Zinc acetate
Zinc acetate is a zinc-salt medicine that blocks the absorption of copper from the diet and from internally secreted copper. Zinc acetate is used for Wilson’s disease (hepatolenticular degeneration).
Pronunciation: zink AS-eh-tate.
- Generic name
- zinc acetate
- Brand names
- GALZIN, Wilzin
- Drug class
- Zinc salt; oral copper-absorption blocker
- Form
- Hard gelatin capsules containing 25 mg or 50 mg of zinc (as zinc acetate)
- Route
- Oral
- Legal status
- Prescription-only medicine
Availability and supply rules vary by country
Trade names by country: United States
Australia: · Full directory
What zinc acetate is and how it works
Zinc acetate is a zinc-salt medicine that blocks the absorption of copper from the diet and from internally secreted copper. It is used as maintenance or lifelong therapy for Wilson’s disease (hepatolenticular degeneration), a rare inherited condition in which the body cannot properly excrete copper. (1) (2)
Zinc acetate is not emergency or initial detoxification treatment. Symptomatic patients are usually started on a copper-chelating agent first. Once a person is clinically stable, a specialist may switch them to zinc acetate for long-term maintenance. Treatment requires strict adherence and regular monitoring of copper levels.
Mechanism of action: how zinc acetate works
Zinc acetate provides zinc cation, which induces the synthesis of metallothionein in intestinal enterocytes. Metallothionein binds dietary and endogenously secreted copper, preventing its transfer into the bloodstream. The bound copper is then shed into the stool with normal intestinal cell turnover. (1) (2)
What is Zinc acetate used for?
Wilson’s disease (hepatolenticular degeneration)
Zinc acetate is indicated for the treatment of Wilson’s disease. In the United Stastes it is specifically labelled for maintenance use after initial chelation. The European label does not restrict it to maintenance but states it has a slow onset and is not recommended as sole initial therapy for symptomatic patients. It is a life‐long therapy. (1) (2)
Before taking zinc acetate
Do not take / not appropriate for
- Do not take zinc acetate if you have had a serious allergic reaction to zinc acetate or any of the capsule ingredients. The exact excipients vary between products. (all products) (1) (2)
- Zinc acetate alone is not suitable for the initial treatment of symptomatic Wilson’s disease; a copper chelator is needed first to remove excess copper. (all indications) (1) (2)
Tell your clinician about
- All of your current Wilson’s disease signs and symptoms, including any liver, neurological, or psychiatric problems.
- If you have ever had stomach ulcers, anaemia, frequent infections, numbness, tingling, weakness, or changes in your blood counts.
- If you are pregnant, planning a pregnancy, or breastfeeding. Anti-copper therapy must usually continue during pregnancy, but the dose and choice of drug need careful specialist management.
- All other medicines you take, especially iron or calcium supplements, tetracycline or fluoroquinolone antibiotics, other copper-reducing medicines (e.g., penicillamine or trientine), or any over-the-counter products.
- If you have trouble swallowing capsules or sticking to a strict three-times-daily schedule on an empty stomach.
Zinc acetate dosage and how to take it
- Take zinc acetate exactly as directed by your Wilson’s disease specialist. This is a life-long treatment; do not stop it yourself.
- Swallow the capsules whole with water. Do not open or chew them unless the specialist instructs you to do so for a young child.
- Take each dose on an empty stomach, at least one hour before food or two to three hours after a meal. Food, especially fibre and phytates, can block zinc absorption.
- If the morning dose upsets your stomach, you may delay it to between breakfast and lunch, or take it with a small amount of protein, as directed by your clinician.
- Do not change the dose or timing yourself. The dose is adjusted based on blood and urine copper tests, not how you feel day-to-day.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3)
Missed dose
If you forget a dose, do not take a double dose to make up for it. If you are unsure what to do, ask the prescribing clinic for advice.
Overdose
Acute overdose with zinc salts is rare but can be serious. If someone may have taken a large amount, seek emergency care immediately or contact a poison information service. Treatment may include emptying the stomach, measuring plasma zinc, and heavy-metal chelation therapy if zinc levels are markedly elevated. (1) (2)
Zinc acetate side effects
Side effects from zinc acetate are mostly mild and often improve with time or dose timing. Contact your specialist for any persistent or worrying symptoms.
