Copper

Trace cofactor mineral, used in parenteral nutrition and supplements

ATC code: A12CX-COPPER

Brand names: Solgar Chelated Copper, Cupric Sulfate Injection, Multitrace-5

Updated 9 Sep 2026 · Methodology

Indications

Copper deficiency

First line

Copper preparations are used in confirmed deficiency after bariatric surgery, malabsorption syndromes, prolonged high-dose zinc intake, parenteral nutrition without copper and the rare paediatric Menkes disease. Baseline strategy: oral copper sulfate, gluconate or bisglycinate 2–8 mg elemental copper/day according to severity; in severe neutropenia and myelopathy – IV copper sulfate 1–2 mg/day. The cause must be addressed in parallel: in most adults it is chronic zinc intake above 40 mg/day or zinc-containing denture cream. Targets: normal caeruloplasmin and reversal of neurological symptoms when treatment starts early. Guidance: ESPEN, ASPEN, Kumar 2004 (Neurology).

Sources

ICD-10: E61.0 · ICD-11: 5B5K.6

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

Anti-aging and longevity

Not recommended

Copper is marketed in supplements as a «grey-hair» remedy, «skin firmness» booster, «hair growth» aid and «longevity» tool. The pitch leans on copper's role in melanin synthesis and collagen cross-linking. Clinical trials in healthy adults showing that oral copper reverses greying, smooths wrinkles or extends life do not exist. NIH ODS and systematic reviews found no benefit of copper supplements in people without confirmed deficiency. Chronic excess is risky: it raises oxidative stress in hepatocytes and may mask Wilson disease. Most adults on a balanced diet have adequate copper. If copper was bought for anti-ageing, consider seeking a second opinion before continuing.

Sources

How to read tiers A–F

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit

Mechanism of action

Copper is a cofactor for caeruloplasmin, cytochrome c oxidase of the respiratory chain, lysyl oxidase (cross-links collagen and elastin), Cu/Zn superoxide dismutase, dopamine beta-hydroxylase (noradrenaline synthesis) and tyrosinase (melanin synthesis). It is absorbed in the duodenum via the CTR1 transporter, transported on albumin and transcuprein, and packaged into caeruloplasmin by the liver. Copper homeostasis is regulated by the liver, which excretes excess into bile. Zinc competes with copper at the enterocyte metallothionein level, so prolonged high-dose zinc intake depletes copper stores.

Safety

Contraindications

Wilson disease (ATP7B mutation causes toxic copper accumulation)
Severe hepatic impairment
Idiopathic childhood cirrhosis
Biliary atresia
Known hypersensitivity to copper salts

Serious adverse effects

Acute copper poisoning at single doses above 10 mg – haemolysis, methaemoglobinaemia, acute tubular necrosis
Chronic hepatotoxicity with years of excess intake
Zinc depletion with prolonged copper doses above 5 mg/day

Common adverse effects

Metallic taste
Nausea
Epigastric pain
Vomiting on empty stomach

Pregnancy: can you take Copper?

Adequate copper intake in pregnancy is 1 mg/day (NIH ODS, EFSA) and is covered by ordinary diet. Copper in parenteral nutrition and in standard prenatal multivitamins is safe. Stand-alone copper supplements in pregnancy are not justified and may be harmful because of the placenta's sensitivity to oxidative stress.

Breastfeeding: can you take Copper?

Copper in human milk decreases from about 0.4 mg/L in early weeks to 0.15–0.2 mg/L by 6 months and covers infant needs. Stand-alone copper supplements during lactation are not justified.

Calculate RID

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

Drug–drug interactions

1 pair found. Sorted from critical to minor.

MajorZinc (oral salts: picolinate, citrate, gluconate, oxide, acetate)Mineral supplements. Trace elements

Mechanism

Zinc induces metallothionein in the enterocyte, and that protein traps copper and returns it to the gut lumen with the shed cell. NIH ODS puts numbers on it: doses of 50 mg of zinc or more over weeks inhibit copper absorption, reduce immune function and lower cholesterol. The resulting copper deficiency is one of the few supplement interactions with documented neurological harm.

Symptoms

Anaemia unresponsive to iron, neutropenia, and in advanced cases myelopathy: tingling and weakness in the legs, unsteady gait, impaired deep sensation. The neurological picture may not fully reverse once copper is corrected.

Management

Sustained high-dose zinc without oversight is the problem, not zinc itself. Above 40 mg daily long term, monitor the blood count and serum copper. -type ophthalmic formulas already include copper for this reason, and that is the sensible reference: long-term zinc comes with copper.

Sources

NIH Office of Dietary Supplements: Zinc – Health Professional Fact Sheet (2025)

Pair details →Zinc (oral salts: picolinate, citrate, gluconate, oxide, acetate) →

Label mentions3 mentions

Verbatim lines from the interaction sections, in the language of the label

From other drugs’ labels

Cefditoren pivoxil
«métodos de reducción de cobre, pero no con los métodos enzimáticos.»
AEMPS, section 4.5 · Open on CIMA
Cefuroxime axetil
«Drug/Laboratory Test Interactions: A false-positive reaction for glucose in the urine may occur with copper reduction tests (e.g., Benedict's or Fehling's solution), but not with enzyme-based tests…»
FDA, section 7 · Open on DailyMed
Iopromide
«Así mismo las concentraciones elevadas de medios de contraste en suero y orina pueden interferir con el análisis de bilirrubina, proteínas y sustancias inorgánicas (hierro, cobre, calcio y fosfatos)…»
AEMPS, section 4.5 · Open on CIMA

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Frequently asked

What is Copper used for?

Copper is evaluated for the following indications with varying evidence strength: Copper deficiency (evidence tier B), Anti-aging and longevity (evidence tier F). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Copper?

Common side effects of Copper (≥ 1 in 100): Metallic taste, Nausea, Epigastric pain, Vomiting on empty stomach. See the Safety section for uncommon and serious reactions.

Is Copper safe during pregnancy?

Is Copper compatible with breastfeeding?

Copper in human milk decreases from about 0.4 mg/L in early weeks to 0.15–0.2 mg/L by 6 months and covers infant needs. Stand-alone copper supplements during lactation are not justified.

Who should not take Copper?

Copper is contraindicated in: Wilson disease (ATP7B mutation causes toxic copper accumulation); Severe hepatic impairment; Idiopathic childhood cirrhosis; Biliary atresia; Known hypersensitivity to copper salts. Full list in the Safety section.

Official sources

Direct links to regulator labels. Open in a new tab.

FDA / DailyMedLabel dated 06/09/2024

Other drugs in this group

Magnesium (oral salts: citrate, glycinate, oxide, sulfate), Magnesium L-threonate (Magtein), Magnesium sulfate, Manganese, Phosphorus, Zinc (oral salts: picolinate, citrate, gluconate, oxide, acetate), Calcium carbonate, Molybdenum