Wilzin: Uses, Dosage & Side Effects

An oral zinc-based therapy for Wilson’s disease that blocks copper absorption from the intestine, used as lifelong maintenance treatment to prevent copper accumulation

Rx ATC: A16AX05 Copper Absorption Inhibitor
Active Ingredient
Zinc (as zinc acetate dihydrate)
Available Forms
Hard capsules
Strengths
25 mg, 50 mg
Manufacturer
Recordati Rare Diseases

Wilzin (zinc acetate dihydrate) is an orphan medicinal product used for the treatment of Wilson’s disease, a rare autosomal recessive disorder that impairs the body’s ability to eliminate excess copper. Copper from the diet that cannot be properly excreted accumulates first in the liver and subsequently in other organs such as the brain and eyes, potentially causing serious liver damage, neurological disorders, and psychiatric symptoms. Wilzin works by blocking copper absorption from the intestine through the induction of metallothionein, a copper-binding protein in intestinal cells. Since Wilson’s disease is a lifelong condition, treatment with Wilzin must be continued indefinitely. It is classified as an orphan medicine and is approved by the European Medicines Agency (EMA) for use throughout the European Union.

Quick Facts: Wilzin

Active Ingredient
Zinc acetate
Drug Class
Copper Absorption Inhibitor
ATC Code
A16AX05
Common Uses
Wilson’s Disease
Available Forms
Hard Capsules
Prescription Status
Rx Only

Key Takeaways

  • Wilzin (zinc acetate dihydrate) is used to treat Wilson’s disease by blocking copper absorption in the intestine through induction of metallothionein, a copper-binding protein produced in enterocytes.
  • It is primarily used as maintenance therapy rather than initial treatment for symptomatic patients, because its copper-blocking effect develops gradually over weeks to months.
  • Treatment must continue for life, as Wilson’s disease is a permanent genetic condition and stopping therapy leads to dangerous copper reaccumulation in the liver and other organs.
  • Wilzin must be taken on an empty stomach (at least 1 hour before or 2–3 hours after meals) to ensure effective copper blocking; food, fiber, and dairy products significantly reduce its absorption.
  • Regular monitoring of blood and urine copper levels, zinc levels, liver function, and blood counts is essential to ensure adequate treatment and to detect both under-treatment (excess copper) and over-treatment (copper deficiency).

What Is Wilzin and What Is It Used For?

Quick Answer: Wilzin (zinc acetate dihydrate) is a prescription medication used to treat Wilson’s disease, a rare inherited disorder that causes dangerous accumulation of copper in the body. It works by blocking copper absorption from the intestine and is used as lifelong maintenance therapy.

Wilzin contains the active substance zinc (in the form of zinc acetate dihydrate) and belongs to a group of medicines used to treat disorders of metabolism and digestion. It is specifically indicated for the treatment of Wilson’s disease (hepatolenticular degeneration), a rare autosomal recessive genetic disorder caused by mutations in the ATP7B gene on chromosome 13. This gene encodes a copper-transporting ATPase that is primarily expressed in the liver and is essential for incorporating copper into ceruloplasmin and for excreting excess copper into bile.

In healthy individuals, dietary copper is absorbed from the small intestine and transported to the liver, where it is either incorporated into ceruloplasmin (a copper-carrying protein released into the bloodstream) or excreted into bile for elimination via the gastrointestinal tract. In patients with Wilson’s disease, both of these hepatic copper-handling pathways are impaired. As a result, copper that cannot be properly processed accumulates progressively, first in the liver and then, as hepatic storage capacity is exceeded, in other organs including the brain (particularly the basal ganglia), eyes (where it forms the characteristic Kayser-Fleischer rings on the cornea), kidneys, and other tissues.

