Zinc gluconate

Pronunciation: zink GLOO-koh-nayt.

Generic name
zinc gluconate
Drug class
Zinc salt / mineral supplement (trace-element replacement)
Form
Lozenge (commonly 5-15 mg elemental zinc), tablet, or capsule (e.g. Rubozinc 15 mg)
Route
Oral (lozenge, tablet, or capsule); historically also intranasal (discontinued in the US -- see warnings)
Legal status
Regulatory status varies genuinely by market and by route: OTC/homeopathic-category oral lozenge in the United States; licensed Natural Health Product in Canada; TGA-listed (AUST L) medicine in Australia; ANSM-authorised oral medicine (Rubozinc) for acne/acrodermatitis enteropathica in France/EU; an IV parenteral-nutrition infusion only in the UK; and an unregulated dietary supplement (not a medicine) in New Zealand. A historic INTRANASAL zinc product line (Zicam) was withdrawn from the US market in 2009 following an FDA anosmia advisory and is a genuinely different, discontinued product category from the oral products covered here. Always check your own country and product label.

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia

Australia: Blackmores Zinc Gluconate (Export) (6), Nature's Own High Strength Zinc 30mg (6), Wagner High Strength Zinc / Thompson's Organic Zinc Tablets (generics) (6) · Full directory

What zinc gluconate is and how it works

Zinc gluconate is a zinc salt used by mouth as a mineral supplement and OTC cold-symptom lozenge, and, in some markets (notably France), as an authorised oral medicine for inflammatory acne and a rare zinc-deficiency skin condition (acrodermatitis enteropathica). A separate intranasal (nasal spray/gel) zinc product line was historically marketed for the common cold but was withdrawn from the US market in 2009 after being linked to loss of smell. (2) (8)

Two real, distinct safety issues are worth knowing before use. First, INTRANASAL zinc products (put into the nose) have a documented, sometimes permanent risk of anosmia (loss of the sense of smell) -- this led US regulators to act in 2009, and the affected products were withdrawn from that market; if you have an older intranasal zinc product, do not use it. Second, taking ORAL zinc (lozenges, tablets, or capsules) at a high dose or for a prolonged period (commonly cited as 6-8 weeks or more) can deplete your body's copper, which can cause anaemia, low white blood cell counts, and, if unrecognised, nerve damage that may not fully reverse. Regulatory treatment also genuinely differs by country -- discuss the right product, dose, and duration for you with a pharmacist or clinician, especially if you plan to use it for more than the short term.

Mechanism of action: how zinc gluconate works

Zinc gluconate provides elemental zinc, a trace element cofactor for numerous enzymes involved in immune function, wound healing, and skin integrity. Oral zinc lozenges are proposed to act partly by direct topical antiviral/immune effects in the oropharynx, distinct from systemic mineral replacement. (8) (9)

What zinc gluconate is used for

Common cold symptom relief (oral lozenges)

OTC oral zinc gluconate lozenges are used to help reduce the duration of the common cold and lessen the severity of symptoms such as cough, sore throat, stuffy/runny nose, sneezing, post-nasal drip, and hoarseness. Not intended to treat influenza or allergies. (1)

Inflammatory acne (in markets where an authorised medicine exists)

In France, an ANSM-authorised oral zinc gluconate medicine (Rubozinc 15 mg) is indicated for minor-to-moderate inflammatory acne, typically for a defined 3-month course. (4)

Acrodermatitis enteropathica

The same French authorised medicine is also indicated for acrodermatitis enteropathica, a rare inherited zinc-deficiency skin condition, typically used long-term (until puberty) under specialist supervision. (4)

Before taking zinc gluconate

Do not take / not appropriate for

  • Do not use any intranasal (nasal spray/gel/swab) zinc product -- this specific route has a documented risk of anosmia (loss of smell), sometimes permanent, and led to a 2009 US market withdrawal. (all countries) (2)
  • Do not take if you have a known hypersensitivity (allergic) reaction to zinc gluconate or the product's other ingredients. (all countries) (4)
  • If you have a wheat allergy (not the same as coeliac disease), avoid capsule products containing wheat starch, such as Rubozinc. (France / EU (product-specific)) (4)

