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, sperm quality, 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: separate it by two hours from antibiotics and bisphosphonates, which it binds in the gut, and note that 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 8 documented pairs we have explicitly assessed for Zinc: 8 amber. 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
Mineral chelation (absorption)
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.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
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.
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.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Zinc can bind to levothyroxine in the gut and reduce how much you absorb. Separating doses by four hours usually avoids it.
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.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Renal zinc wasting (drug-induced)
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.
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.
Indapamide is a thiazide-like water tablet. The classic thiazides are known to make the kidneys pass more zinc into the urine, which can lower body zinc over months. Indapamide is closely related but works a bit more gently on the kidney's salt handling, and it has not been measured directly for zinc, so the effect is likely present but probably smaller. Taking a zinc supplement is supportive here rather than harmful. 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.
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.
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 methodologyWant this reasoning across everything you take?
This page checks the pairs you enter. A personalised Distil report applies the same graded, cited reasoning to your whole stack: your goals, conditions, medications, diet, and the compounds worth adding or dropping. The interactions check is one section of it. You can read a real one in full before you decide.
See a real sample reportSomething missing?
If a supplement or medication you take isn't in our autocomplete, tell us. We go through what people flag every week and add what's missing.