Untreated copper accumulation leads to a range of clinical manifestations. Hepatic presentations include asymptomatic elevation of liver enzymes, chronic hepatitis, cirrhosis, and in some cases fulminant hepatic failure. Neurological presentations, which tend to appear later (typically in the second or third decade of life), include tremor, dystonia, dysarthria (difficulty speaking), dysphagia (difficulty swallowing), and gait disturbances. Psychiatric manifestations including depression, anxiety, personality changes, and psychosis may also occur and can sometimes precede the recognition of neurological or hepatic disease. Wilson’s disease affects approximately 1 in 30,000 people worldwide, though prevalence estimates vary by population.

Wilzin works by a fundamentally different mechanism from chelating agents such as penicillamine or trientine. Rather than removing copper that has already accumulated in the body, Wilzin prevents new copper from being absorbed. When zinc is administered orally, it induces the synthesis of metallothionein in the mucosal cells (enterocytes) lining the small intestine. Metallothionein is a small, cysteine-rich protein with an exceptionally high affinity for copper ions. When metallothionein is present in abundance within enterocytes, it preferentially binds any copper that enters those cells — whether from the diet or from endogenous sources such as saliva, gastric secretions, and biliary excretion into the gut. The copper-metallothionein complex remains trapped within the enterocyte and is unable to be transported across the basolateral membrane into the portal circulation. Since enterocytes are naturally shed and replaced approximately every five to six days, the trapped copper is eliminated in the feces as the old cells slough off into the intestinal lumen.

This mechanism effectively creates a “copper block” at the level of the intestine. Over time, as dietary copper is continuously prevented from entering the body and existing body copper is gradually utilized and excreted through other minor pathways, overall copper balance shifts from positive (accumulation) to negative (depletion). It is important to note, however, that this process is gradual. The full therapeutic effect of Wilzin takes weeks to months to develop, which is why it is generally not recommended as the sole initial treatment in patients who already have active symptoms of Wilson’s disease and require rapid copper removal.

Orphan Medicine Status

Wilzin is designated as an orphan medicinal product by the European Medicines Agency (EMA), reflecting the rarity of Wilson’s disease. This special designation supports the development and availability of treatments for rare conditions that might otherwise lack sufficient commercial incentive for pharmaceutical development. Wilzin was first authorized in the EU in 2004 and remains one of only a few medicines specifically approved for Wilson’s disease.

What Should You Know Before Taking Wilzin?

Quick Answer: Do not take Wilzin if you are allergic to zinc or any of the other ingredients. Tell your doctor about all medications you take, especially other anti-copper treatments, iron or calcium supplements, and certain antibiotics. Anti-copper treatment must continue during pregnancy; breastfeeding should be avoided.

Contraindications

There are specific situations in which Wilzin must not be used. Understanding these absolute contraindications is essential before treatment begins.

  • Hypersensitivity: Do not take Wilzin if you are allergic (hypersensitive) to zinc or any of the other ingredients in the product (corn starch, magnesium stearate, gelatin, titanium dioxide E171, brilliant blue FCF E133 in the 25 mg capsule, or sunset yellow FCF E110 in the 50 mg capsule).

There are no other absolute contraindications listed for Wilzin. However, the medicine must be used with caution and under careful medical supervision in all patients, given the complexity of managing Wilson’s disease and the potential consequences of both inadequate and excessive copper depletion.

Warnings and Precautions

As with other anti-copper medicines, including penicillamine and trientine, your symptoms may temporarily worsen when treatment is first started. This phenomenon, sometimes called “paradoxical worsening,” can occur because mobilized copper may transiently increase in the circulation before being eliminated. If this happens, it is essential to inform your doctor immediately so that appropriate adjustments can be made to your treatment regimen.