Tell your clinician about

  • If you plan to use oral zinc at a high dose or for longer than the short-term (a few weeks), since prolonged/high-dose use is linked to copper deficiency, which can cause anaemia, neutropenia, and, if unrecognised, nerve damage.
  • Any medicines you take by mouth, especially minocycline, doxycycline, or tetracycline antibiotics, warfarin (coumadin), fluoroquinolone antibiotics, or iron/calcium supplements, since zinc can reduce absorption of these and vice versa.
  • If you are pregnant or breastfeeding.
  • If you have galactose intolerance or complete lactase deficiency, or a wheat allergy, before taking a product containing lactose or wheat starch as an inactive ingredient.
  • If you use zinc-containing denture adhesive cream in large amounts or over a long period -- this is a separate but related real source of excess zinc exposure that has been linked to copper-deficiency neuropathy.
(1) (4) (8)

How to take zinc gluconate

  • Oral lozenges: dissolve completely in the mouth; do not chew or swallow whole. Begin treatment for a cold within 24-48 hours of symptom onset for the best chance of benefit.
  • Avoid taking on an empty stomach to reduce minor stomach upset, and avoid citrus fruit or juice within about 30 minutes of a dose, as this may reduce effectiveness.
  • Capsule products (e.g. Rubozinc): take with a large glass of water while sitting upright, avoid lying down for about 30 minutes afterward, and separate dosing from meals by more than 2 hours, and from iron, calcium, or tetracycline/fluoroquinolone antibiotics by at least 2 hours, for best absorption of both.
  • Do not use any product beyond the short course/duration described on its label without checking with a pharmacist or clinician first -- prolonged use raises the real risk of copper deficiency.
  • Never use an intranasal (nasal) zinc product.
(1) (4)

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) (4) (5) (6) (7) (8) (9)

Missed dose

For short-course cold-symptom lozenges, simply resume the normal dosing schedule at your next symptom-appropriate interval -- do not take an extra dose. For a longer, clinician-directed course (such as Rubozinc for acne or acrodermatitis enteropathica), follow your product's label or ask your pharmacist or clinician if a dose is missed.

Overdose

A single accidentally doubled lozenge dose is unlikely to be serious, but taking a large amount at once, or using oral zinc at high doses for a prolonged period, can cause nausea, vomiting, stomach cramps, and, over time, copper deficiency with anaemia, neutropenia, and neurological symptoms (numbness, tingling, weakness, poor balance) that may not fully reverse if not caught early. If a large overdose is suspected (especially in a child), or if you develop any of these symptoms after prolonged use, contact a doctor or poison control centre promptly. Never use an intranasal zinc product regardless of dose, due to the separate, unrelated risk of permanent smell loss. (8) (9)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Nausea or minor stomach upset, especially if taken on an empty stomach.

What to notice: Nausea or minor stomach upset, especially if taken on an empty stomach.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Unpleasant or metallic taste, or mouth/throat irritation from lozenges.

What to notice: Unpleasant or metallic taste, or mouth/throat irritation from lozenges.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Mild gastrointestinal disturbance with capsule products (uncommon).

What to notice: Mild gastrointestinal disturbance with capsule products (uncommon).

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (4)

Serious warnings

Loss of smell (anosmia) from INTRANASAL zinc products — emergency

Symptoms: Sudden reduction or complete loss of the sense of smell, which can occur after even a single dose of a nasal zinc spray/gel/swab.

Action: Seek medical evaluation immediately, and let the clinician advise on whether to continue or stop use. This risk is specific to the intranasal route -- oral lozenges/tablets/capsules are not associated with this particular risk. The affected US intranasal products were withdrawn from the market in 2009 following an FDA public health advisory; do not use any older intranasal zinc product you may still have. (2)

Zinc-induced copper deficiency with prolonged/high-dose oral use — high caution

Symptoms: Unusual tiredness or paleness (anaemia), increased infections (low white blood cell count/neutropenia), and -- especially if the deficiency goes unrecognised -- numbness, tingling, weakness, or poor balance from nerve damage.