Gastric irritation
What to notice: Stomach discomfort, nausea, or sickness, often worst with the first morning dose.
What to do: Ask the specialist about delaying the morning dose to mid-morning or taking it with a small amount of protein. This often reduces the discomfort. (1) (2)
Elevations in laboratory tests
What to notice: Increases in blood levels of alkaline phosphatase, amylase, or lipase may be seen on routine tests.
What to do: These changes are often temporary and settle within the first year or two of treatment. The specialist will monitor them. (1) (2)
Symptoms or signs of copper deficiency
What to notice: Unusual tiredness, pale skin, frequent infections, easy bruising or bleeding, numbness, tingling, weakness, or changes in thinking or walking.
What to do: Contact the specialist promptly. These can be signs that zinc treatment is excessively lowering copper levels. The specialist will check blood counts and copper levels and may adjust the dose. (1) (2)
Possible gastric ulcer
What to notice: Persistent or severe stomach pain, dark or tarry stools, vomiting blood, or feeling faint.
What to do: Seek medical attention promptly. The specialist needs to assess the stomach and review whether to continue zinc acetate. (1)
Serious warnings
Copper deficiency (from overtreatment) — serious
Symptoms: Anaemia, leukopenia (low white-cell count), pancytopenia, or myeloneuropathy causing sensory and motor symptoms such as numbness, tingling, or weakness.
Action: Contact the specialist. Do not adjust the dose yourself; copper deficiency is managed by the clinician based on blood and urine copper results. (1) (2)
Worsening of Wilson’s disease at start of treatment — serious
Symptoms: New or worsening neurological or psychiatric symptoms, or liver-related symptoms.
Action: Report any change immediately to the specialist. A change in therapy may be needed. (2)
Hepatic decompensation in patients switched from a chelator — emergency
Symptoms: Sudden worsening of liver function, jaundice, confusion, vomiting blood, or severe abdominal swelling.
Action: Seek emergency care immediately. This has been reported in a small number of patients with advanced liver disease after switching from penicillamine to zinc. The specialist manages the transition. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Other Wilson’s disease medicines (penicillamine, trientine) | Combination with zinc may reduce the effect of both drugs. However, when switching to zinc for maintenance, the two are taken together for 2-3 weeks with doses separated by at least 1 hour. | Follow the specialist’s exact switching schedule. Never change the timetable yourself. (2) |
| Iron and calcium supplements, tetracycline and fluoroquinolone antibiotics, phosphorus-containing compounds | These can reduce the absorption of zinc, and zinc can reduce the absorption of these substances. | Keep the specialist and pharmacist informed of all supplements and medicines. They will give you a timing schedule to separate doses. (2) |
| Food and drink (except water) | Many foods, especially those high in fibre, phytates, milk, coffee, and eggs, significantly reduce zinc absorption. | Take zinc acetate at least one hour before or two to three hours after food or drinks other than plain water. (1) (2) |
Special populations
Children and adolescents
Paediatric dosing is based on age and body weight. The US label studied children aged 10 years and above. The European label gives doses from age 1 year. Children who cannot swallow capsules may have the capsule opened and the contents mixed with a little water. Specialist-led monitoring is essential because children are vulnerable to copper deficiency. (1) (2)
Pregnancy and breastfeeding
Pregnant women with Wilson’s disease must usually continue anti-copper treatment because stopping can cause toxic copper build-up. The dose is often reduced to 25 mg three times a day and adjusted by copper monitoring. Breastfeeding is not recommended because zinc passes into breast milk and can cause copper deficiency in the nursing baby. (1) (2)
Patients with portal hypertension switching from a chelator
Caution is required; a small number of patients with advanced portal hypertension have experienced hepatic decompensation after switching from penicillamine to zinc. The switch must be carefully managed by the specialist. (2)
Monitoring
Before starting
- Confirm the diagnosis of Wilson’s disease and that the patient is clinically stable after initial chelation (if symptomatic).
- Select the correct zinc acetate product and capsule strength.
- Check baseline copper status, liver function, neuropsychiatric status, and blood counts.
During treatment
- Monitor 24-hour urinary copper excretion; the target is 125 micrograms per 24 hours or less (in the US) or below 125 micrograms/24 h (in the EU).
