIR (Norvir)

    Be cautious with this combination.

    Moderate

    RITONAVIR (Norvir)

    Be cautious with this combination.

    Moderate

    RITONAVIR (Norvir)

    Be cautious with this combination.

    Severity: mild
    Occurrence: probable
    Level of Evidence: B

    Zinc modestly reduces levels of ritonavir.<br> Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption (93578). In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16% (90216). However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.

    References

    93578

    Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15.

    90216

    Moyle G, Else L, Jackson A, Back D, Yapa MH, Seymour N, Ringner-Nackter L, Karolia Z, Gazzard B, Boffito M. Coadministration of atazanavir-ritonavir and zinc sulfate: impact on hyperbilirubinemia and pharmacokinetics. Antimicrob Agents Chemother. 2013 Aug;57(8):3640-4.

    Moderate

    PENICILLAMINE (Cuprimine, Depen)

    Be cautious with this combination.

    Moderate

    PENICILLAMINE (Cuprimine, Depen)

    Be cautious with this combination.

    Moderate

    PENICILLAMINE (Cuprimine, Depen)

    Be cautious with this combination.

    Severity: moderate
    Occurrence: probable
    Level of Evidence: B

    Zinc might reduce the levels and clinical effects of penicillamine. <br> By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated (2678,4534,11605). Advise patients to take zinc and penicillamine at least 2 hours apart.

    References

    2678

    Brewer GJ, Yuzbasiyan-Gurkan V, Johnson V, et al. Treatment of Wilson's disease with zinc: XI. Interaction with other anticopper agents. J Am Coll Nutr 1993;12:26-30.

    4534

    Seelig MS. Auto-immune complications of D-penicillamine - A possible result of zinc and magnesium depletion and of pyridoxine inactivation. J Am Coll Nutr 1982;1:207-14.

    11605

    Mery C, Delrieu F, Ghozlan R, et al. Controlled trial of D-penicillamine in rheumatoid arthritis. Dose effect and the role of zinc. Scand J Rheumatol 1976;5:241-7.

    Moderate

    CISPLATIN (Platinol-AQ)

    Be cautious with this combination.

    Moderate

    CISPLATIN (Platinol-AQ)

    Be cautious with this combination.

    Moderate

    CISPLATIN (Platinol-AQ)

    Be cautious with this combination.

    Severity: high
    Occurrence: possible
    Level of Evidence: D

    Theoretically, zinc might interfere with the therapeutic effects of cisplatin.<br> Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin (11624,11625). It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.

    References

    11624

    Kondo Y, Yamagata K, Satoh M, et al. Optimal administration schedule of cisplatin for bladder tumor with minimal induction of metallothionein. J Urol 2003;170:2467-70.

    11625

    Doz F, Berens ME, Deschepper CF, et al. Experimental basis for increasing the therapeutic index of cis-diamminedicarboxylatocyclobutaneplatinum(II) in brain tumor therapy by a high-zinc diet. Cancer Chemother Pharmacol 1992;29:219-26.

    Moderate

    ATAZANAVIR (Reyataz)

    Be cautious with this combination.

    Moderate

    ATAZANAVIR (Reyataz)

    Be cautious with this combination.

    Moderate

    ATAZANAVIR (Reyataz)

    Be cautious with this combination.

    Severity: mild
    Occurrence: probable
    Level of Evidence: B

    Zinc modestly reduces levels of atazanavir.<br> Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption (93578). Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication (90216).

    References

    93578

    Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15.

    90216

    Moyle G, Else L, Jackson A, Back D, Yapa MH, Seymour N, Ringner-Nackter L, Karolia Z, Gazzard B, Boffito M. Coadministration of atazanavir-ritonavir and zinc sulfate: impact on hyperbilirubinemia and pharmacokinetics. Antimicrob Agents Chemother. 2013 Aug;57(8):3640-4.

    Moderate

    CEPHALEXIN (Keflex)

    Be cautious with this combination.

    Moderate

    CEPHALEXIN (Keflex)

    Be cautious with this combination.

    Moderate

    CEPHALEXIN (Keflex)

    Be cautious with this combination.

    Severity: moderate
    Occurrence: probable
    Level of Evidence: B

    Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption. <br> A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose (94163). To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.

    References

    94163

    Ding Y, Jia YY, Li F, et al. The effect of staggered administration of zinc sulfate on the pharmacokinetics of oral cephalexin. Br J Clin Pharmacol. 2012 Mar;73(3):422-7.

    Moderate

    INTEGRASE INHIBITORS

    Be cautious with this combination.

    Moderate

    INTEGRASE INHIBITORS

    Be cautious with this combination.

    Moderate

    INTEGRASE INHIBITORS

    Be cautious with this combination.

    Severity: high
    Occurrence: possible
    Level of Evidence: D

    Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.<br> Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation (93578,93579).

    References

    93578

    Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15.

    93579

    Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents: Drug Interactions between Integrase Inhibitors and Other Drugs. AIDSinfo. July 14, 2016. Available at: https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/287/insti-drug-interactions. (Accessed: 4/12/2017).

    Moderate

    TETRACYCLINE ANTIBIOTICS

    Be cautious with this combination.

    Moderate

    TETRACYCLINE ANTIBIOTICS

    Be cautious with this combination.

    Moderate

    TETRACYCLINE ANTIBIOTICS

    Be cautious with this combination.

    Severity: moderate
    Occurrence: probable
    Level of Evidence: B

    Zinc might reduce levels of tetracycline antibiotics.<br> Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time (3046,4945). Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40% (11615). Demeclocycline and minocycline cause a similar interaction (4945). However, doxycycline does not seem to interact significantly with zinc (11615). Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.

    References

    3046

    Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.

