Uses

What is silver sulfadiazine used for?

Topical silver sulfadiazine is commonly used to treat and prevent wound infections in people with severe burns. 

Topical silver sulfadiazine may not be appropriate for the infection listed above, depending on which germs are causing the infection. Bacteria in some locations may have developed resistance to topical silver sulfadiazine, which will make it less effective.

Topical silver sulfadiazine may also be used for other conditions as determined by your healthcare provider.

How does silver sulfadiazine work (mechanism of action)?

Topical silver sulfadiazine kills certain types of bacteria by affecting their cell wall or membrane.

How is silver sulfadiazine supplied (dosage forms)?

Topical silver sulfadiazine is available as Silvadene, SSD, Thermazene, and silver sulfadiazine generic in the following dosage form that is applied to the skin.

  • 1% cream

How should I store silver sulfadiazine?

Topical silver sulfadiazine should be stored at room temperature,  between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place. Keep tightly closed.

Side Effects

What are the most common side effects of silver sulfadiazine?

The most common side effects of topical silver sulfadiazine are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Pain, burning, itching, rashes, and skin discoloration 
  • Low white blood cells (leukopenia)
  • Reduced need to pee
  • Swelling in your face, feet, ankles, or legs
  • Sudden weight gain

There may be other side effects of topical silver sulfadiazine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at https://www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at https://www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of silver sulfadiazine?

While less common, the most serious side effects of topical silver sulfadiazine are described below, along with what to do if they happen.

Severe Allergic Reactions. Topical silver sulfadiazine can cause allergic reactions, which can be serious. Stop using topical silver sulfadiazine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Severe Skin Reactions. Topical silver sulfadiazine can cause severe skin reactions called Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and exfoliative dermatitis that can lead to death if not treated. If you develop a rash, stop topical silver sulfadiazine and call your healthcare provider right away. Get emergency help right away if you have any of the following symptoms of SJS, TEN, or exfoliative dermatitis.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using topical silver sulfadiazine. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light colored poop
  • Dark colored urine
  • Your skin or the whites of your eyes turning yellowish in color (jaundice)

Kidney Damage. Kidney damage can happen when using topical silver sulfadiazine. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs 
  • Weakness or unusual tiredness
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

Blood Disorders. Topical silver sulfadiazine can cause blood disorders such as agranulocytosis, aplastic anemia, hemolytic anemia, low platelets (thrombocytopenia), and low white blood cell count (leukopenia). Stop using topical silver sulfadiazine and get help right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Another Infection. Using topical silver sulfadiazine may lead to an infection with another type of germ, such as fungi. Call your healthcare provider if your wound infection does not improve or gets worse.

Warnings & Precautions

Who should not use silver sulfadiazine?

Allergies to Ingredients. People who are allergic to any of the following should not use topical silver sulfadiazine.

  • silver sulfadiazine
  • Silvadene
  • SSD
  • Thermazene
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific topical silver sulfadiazine products they stock.

Term or Near Term Pregnancy. Do not use topical silver sulfadiazine if you are pregnant and at or near your delivery date.  See the Pregnancy section below for more details.

Premature Babies or Newborns Younger than 2 Months Old. Premature babies or newborn infants during the first 2 months of life should not use topical silver sulfadiazine because of a possible serious side effect called kernicterus. Kernicterus is a condition when a substance called bilirubin builds up in your blood and causes brain damage. 

What should I know about silver sulfadiazine before using it?

Do not use topical silver sulfadiazine unless it has been prescribed to you by a healthcare provider. Use it as prescribed.

Do not share topical silver sulfadiazine with other people, even if they have the same condition as you. It may harm them.

Keep topical silver sulfadiazine out of the reach of children.

Topical silver sulfadiazine is only for use on the skin. Do not get topical silver sulfadiazine in your eyes.

You should continue to use silver sulfadiazine until the area is healed or until the site is ready for grafting. 

What should I tell my healthcare provider before using silver sulfadiazine?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if topical silver sulfadiazine is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following health conditions.

Pregnancy. It is not known if or how topical silver sulfadiazine could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use topical silver sulfadiazine while you are pregnant or trying to get pregnant. Severe side effects can occur in a baby if the mother uses topical silver sulfadiazine near her delivery date. 

Breastfeeding. It is not known if topical silver sulfadiazine passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Severe side effects can occur in a baby who is fed by a mother who is using topical silver sulfadiazine. Talk with your healthcare provider about stopping either breastfeeding or topical silver sulfadiazine. 

Interactions

Does silver sulfadiazine interact with foods or drinks?

There are no known interactions between topical silver sulfadiazine and foods or drinks.

It is unknown if drinking alcohol will affect topical silver sulfadiazine.

Does silver sulfadiazine interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. In particular, make sure that you discuss any other medicines that may be applied to the same area of your skin as topical silver sulfadiazine.

Does Silver Sulfadiazine Cream interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much silver sulfadiazine?

If you or someone else has used too much topical silver sulfadiazine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of silver sulfadiazine?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose, and use only the next dose. Do not use double or extra doses.

It is important to complete your prescribed course of topical silver sulfadiazine, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to topical silver sulfadiazine or other similar medicines.

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