To monitor the effectiveness and safety of your treatment, your doctor will perform regular blood and urine tests throughout the course of therapy. These tests typically include:

  • 24-hour urinary copper excretion: Used to assess whether copper is being adequately controlled. Values that are too high suggest insufficient treatment, while very low values may indicate over-treatment.
  • Non-ceruloplasmin-bound copper (free copper): A more direct measure of the biologically active copper in the blood. Ideally this should be maintained within the normal range.
  • Serum zinc levels: Monitored to confirm adequate zinc absorption and dosing.
  • Liver function tests: Checked regularly to assess hepatic status and detect any liver-related complications.
  • Complete blood count: Monitored because both copper deficiency (from over-treatment) and zinc excess can affect blood cell production.

Monitoring is particularly important in certain populations. In growing children, copper deficiency from over-treatment can impair normal development. In pregnant women, both copper excess and copper deficiency can harm the developing fetus. If you experience unusual muscle weakness or abnormal sensations (tingling, numbness) in your arms or legs, report these to your doctor, as they may indicate excessive copper depletion.

Pregnancy and Breastfeeding

If you are planning to become pregnant, it is crucial to discuss this with your doctor well in advance. Maintaining anti-copper treatment throughout pregnancy is considered essential, as untreated Wilson’s disease poses serious risks to both the mother and the developing fetus, including miscarriage, stillbirth, and maternal hepatic decompensation. The decision regarding which anti-copper therapy to use during pregnancy should be made in consultation with a specialist experienced in managing Wilson’s disease.

Zinc-based therapy is generally considered the preferred option during pregnancy by many hepatologists, as it has a more favorable safety profile compared with chelating agents such as penicillamine, which has been associated with connective tissue abnormalities in the fetus. If you become pregnant while taking Wilzin, your doctor will determine the most appropriate treatment and dosage for your individual situation. Dose adjustments may be necessary, as both copper excess and copper deficiency can be harmful to the developing fetus.

Breastfeeding should be avoided during treatment with Wilzin, as zinc is excreted in breast milk and could affect the nursing infant. Discuss alternative feeding options with your doctor and midwife if you wish to breastfeed.

Driving and Using Machines

No formal studies have been conducted on the effects of Wilzin on the ability to drive or operate machinery. However, based on the pharmacological profile of zinc acetate and clinical experience, no significant impairment is expected. Patients should nevertheless be aware that Wilson’s disease itself can cause neurological symptoms that may affect driving ability, and any such symptoms should be discussed with their doctor.

Important Information About Excipients

Wilzin 50 mg hard capsules contain sunset yellow FCF (E110), a coloring agent that may cause allergic reactions in susceptible individuals. If you have a known sensitivity to azo dyes, inform your doctor before taking the 50 mg capsules. The 25 mg capsules contain brilliant blue FCF (E133) instead and may be a suitable alternative if E110 sensitivity is a concern.

How Does Wilzin Interact with Other Drugs?

Quick Answer: Wilzin can interact with several medications and supplements. Iron, calcium, and phosphorus supplements can reduce its effectiveness, while Wilzin can decrease the absorption of tetracycline and fluoroquinolone antibiotics. If you are also taking penicillamine or trientine, allow at least one hour between medications.

Drug interactions are an important consideration when taking Wilzin, as several commonly used medications and supplements can either reduce the effectiveness of zinc therapy or have their own absorption impaired by zinc. Understanding these interactions is essential for maintaining both effective copper control and adequate efficacy of other treatments you may be taking.

The primary mechanism underlying most Wilzin interactions is chelation — the formation of insoluble complexes between zinc ions and other substances in the gastrointestinal tract. When such complexes form, neither the zinc nor the interacting substance can be properly absorbed from the intestine, effectively reducing the bioavailability of both. For this reason, timing of administration is the key strategy for managing most Wilzin interactions.

