Zinc and medications.
Zinc is classified as a foundation supplement in the Distil database, evidence Grade A. The page below lists every medication we have explicitly assessed it against.
Zinc is a cofactor for immune function, wound healing, skin, and the dopamine and testosterone pathways, and most people get enough from food, though vegetarians, vegans and older adults can run low. The form on the label changes how well it absorbs: bisglycinate, citrate and picolinate are well absorbed and gentle, while oxide is cheap but poorly taken up. One honest point on testosterone: zinc restores normal function where a deficiency exists rather than boosting levels in people who are already replete, so it is a correction, not an enhancer. The usual dose is 15 to 25mg of elemental zinc with food, since an empty stomach tends to cause nausea. Whichever form you take, the drug interactions are the same, because they come from the zinc itself, which binds some medicines in the gut. Take an antibiotic such as ciprofloxacin or doxycycline at least two hours before, or six hours after, your zinc. With a bisphosphonate such as alendronic acid, take the bisphosphonate first thing as its leaflet directs, then wait at least two hours before any zinc, longer than the 30 minutes the leaflet asks for. In the other direction, ACE inhibitors and thiazide water tablets can lower your zinc over time. At chronic doses above 40mg it can deplete copper, so a little copper is worth adding for long-term high dosing. In established kidney disease, only take it under GP supervision.
Below are the 20 documented pairs we have explicitly assessed for Zinc: 19 amber and 1 green. The pairs cluster around 2 mechanisms: Mineral chelation (absorption) and Renal zinc wasting (drug-induced). Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.
Documented interactions
Last reviewed 31 August 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Mineral chelation (absorption)
Amber Does interact with Alendronic acid?
Zinc is a divalent metal that can bind to alendronic acid in the gut and reduce how much you absorb, the same way calcium and iron do. Take alendronic acid first thing in the morning with plain water on an empty stomach, stay upright for 30 minutes, then separate any zinc supplement by at least two hours.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Bictegravir?
Zinc can bind to Bictegravir in the gut, and taking them at the same time may sharply reduce how much of your HIV medicine you absorb, which in turn may reduce how well it works. Bictegravir is usually taken at least 2 hours BEFORE a magnesium or aluminium antacid, and taking it 2 hours after is not equivalent. Taking it with food at the same time is the other option. The gap that is right for you depends on which HIV medicine you take, so please check it with your HIV pharmacist before you start.
Evidence: Supported by human study data.
Amber Does interact with Bictegravir with emtricitabine and tenofovir alafenamide?
Zinc can bind to Biktarvy in the gut, and taking them at the same time may sharply reduce how much of your HIV medicine you absorb, which in turn may reduce how well it works. Bictegravir is usually taken at least 2 hours BEFORE a magnesium or aluminium antacid, and taking it 2 hours after is not equivalent. Taking it with food at the same time is the other option. The gap that is right for you depends on which HIV medicine you take, so please check it with your HIV pharmacist before you start.
Evidence: Supported by human study data.
Amber Does interact with Ciprofloxacin?
Zinc can bind to ciprofloxacin in the gut and reduce how much antibiotic you absorb, which may let an infection persist. Take ciprofloxacin at least two hours before, or six hours after, any zinc supplement.
Evidence: Supported by human study data.
Amber Does interact with Dolutegravir?
Zinc can bind to Dolutegravir (Tivicay) in the gut, and taking them at the same time may sharply reduce how much of your HIV medicine you absorb, which in turn may reduce how well it works. When fasted, the HIV medicine is usually taken at least 2 hours before, or 6 hours after, the supplement. Taking them at the same time with food is also an option and works for calcium, iron and magnesium. The gap that is right for you depends on which HIV medicine you take, so please check it with your HIV pharmacist before you start.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Dolutegravir with abacavir and lamivudine?
Zinc can bind to Triumeq in the gut, and taking them at the same time may sharply reduce how much of your HIV medicine you absorb, which in turn may reduce how well it works. When fasted, the HIV medicine is usually taken at least 2 hours before, or 6 hours after, the supplement. Taking them at the same time with food is also an option and works for calcium, iron and magnesium. The gap that is right for you depends on which HIV medicine you take, so please check it with your HIV pharmacist before you start.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Dolutegravir with lamivudine?
Zinc can bind to Dovato in the gut, and taking them at the same time may sharply reduce how much of your HIV medicine you absorb, which in turn may reduce how well it works. When fasted, the HIV medicine is usually taken at least 2 hours before, or 6 hours after, the supplement. Taking them at the same time with food is also an option and works for calcium, iron and magnesium. The gap that is right for you depends on which HIV medicine you take, so please check it with your HIV pharmacist before you start.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Dolutegravir with rilpivirine?
Zinc can bind to Juluca in the gut, and taking them at the same time may sharply reduce how much of your HIV medicine you absorb, which in turn may reduce how well it works. When fasted, the HIV medicine is usually taken at least 2 hours before, or 6 hours after, the supplement. Taking them at the same time with food is also an option and works for calcium, iron and magnesium. The gap that is right for you depends on which HIV medicine you take, so please check it with your HIV pharmacist before you start.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Doxycycline?
