Zinc gluconate is a common zinc supplement widely used in clinical practice for conditions such as malnutrition, anorexia, pica, oral ulcers, and acne caused by zinc deficiency. However, there are specific contraindications and drug interactions that require special attention when using it. The details are as follows:

I. Contraindications

1. Contraindication for Allergic Individuals

Individuals allergic to zinc gluconate or its excipients should strictly avoid use to prevent allergic reactions such as rashes, itching, or difficulty breathing.

2. Cautious Use for Special Populations

Pregnant and Lactating Women

While zinc gluconate may benefit maternal and infant health during pregnancy and lactation, excessive intake may harm the fetus or infant. Use under medical supervision is essential.

Children

Must be used under adult supervision and with strict adherence to recommended dosages. Immature organ function in children may lead to impaired absorption of other trace elements and disrupt normal growth if zinc is over-supplemented.

Older Adults

Due to reduced physical function and weakened drug tolerance/metabolism, older adults should use zinc gluconate cautiously and monitor physical reactions closely.

3. Cautious Use for Patients with Specific Diseases

Acute or Active Gastrointestinal Ulcer Patients

Zinc gluconate may irritate the ulcer surface, exacerbating pain and discomfort, and hinder ulcer healing. These patients should avoid use.

Renal Insufficiency Patients

The kidneys are critical for drug excretion. Reduced excretory capacity in renal insufficiency may cause zinc accumulation, increasing the risk of adverse reactions. Dosage adjustment and close monitoring are required.

II. Drug Interactions

1. Absorption Interference with Other Medications

Antacids

Medications like sodium bicarbonate and aluminum magnesium carbonate increase gastrointestinal pH, reducing zinc gluconate absorption. Avoid concurrent use; if necessary, space doses by at least 2 hours.

Tetracycline Antibiotics

Zinc gluconate forms complexes with tetracyclines (e.g., tetracycline, oxytetracycline, doxycycline), impairing antibiotic absorption and efficacy. Maintain a 2-hour interval if combined use is needed.

Penicillamine

Penicillamine binds to zinc ions to form stable complexes, reducing zinc gluconate absorption. Separate doses by a certain interval if co-administered.

2. Efficacy Interference with Other Medications

Quinolone Antibacterials

Zinc gluconate decreases the bioavailability of quinolones (e.g., norfloxacin, ciprofloxacin, levofloxacin), compromising their antibacterial effects. Avoid simultaneous use; if combined, space by at least 2 hours.

3. Food Interactions

Tannic Acid-Rich Foods

Foods like tea and persimmons contain high tannic acid, which forms insoluble complexes with zinc gluconate and hinders absorption. Avoid consuming large amounts of such foods during zinc gluconate therapy.

Milk

Calcium in milk competes with zinc for absorption sites. Do not take zinc gluconate with milk; ideally, leave a 1–2-hour interval.

When using zinc gluconate, always consult a healthcare provider or pharmacist to ensure safe and appropriate use, especially for special populations or when combining with other medications/foods.