Major Interactions

Major Drug Interactions with Wilzin
Interacting Substance Effect Management
Penicillamine Penicillamine can chelate zinc in the gut, reducing the absorption and effectiveness of both medications Take at least 1 hour apart; your doctor will manage the transition period carefully
Trientine Trientine can chelate zinc, reducing the effectiveness of Wilzin Take at least 1 hour apart during any overlap period
Iron supplements Iron and zinc compete for absorption pathways and can form complexes that reduce the absorption of both Take at least 2 hours apart; consult your doctor before starting iron supplements
Tetracyclines (e.g., doxycycline, minocycline) Zinc chelates tetracyclines, significantly reducing their absorption and antibiotic effectiveness Take tetracyclines at least 2 hours before or 4–6 hours after Wilzin
Fluoroquinolones (e.g., ciprofloxacin, levofloxacin) Zinc chelates fluoroquinolones, reducing their absorption and antibiotic effectiveness Take fluoroquinolones at least 2 hours before or 6 hours after Wilzin

Minor Interactions

Minor Drug Interactions with Wilzin
Interacting Substance Effect Management
Calcium supplements Calcium may interfere with zinc absorption Take at least 2 hours apart
Phosphorus supplements Phosphorus can reduce zinc absorption Take at least 2 hours apart
High-fiber foods Phytates in fiber-rich foods bind zinc and reduce its absorption Always take Wilzin on an empty stomach, away from high-fiber meals
Dairy products Casein and calcium in dairy can impair zinc absorption Avoid dairy products close to dosing times; use protein sources like meat instead if needed

Always inform your doctor or pharmacist about all medications, supplements, and herbal products you are taking or have recently taken, including over-the-counter medicines. Your doctor can advise on the optimal timing of each medication to minimize interactions and ensure that both your Wilson’s disease treatment and any other therapies remain fully effective.

What Is the Correct Dosage of Wilzin?

Quick Answer: The standard adult dose is 50 mg zinc three times daily. Children aged 1–6 years typically take 25 mg twice daily, while children aged 6–16 years (under 57 kg) take 25 mg three times daily. Wilzin must be taken on an empty stomach, at least 1 hour before or 2–3 hours after meals.

Always take Wilzin exactly as prescribed by your doctor. The dosage depends on your age, body weight, and clinical response. Your doctor will individualize the dose based on regular monitoring of copper and zinc levels in your blood and urine. The available capsule strengths (25 mg and 50 mg) allow for flexible dosing across different patient populations.

Adults

Standard Adult Dosage

The usual dose for adults is 50 mg zinc (one 50 mg capsule or two 25 mg capsules) three times daily. The maximum daily dose is 50 mg zinc five times daily (250 mg total), though such high doses are rarely needed and should only be used under close medical supervision.

Children and Adolescents

Dosing in children is adjusted according to age and body weight. Wilzin may be used in children from 1 year of age.

Pediatric Dosing Guide for Wilzin
Age Group Weight Dose Frequency
1 to 6 years Any 25 mg zinc (one 25 mg capsule) Twice daily
6 to 16 years Under 57 kg 25 mg zinc (one 25 mg capsule) Three times daily
16 years and older, or 6+ years Over 57 kg 50 mg zinc (one 50 mg capsule or two 25 mg capsules) Three times daily

For young children who are unable to swallow capsules, the capsule may be opened and the powder mixed with a small amount of water. The water may be flavored with sugar or syrup to improve palatability. This method should be discussed with your doctor or pharmacist to ensure proper dosing.

Elderly Patients

Elderly Dosage

No specific dose adjustments are generally recommended for elderly patients. However, age-related changes in kidney and liver function may affect drug handling, and dosing should be guided by regular monitoring of copper and zinc levels, as with all other patient groups. Elderly patients may also be more susceptible to gastrointestinal side effects.

How to Take Wilzin

Correct timing of Wilzin doses is critical for its effectiveness. The following administration guidelines must be followed:

  • Take on an empty stomach: Wilzin should be taken at least 1 hour before or 2–3 hours after meals. Food, particularly fiber-rich foods and dairy products, significantly reduces zinc absorption and can render the medication less effective.
  • Morning dose adjustment: Some patients experience stomach discomfort after the morning dose. If this occurs, the morning dose may be delayed until mid-morning (between breakfast and lunch). Alternatively, it may be taken with a small amount of protein-containing food such as meat (but not milk or dairy products), which has less impact on zinc absorption.
  • Separation from other medicines: If you are also taking penicillamine or trientine, allow at least 1 hour between Wilzin and the other medication to prevent them from binding to each other in the gut.
  • Swallow whole with water: Capsules should be swallowed whole with a glass of water. Do not crush or chew unless the capsule needs to be opened for a child who cannot swallow it.