    4945

    Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54..

    11615

    Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.

    Moderate

    QUINOLONE ANTIBIOTICS

    Be cautious with this combination.

    Moderate

    QUINOLONE ANTIBIOTICS

    Be cautious with this combination.

    Moderate

    QUINOLONE ANTIBIOTICS

    Be cautious with this combination.

    Severity: moderate
    Occurrence: probable
    Level of Evidence: B

    Zinc can decrease the levels and clinical effects of quinolones antibiotics. <br> Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time (828,2682,3046,11600). Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.

    References

    3046

    Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.

    828

    Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40.

    2682

    Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33.

    11600

    Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4.

    Minor

    AMILORIDE (Midamor)

    Be watchful with this combination.

    Minor

    AMILORIDE (Midamor)

    Be watchful with this combination.

    Minor

    AMILORIDE (Midamor)

    Be watchful with this combination.

    Severity: insignificant
    Occurrence: probable
    Level of Evidence: B

    Amiloride can modestly reduce zinc excretion and increase zinc levels. <br> Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses (830,11626,11627,11634). The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.

    References

    830

    Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.

    11626

    Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12.

    11627

    Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4.

    11634

    Leary WP, Reyes AJ, Van der Byl K. Urinary magnesium and zinc excretion after two different single doses of amiloride in healthy adults. Curr Ther Res 1983;34:205-16.


    Full Reference List

    3046
    Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
    828
    Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40.
    2682
    Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33.
    11600
    Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4.
    4945
    Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54..
    11615
    Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
    93578
    Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15.
    93579
    Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents: Drug Interactions between Integrase Inhibitors and Other Drugs. AIDSinfo. July 14, 2016. Available at: https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/287/insti-drug-interactions. (Accessed: 4/12/2017).
    94163
    Ding Y, Jia YY, Li F, et al. The effect of staggered administration of zinc sulfate on the pharmacokinetics of oral cephalexin. Br J Clin Pharmacol. 2012 Mar;73(3):422-7.
    90216
    Moyle G, Else L, Jackson A, Back D, Yapa MH, Seymour N, Ringner-Nackter L, Karolia Z, Gazzard B, Boffito M. Coadministration of atazanavir-ritonavir and zinc sulfate: impact on hyperbilirubinemia and pharmacokinetics. Antimicrob Agents Chemother. 2013 Aug;57(8):3640-4.
    11624
    Kondo Y, Yamagata K, Satoh M, et al. Optimal administration schedule of cisplatin for bladder tumor with minimal induction of metallothionein. J Urol 2003;170:2467-70.
    11625
    Doz F, Berens ME, Deschepper CF, et al. Experimental basis for increasing the therapeutic index of cis-diamminedicarboxylatocyclobutaneplatinum(II) in brain tumor therapy by a high-zinc diet. Cancer Chemother Pharmacol 1992;29:219-26.
    2678
    Brewer GJ, Yuzbasiyan-Gurkan V, Johnson V, et al. Treatment of Wilson's disease with zinc: XI. Interaction with other anticopper agents. J Am Coll Nutr 1993;12:26-30.
    4534
    Seelig MS. Auto-immune complications of D-penicillamine - A possible result of zinc and magnesium depletion and of pyridoxine inactivation. J Am Coll Nutr 1982;1:207-14.
    11605
    Mery C, Delrieu F, Ghozlan R, et al. Controlled trial of D-penicillamine in rheumatoid arthritis. Dose effect and the role of zinc. Scand J Rheumatol 1976;5:241-7.
    830
    Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
    11626
    Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12.
    11627
    Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4.
    11634
    Leary WP, Reyes AJ, Van der Byl K. Urinary magnesium and zinc excretion after two different single doses of amiloride in healthy adults. Curr Ther Res 1983;34:205-16.

    Rating System Description

    Level of Significance: Stop‑Light Rating System Occurrence/Severity
    Major

    Do not use combination; contraindicated; strongly discourage patients from using this combination; a serious adverse outcome could occur.

    Moderate

    Use cautiously or avoid combination; warn patients that a significant interaticon or adverse outcome could occur.

    Minor

    Be aware that there is a chance of an interaction; advise patients to watch for warning signs of a potential interaction.

    Likelihood of Occurrence

    Likely: Well‑controlled human studies have demonstrated existence of this interaction.

    Probable: Interaction has not been documented in well‑controlled studies, however interaction has been demonstrated in human studies or in controlled animal studies plus multiple case reports.

    Possible: Interaction has been documented in animal or in vitro research, or interaction has been documented in humans but is limited to case reports or conflicting clinical research.

    Unlikely: Interaction has been demonstrated in animal or in vitro research but has been shown not to occur in humans.

    Severity

    High: Life threatening or requires medical intervention to prevent a serious adverse event.

    Moderate: Worsened clinical status and/or requires medication adjustment.

    Mild: May cause minor clinical side effects. Unlikely to require medication adjustment.

    Insignificant: Drug or supplement levels may be affected but will not cause clinical effects.

    Level of Evidence

    A: High-quality randomized controlled trial(RCT).

    A: High-quality meta-analysis (quantitative systematic review)

    B: Nonrandomized clinical trial

    B: Nonquantitative systematic review

    B: Lower quality RCT

    B: Clinical cohort study

    B: Case-control study

    B: Historical control

    B: Epidemoilogic study

    C: Consensus

    C: Expert opinion

    D: Acecdotal evidence

    D: In vitro or animal study

    D: Theoretical based on pharmacology


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    Disclaimer: This information on interactions is licensed from the TRC Natural Medicines Database. Neither Bio Concepts nor TRC are providing medical, clinical or other advice and nothing should be interpreted as constituting such advice. Currently this does not check for drug-drug or supplementsupplement interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgement is necessary.