- Monitor non-ceruloplasmin plasma copper (free copper); the target is below 20 micrograms/dL (US) or below 250 micrograms/litre (EU).
- In children and pregnant women, aim for urinary copper levels a little above the upper limit of normal to avoid copper deficiency.
- Check 24-hour urinary zinc or plasma zinc as a compliance measure.
- Perform regular liver-function tests, neuropsychiatric assessment, full blood counts, and lipid profiles to detect copper deficiency.
- Be alert for sensory or motor symptoms that could indicate copper-deficiency myeloneuropathy.
- Do not use hepatic (liver) copper content to manage therapy, as it does not distinguish between safe bound copper and toxic free copper.
Storage
Store at controlled room temperature, 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C and 30°C. Keep the capsules in the original tight, light-resistant container with the child-resistant cap closed.
Professional information
Clinician-facing context only. Always use the current local label, regional monitoring targets, and paediatric dosing tables.
United States
Indication: Maintenance treatment of Wilson’s disease (after initial chelation)
Dose summary: Adults: 50 mg elemental zinc three times daily. Children aged 10 years and older or pregnant women: 25 mg three times daily, increased to 50 mg three times daily if monitoring shows loss of control.
Renal context: No specific renal dose adjustment is given in the current US label. Renal failure has been associated with massive zinc overdose. For patients with pre-existing renal impairment, individual specialist assessment is required. (1)
Europe (Wilzin SmPC)
Indication: Treatment of Wilson’s disease (life-long therapy, all stages under specialist guidance)
Dose summary: Adults: usual dose 50 mg three times daily, maximum 50 mg five times daily. Children 1-6 years: 25 mg twice daily. 6-16 years (bodyweight <57 kg): 25 mg three times daily. 16 years and above (or bodyweight ≥57 kg): 50 mg three times daily. Pregnant women: 25 mg three times daily, adjusted to copper levels. Dose adjustment in all groups guided by urinary copper and non-ceruloplasmin plasma copper.
Renal context: No specific renal dose adjustment is given in the current European SmPC. Specialist assessment is required for any patient with renal impairment. (2)
Hepatic guidance
Use specialist judgement; this page does not provide impairment-specific dosing. Caution is needed when switching patients with portal hypertension from a chelator to zinc acetate.
Overdose note
Overdose management includes gastric lavage or induced emesis to remove unabsorbed drug, measurement of plasma zinc, and consideration of heavy-metal chelation therapy if plasma zinc is markedly elevated (>1000 μg/dL [US] or >10 mg/L [EU]). Supportive care and treatment of complications such as renal failure or pancreatitis may be required. (1) (2)
Frequently asked questions
Can I ever stop taking zinc acetate?
Wilson’s disease requires life-long therapy. Do not stop zinc acetate unless your specialist tells you to. Stopping can lead to dangerous copper accumulation and organ damage. (2)
Why do I have to take zinc acetate on an empty stomach?
Many foods, especially those containing fibre or phytates, can bind zinc and stop it from being absorbed properly. Taking it on an empty stomach ensures enough zinc enters the intestinal cells to block copper uptake. (1) (2)
What are the signs that my treatment is lowering copper too much?
Symptoms of low copper (copper deficiency) can include anaemia, frequent infections, easy bruising, numbness, tingling, or difficulty walking. Tell your specialist straight away if you notice any of these; they will check your levels and may adjust the dose. (1) (2)
What is the mechanism of action of zinc acetate?
Zinc acetate provides zinc cation, which induces the synthesis of metallothionein in intestinal enterocytes. Metallothionein binds dietary and endogenously secreted copper, preventing its transfer into the bloodstream. The bound copper is then shed into the stool with normal intestinal cell turnover. (1) (2)
References
- GALZIN (zinc acetate) capsules — prescribing informationU.S. National Library of Medicine, DailyMed · United States · dated 09/2025 · accessed 2026-10-19 · source 1
- Wilzin (zinc acetate) EPAR Product Information — SmPCEuropean Medicines Agency · European Union · accessed 2026-10-19 · source 2
- Wilson diseaseMedlinePlus Genetics, U.S. National Library of Medicine · United States · accessed 2026-10-19 · source 3
Brand names by country
Single-ingredient zinc acetate names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- GalzinEton Pharmaceuticals, Inc.regulator source
View brands in additional countries.
European Union
Wilzin