Missed Dose

If You Miss a Dose

If you forget to take a dose of Wilzin, skip the missed dose and take your next dose at the scheduled time. Do not take a double dose to make up for the forgotten one. Missing occasional doses is unlikely to cause immediate harm, but consistently missing doses will reduce the effectiveness of copper blocking and may allow copper to accumulate over time.

Overdose

What Are the Side Effects of Wilzin?

Quick Answer: The most common side effect is gastric irritation (stomach discomfort), particularly at the beginning of treatment. Elevated liver and pancreatic enzymes in blood tests are also common. Less commonly, decreases in red and white blood cell counts may occur. Most side effects are manageable with dose timing adjustments.

Like all medicines, Wilzin can cause side effects, although not everybody experiences them. The side effects of Wilzin are generally considered mild to moderate in severity and are often related to the local effects of zinc on the gastrointestinal tract. Many patients find that side effects improve as the body adapts to the medication over the first few weeks of treatment.

The side effects reported with Wilzin are categorized below by frequency, based on how often they have been observed in clinical studies and post-marketing surveillance:

Common

Affects 1 to 10 in every 100 patients

  • Gastric irritation (stomach discomfort, nausea, epigastric pain) — most frequent at the start of treatment
  • Elevated liver enzymes (ALT, AST, GGT) detected on blood tests
  • Elevated pancreatic enzymes (amylase, lipase) detected on blood tests

Uncommon

Affects 1 to 10 in every 1,000 patients

  • Decreased red blood cell count (anemia)
  • Decreased white blood cell count (leukopenia)

Not Known

Frequency cannot be estimated from available data

  • Sideroblastic anemia (a type of anemia caused by copper deficiency from excessive zinc intake)
  • Copper deficiency symptoms (unusual muscle weakness, abnormal sensations in arms and legs) — indicates over-treatment

The most notable side effect is gastric irritation, which tends to be worst after the first morning dose. This occurs because zinc can irritate the stomach lining when taken on an empty stomach. Several strategies can help manage this side effect:

  • Delay the morning dose until mid-morning (between breakfast and lunch) rather than taking it first thing in the morning
  • Take the first dose with a small amount of protein-rich food such as lean meat (avoid dairy products, which impair zinc absorption)
  • Drink a full glass of water with each dose
  • Discuss with your doctor if stomach discomfort persists, as dose adjustments may help

It is important to distinguish between side effects of Wilzin itself and potential signs of inadequate copper control (under-treatment) or excessive copper removal (over-treatment). Symptoms such as worsening of neurological symptoms, new psychiatric symptoms, or deteriorating liver function may indicate that your copper balance is not optimally managed and should be reported to your doctor promptly. Conversely, symptoms such as unusual fatigue, recurrent infections, or unexplained anemia may suggest copper deficiency from over-treatment.

Reporting Side Effects

If you experience any side effects, including those not listed above, talk to your doctor or pharmacist. You can also report side effects directly to your national medicines regulatory authority (e.g., the FDA MedWatch program in the United States or the Yellow Card Scheme in the United Kingdom). Reporting helps authorities continuously monitor the benefit-risk balance of medicines.

How Should You Store Wilzin?

Quick Answer: Store Wilzin at or below 25°C (77°F) in its original container, out of the reach of children. Do not use after the expiry date printed on the packaging. Return unused medicine to your pharmacist for proper disposal.