Action: Do not use oral zinc products beyond the short course described on the label without medical advice. If you have used oral zinc at a high dose or for more than about 6-8 weeks and notice any of these symptoms, see your clinician promptly for blood tests -- early recognition matters because the neurological effects can become difficult to reverse. (8) (4)

Allergic reaction — emergency

Symptoms: Swelling of the face, lips, tongue, or throat; difficulty breathing; widespread rash or hives.

Action: Seek emergency medical help immediately. (4)

Interactions

  • Minocycline, doxycycline, and tetracycline antibiotics: zinc can inhibit absorption of these medicines -- separate dosing and consult a doctor before use if you are taking one of these. (1)
  • Warfarin (coumadin): zinc may inhibit absorption -- consult a doctor before use if you are on warfarin therapy. (1)
  • Fluoroquinolone antibiotics: absorption of these antibiotics is reduced when taken together with zinc -- separate dosing by at least 2 hours. (4)
  • Iron and calcium supplements: reduce zinc absorption, and vice versa -- separate dosing by at least 2 hours. (4)
  • Strontium: absorption is reduced when taken together with zinc -- separate dosing. (4)
  • Phytate-rich foods (legumes, whole grains, nuts): can reduce zinc bioavailability when eaten close to a dose. (4)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Seek advice from a pharmacist or health professional before use if pregnant, per the US OTC label reviewed; use of the French acne/acrodermatitis-enteropathica medicine in pregnancy should be a clinician-guided decision. (1) (2) (3) (4) (5) (6) (7) (8) (9)

Breastfeeding

Seek advice from a pharmacist or health professional before use if breastfeeding, per the US OTC label reviewed. (1) (2) (3) (4) (5) (6) (7) (8) (9)

Children

US OTC lozenges: children under 12 should consult a physician before use. French Rubozinc capsules are not recommended under age 6 due to aspiration risk, but are used (under specialist supervision) for acrodermatitis enteropathica in children until puberty. (1) (2) (3) (4) (5) (6) (7) (8) (9)

Elderly

No specific age-based dose adjustment described in the sources reviewed for this dossier beyond general caution around prolonged use and copper-deficiency monitoring. (1) (2) (3) (4) (5) (6) (7) (8) (9)

Monitoring

Before starting

  • Confirm the product is for oral use only -- never use an intranasal zinc product.
  • Review other medicines for absorption-affecting interactions (tetracyclines, warfarin, fluoroquinolones, iron/calcium).
  • For any planned prolonged course, discuss baseline blood counts and copper status with a clinician.

During treatment

  • Do not exceed the labelled duration/dose without medical advice.
  • Watch for any new numbness, tingling, weakness, unusual tiredness, or frequent infections, which could signal copper deficiency with prolonged use.
  • Any loss of smell after using a nasal zinc product is a genuine emergency signal requiring immediate medical evaluation.
(8) (2)

Storage

Store at room temperature in a cool, dry place, away from moisture, and out of reach of children.

Professional information

Clinician-facing context only, sourced from the current US DailyMed OTC label, France's ANSM database entry for Rubozinc, the UK EMC ingredient index, Health Canada's Natural Health Products database, Australia's TGA ARTG, New Zealand's Medsafe dietary-supplement policy, and two peer-reviewed reviews on zinc-induced copper deficiency reviewed for this dossier; verify against the current full label for the specific product before recommending.

United States

Indication: OTC cold-symptom relief

Dose summary: 1 lozenge (13.3 mg zinc) every 2-4 hours as needed, max 6/day (adults) or 4/day (ages 12-17).

Renal context: No specific renal dose adjustment described in the sources reviewed. (1)

France (European Union)

Indication: Inflammatory acne / acrodermatitis enteropathica

Dose summary: Acne: 30 mg/day for 3 months, then 15 mg/day; acrodermatitis enteropathica: 15-30 mg/day until puberty.