Zinc can bind to doxycycline in the gut and reduce how much antibiotic you absorb, which may let an infection persist. Take doxycycline at least two hours before, or six hours after, any zinc supplement.
Evidence: Limited human data, from small studies or case reports, alongside a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Elvitegravir?
Zinc can bind to Elvitegravir in the gut, and taking them at the same time may sharply reduce how much of your HIV medicine you absorb, which in turn may reduce how well it works. The UK label asks for at least 4 hours between the two, in either direction. ⚠️ Taking them together with food is NOT offered as an alternative here, unlike dolutegravir and bictegravir. The gap that is right for you depends on which HIV medicine you take, so please check it with your HIV pharmacist before you start.
Evidence: Limited human data, from small studies or case reports, alongside a known mechanism.
Amber Does interact with Elvitegravir with cobicistat, emtricitabine and tenofovir alafenamide?
Zinc can bind to Genvoya in the gut, and taking them at the same time may sharply reduce how much of your HIV medicine you absorb, which in turn may reduce how well it works. The UK label asks for at least 4 hours between the two, in either direction. ⚠️ Taking them together with food is NOT offered as an alternative here, unlike dolutegravir and bictegravir. The gap that is right for you depends on which HIV medicine you take, so please check it with your HIV pharmacist before you start.
Evidence: Limited human data, from small studies or case reports, alongside a known mechanism.
Amber Does interact with Elvitegravir with cobicistat, emtricitabine and tenofovir disoproxil?
Zinc can bind to Stribild in the gut, and taking them at the same time may sharply reduce how much of your HIV medicine you absorb, which in turn may reduce how well it works. The UK label asks for at least 4 hours between the two, in either direction. ⚠️ Taking them together with food is NOT offered as an alternative here, unlike dolutegravir and bictegravir. The gap that is right for you depends on which HIV medicine you take, so please check it with your HIV pharmacist before you start.
Evidence: Limited human data, from small studies or case reports, alongside a known mechanism.
Amber Does interact with Levothyroxine?
Zinc can bind to levothyroxine in the gut and reduce how much you absorb. Separating doses by four hours usually avoids it.
Evidence: Limited human data, from small studies or case reports, alongside a known mechanism.
Amber Does interact with Minocycline?
Zinc can bind to minocycline in the gut and reduce how much antibiotic you absorb. The effect is smaller than with older tetracyclines, but keep them apart: take minocycline at least 2 hours before or 6 hours after a zinc supplement.
Evidence: Limited human data, from small studies or case reports, alongside a known mechanism.
Amber Does interact with Raltegravir?
Zinc can bind to Raltegravir (Isentress) in the gut, and taking them at the same time may sharply reduce how much of your HIV medicine you absorb, which in turn may reduce how well it works. Spacing the doses apart may not be enough on its own for raltegravir, so this is one to settle with the HIV team rather than to manage with a gap. The gap that is right for you depends on which HIV medicine you take, so please check it with your HIV pharmacist before you start.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Risedronate sodium?
Zinc is a divalent metal that can bind to risedronate in the gut and reduce how much you absorb, the same way calcium and iron do. Take risedronate on an empty stomach with plain water, stay upright for 30 minutes, then separate any zinc supplement by at least two hours.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Renal zinc wasting (drug-induced)
Amber Does interact with Bendroflumethiazide?
Bendroflumethiazide and other thiazide water tablets make your kidneys pass more zinc into your urine, which can lower your body's zinc over months of use. Taking a zinc supplement is generally helpful here rather than harmful, since it tops up what the diuretic is draining. If you have been on a thiazide long term and notice things like a poor sense of taste or slow-healing skin, mention it to your GP, who can check your zinc.
Evidence: Supported by human study data.
Amber Does interact with Enalapril maleate?
Enalapril can make the kidneys pass out more zinc in the urine, so people on it long term can drift towards low zinc. This works the opposite way to most interactions: the medicine lowers your zinc rather than the supplement affecting the medicine, so taking zinc is generally a supportive response rather than a hazard. If you take enalapril long term it is worth letting your GP know you supplement zinc, and not taking very high doses without a reason, since too much zinc over time can lower copper.
Evidence: Supported by human study data.
Amber Does interact with Indapamide?
Taking a zinc supplement alongside indapamide is supportive rather than harmful: indapamide is a thiazide-like water tablet, and the classic thiazides are known to make the kidneys pass more zinc into the urine, which can lower body zinc over months. Indapamide works a bit more gently on the kidney's salt handling and has not been measured directly for zinc, so the effect is likely present but probably smaller. If you have been on indapamide long term, your GP can check your zinc if you have symptoms like a poor sense of taste or slow-healing skin.
Evidence: Limited human data, from small studies or case reports, alongside a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Other
Green Does interact with Doravirine?
Zinc and doravirine can be taken together. Doravirine was studied alongside an aluminium and magnesium antacid and the amount absorbed stayed the same. Unlike the integrase inhibitor HIV medicines, doravirine works without binding metal ions, so there is no reason to space them apart.
Evidence: Limited human data, from small studies or case reports, alongside a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.
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How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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