Proper storage of Wilzin is essential to ensure the medication remains effective throughout its shelf life. The following storage guidelines should be followed:

  • Temperature: Store at a temperature not exceeding 25°C (77°F). Do not freeze. Avoid storing in areas exposed to excessive heat or direct sunlight, such as car dashboards, window sills, or bathrooms.
  • Container: Keep the capsules in the original polyethylene bottle with its polypropylene and polyethylene closure. The bottles contain a cotton filler to protect the capsules during transport. Do not transfer capsules to other containers.
  • Children: Keep this medicine out of the sight and reach of children at all times.
  • Expiry date: Do not use Wilzin after the expiry date stated on the bottle and carton (after “EXP”). The expiry date refers to the last day of that month.
  • Disposal: Do not dispose of medicines via household waste or wastewater. Return any unused or expired medication to your pharmacist for proper disposal. This helps protect the environment.

If you notice any change in the appearance of the capsules (discoloration, unusual smell, or physical damage), do not take them and consult your pharmacist.

What Does Wilzin Contain?

Quick Answer: Each Wilzin 25 mg capsule contains 25 mg of zinc (equivalent to 83.92 mg zinc acetate dihydrate), and each 50 mg capsule contains 50 mg of zinc (equivalent to 167.84 mg zinc acetate dihydrate). Inactive ingredients include corn starch, magnesium stearate, gelatin, and coloring agents.

Active Substance

The active substance in Wilzin is zinc, provided in the form of zinc acetate dihydrate. The dosage is expressed in terms of elemental zinc content:

  • Wilzin 25 mg: Each hard capsule contains 25 mg of zinc (equivalent to 83.92 mg of zinc acetate dihydrate)
  • Wilzin 50 mg: Each hard capsule contains 50 mg of zinc (equivalent to 167.84 mg of zinc acetate dihydrate)

Inactive Ingredients (Excipients)

The other ingredients in Wilzin capsules are:

  • Capsule contents: Corn starch and magnesium stearate
  • Capsule shell: Gelatin, titanium dioxide (E171), and either brilliant blue FCF (E133) for the 25 mg capsule or sunset yellow FCF (E110) for the 50 mg capsule
  • Printing ink: Black iron oxide (E172) and shellac

Appearance and Packaging

Wilzin capsules are easy to identify by their color and markings:

  • Wilzin 25 mg: Light blue (aqua) hard capsule, imprinted with “93-376”
  • Wilzin 50 mg: Orange opaque hard capsule, imprinted with “93-377”

Both strengths are available in polyethylene bottles containing 250 hard capsules, with a polypropylene and polyethylene closure. A cotton filler is included inside each bottle to protect the capsules. Wilzin is manufactured by Recordati Rare Diseases, based in Puteaux, France.

Frequently Asked Questions About Wilzin

Wilson’s disease is a rare genetic disorder caused by mutations in the ATP7B gene, which is responsible for copper transport and excretion in the liver. Because the genetic defect is permanent, the body never regains the ability to properly eliminate excess copper. Without treatment, copper continuously accumulates in the liver, brain, eyes, and other organs, causing progressive damage. Treatment with copper-blocking or copper-chelating medications must therefore continue for life to prevent this accumulation. Even patients who feel completely well must maintain their treatment, as copper buildup resumes rapidly once therapy is stopped.

Wilzin should ideally be taken on an empty stomach, at least 1 hour before or 2–3 hours after meals. This is because food — especially fiber-rich foods and dairy products — can significantly reduce zinc absorption and therefore the effectiveness of the medication. However, if the morning dose causes stomach discomfort, your doctor may advise taking it with a small amount of protein-containing food such as lean meat. Dairy products (milk, cheese, yogurt) should be avoided near dosing times, as the casein and calcium they contain particularly impair zinc absorption.