Renal context: No specific renal dose adjustment described in the sources reviewed. (4)

Mechanism of action

Hepatic guidance

No specific hepatic-impairment dose adjustment was identified in the sources reviewed for this dossier.

Overdose note

Acute overdose can cause gastrointestinal symptoms; chronic excess causes zinc-induced copper deficiency via intestinal metallothionein upregulation, which preferentially binds copper over zinc. Management of suspected copper deficiency involves confirmatory serum copper/ceruloplasmin testing and copper repletion under specialist guidance; the sources reviewed did not detail a specific antidote for acute zinc overdose. (8) (9)

Frequently asked questions

Is zinc gluconate available in the US, UK, EU, Canada, Australia, and New Zealand?

Yes, but its regulatory category genuinely differs by market and route. Oral lozenges are sold as an OTC homeopathic product in the United States, a licensed Natural Health Product in Canada, and a TGA-listed medicine in Australia. In France, an ANSM-authorised prescription-adjacent medicine (Rubozinc) exists for acne and acrodermatitis enteropathica. The only UK EMC-licensed zinc gluconate product found is an IV parenteral-nutrition infusion, not an oral product. In New Zealand, oral zinc is regulated as a dietary supplement, not as a Medsafe-approved medicine. (1) (3) (4) (5) (6) (7)

Is it true that zinc nasal sprays can cause permanent loss of smell?

Yes -- this is a real, well-documented risk. In 2009, the FDA issued a public health advisory after receiving more than 130 reports (and the manufacturer over 800) of anosmia associated with intranasal zinc cold remedies, some occurring after a single dose and some permanent. The affected products were withdrawn from the US market. This risk is specific to putting zinc into the nose -- it has not been reported with oral zinc lozenges, tablets, or capsules. (2)

Can taking zinc lozenges cause a copper deficiency?

Yes, with prolonged or high-dose use. Sustained excess zinc intake triggers a protein in the gut (metallothionein) that preferentially binds copper, blocking its absorption. Prolonged zinc lozenge use (commonly cited as 6-8 weeks or more) is likely to cause copper deficiency, which can present as anaemia or low white blood cell counts and, if not caught early, nerve damage (numbness, tingling, weakness, poor balance) that may not fully reverse. This is also why excessive, prolonged use of zinc-containing denture adhesive cream has separately been linked to the same kind of nerve damage. (8) (9)

How much zinc is safe to take per day?

Regulatory guidance genuinely differs: the US tolerable upper intake level for adults is 40 mg/day, while the EU's food safety authority (EFSA) sets a stricter 25 mg/day, and New Zealand caps zinc in dietary supplements at 15 mg/day. Staying within your product's labelled dose and duration, and checking with a pharmacist or clinician before any prolonged or high-dose use, is the safest approach regardless of which limit applies in your country. (9) (7)

What is the mechanism of action of zinc gluconate?

Zinc gluconate provides elemental zinc, a trace element cofactor for numerous enzymes involved in immune function, wound healing, and skin integrity. Oral zinc lozenges are proposed to act partly by direct topical antiviral/immune effects in the oropharynx, distinct from systemic mineral replacement. (8) (9)

What is the generic name of Zinc gluconate?

The generic name is zinc gluconate. (1) (4)

What class of drug is zinc gluconate?

Zinc gluconate is classed as: Zinc salt / mineral supplement (trace-element replacement). (1) (4)

References

  1. COLD-EEZE - zinc gluconate lozenge - Drug Facts labelDailyMed (U.S. National Library of Medicine) -- OTC Drug Facts label · United States · accessed 2026-07-30 · source 1
  2. FDA warns consumers to stop using three Zicam intranasal zinc cold remedies linked to anosmia (loss of smell)US FDA public health advisory and warning letter to Matrixx Initiatives, Inc. (manufacturer of Zicam), June 2009 -- corroborated via multiple independent contemporaneous news/legal secondary sources after a direct fetch of the original FDA advisory/warning-letter page returned 404/403 · United States · accessed 2026-07-30 · source 2
  3. Medicines containing the active ingredient zinc gluconate -- Nutryelt concentrate for solution for infusionelectronic medicines compendium (emc), United Kingdom -- ingredient-level product listing · United Kingdom · accessed 2026-07-30 · source 3
  4. RUBOZINC 15 mg, gelule -- medicine extractAgence nationale de securite du medicament et des produits de sante (ANSM), France -- Base de donnees publique des medicaments · European Union (France) · accessed 2026-07-30 · source 4
  5. Zinc gluconate-containing Natural Health Products (e.g. Life Brand Zinc Lozenges with Vitamin C & Echinacea, NPN 80051702; Natural Factors Echinamide Zinc Lozenges)Health Canada -- Licensed Natural Health Products Database (LNHPD) / Natural Product Number (NPN) system · Canada · accessed 2026-07-30 · source 5
  6. Zinc gluconate-containing listed medicines on the ARTG (e.g. Blackmores Zinc Gluconate (Export), Wagner High Strength Zinc, Thompson's Organic Zinc Tablets, Nature's Own High Strength Zinc 30mg)Therapeutic Goods Administration (TGA), Australia -- Australian Register of Therapeutic Goods (ARTG) · Australia · accessed 2026-07-30 · source 6
  7. Regulation of Dietary Supplements -- zinc/mineral supplementsMedsafe (New Zealand regulator) -- Dietary Supplements Regulations 1985 guidance · New Zealand · accessed 2026-07-30 · source 7
  8. Iatrogenic copper deficiency: Risks and cautions with zinc prescribing (Duncan et al., 2023)British Journal of Clinical Pharmacology -- peer-reviewed clinical pharmacology review · international / clinical literature · accessed 2026-07-30 · source 8
  9. Zinc Toxicity: Understanding the Limitspeer-reviewed toxicology review (MDPI, Molecules, 2024) · international / regulatory comparison · accessed 2026-07-30 · source 9
  10. FDA urged denture-cream manufacturers to remove zinc after case reports linked chronic overuse to copper-deficiency neuropathyContemporaneous US news/legal secondary reporting on FDA engagement with denture-adhesive manufacturers regarding zinc, 2010-2011 (included for context on the broader zinc-copper-deficiency-neuropathy phenomenon; this specific reporting concerns zinc-containing denture creams generally, not zinc gluconate lozenges/nasal products specifically, and is disclosed as such) · United States · accessed 2026-07-30 · source 10

Brand names by country

Single-ingredient zinc gluconate names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Cold-EEZE (oral lozenge) (1)DailyMed OTC homeopathic label confirmed · 13.3 mg zinc (as zinc gluconate 2X) · ProPhase Labs, Inc. / Pharmaloz Manufacturing, Inc.

United Kingdom

  • Nutryelt (IV trace-element concentrate for infusion) (3)EMC licensed confirmed · trace-element concentrate, zinc gluconate one of several active ingredients · Baxter Healthcare Ltd

Canada

  • Life Brand Zinc Lozenges with Vitamin C & Echinacea (5)Health Canada NPN licensed confirmed · zinc (citrate/gluconate) 5 mg · NPN 80051702
  • Natural Factors Echinamide Zinc Lozenges (5)Health Canada NHP licensed confirmed · zinc gluconate 10 mg · Natural Factors

Australia

  • Blackmores Zinc Gluconate (Export) (6)TGA ARTG listed confirmed · not independently confirmed this session · Blackmores Ltd
  • Nature's Own High Strength Zinc 30mg (6)TGA ARTG listed confirmed · 30 mg · Sanofi-Aventis Healthcare Pty Ltd
  • Wagner High Strength Zinc / Thompson's Organic Zinc Tablets (generics) (6)TGA ARTG listed confirmed · not independently confirmed this session · RF Six Pty Ltd; Homart Wellness Aust Pty Ltd
View brands in additional countries.

European Union

Rubozinc 15 mg (gelule) (4), Effizinc (oral) (4)

This page provides general reference information about zinc gluconate and is not a substitute for advice from your pharmacist or clinician. Never use an intranasal (nasal) zinc product, and check with a pharmacist or clinician before using oral zinc at a high dose or for longer than the short-term.

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