Wilzin (zinc) and chelating agents like penicillamine and trientine work through fundamentally different mechanisms. Chelating agents actively bind copper that has already accumulated in tissues and organs, forming complexes that are then excreted in the urine. They act relatively quickly to reduce the body’s copper burden. Wilzin, in contrast, prevents new copper from being absorbed in the intestine by inducing metallothionein production. It does not remove copper that has already accumulated. Because of this slower mechanism, Wilzin is typically used as maintenance therapy after initial de-coppering with a chelator, or as first-line therapy in presymptomatic patients. Wilzin generally has fewer and milder side effects than chelating agents.

Stopping Wilzin without medical supervision can have serious, potentially life-threatening consequences. Because Wilson’s disease is a permanent genetic condition, the body continuously absorbs dietary copper and cannot properly excrete it. Without the copper-blocking effect of Wilzin, copper rapidly reaccumulates in the liver and other organs. This can lead to acute hepatic decompensation (sudden liver failure), worsening of neurological symptoms, psychiatric deterioration, and in severe cases, death. Some patients have developed fulminant liver failure within months of stopping anti-copper therapy. Never discontinue Wilzin without consulting your specialist.

The frequency of monitoring depends on your stage of treatment and clinical stability. During the initial phase of treatment or during transition from a chelating agent, more frequent monitoring (every 1–3 months) is typically required. Once stable maintenance therapy is established, monitoring intervals may be extended to every 6–12 months, though this varies by clinical center and individual patient needs. Tests typically include 24-hour urinary copper excretion, serum free (non-ceruloplasmin-bound) copper, serum zinc levels, liver function tests, and complete blood counts. Your specialist will determine the appropriate monitoring schedule for your situation.

Yes, Wilzin is approved for use in children from 1 year of age. Dosing is adjusted according to the child’s age and body weight. For children aged 1–6 years, the usual dose is 25 mg zinc twice daily. For children aged 6–16 years weighing under 57 kg, the dose is 25 mg three times daily. Children who weigh over 57 kg or are 16 years or older receive the adult dose. For young children who cannot swallow capsules, the capsule may be opened and the powder mixed with a small amount of water, potentially flavored with sugar or syrup. Monitoring is especially important in growing children, as both copper deficiency and copper excess can impair normal development.

References & Medical Sources

  1. European Medicines Agency (EMA). Wilzin — Summary of Product Characteristics. Last updated 2024. Available at: ema.europa.eu/en/medicines/human/EPAR/wilzin
  2. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Wilson’s disease. Journal of Hepatology. 2012;56(3):671–685. doi:10.1016/j.jhep.2011.11.007
  3. Schilsky ML, Roberts EA, Bronstein JM, et al. A multidisciplinary approach to the diagnosis and management of Wilson disease: 2022 Practice Guidance from the American Association for the Study of Liver Diseases. Hepatology. 2023;77(4):1428–1455. doi:10.1002/hep.32801
  4. Brewer GJ, Dick RD, Johnson VD, et al. Treatment of Wilson’s disease with zinc: XV long-term follow-up studies. Journal of Laboratory and Clinical Medicine. 1998;132(4):264–278.
  5. Czlonkowska A, Litwin T, Dusek P, et al. Wilson disease. Nature Reviews Disease Primers. 2018;4(1):21. doi:10.1038/s41572-018-0018-3
  6. Weiss KH, Gotthardt DN, Klemm D, et al. Zinc monotherapy is not as effective as chelating agents in treatment of Wilson disease. Gastroenterology. 2011;140(4):1189–1198. doi:10.1053/j.gastro.2010.12.034
  7. World Health Organization (WHO). WHO Model List of Essential Medicines. 23rd edition, 2023. Geneva: WHO.
  8. British National Formulary (BNF). Zinc acetate. National Institute for Health and Care Excellence (NICE). Accessed 2025.
  9. Ala A, Walker AP, Ashkan K, et al. Wilson’s disease. The Lancet. 2007;369(9559):397–408. doi:10.1016/S0140-6736(07)60196-2
  10. Recordati Rare Diseases. Wilzin Product Information. Puteaux, France. Last revised November 2024.

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