silver sulfadiazine (Silvadene, SSD, SSD AF, Thermazene)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Other rare skin reactions reported with silver sulfadiazine use include:

  • skin necrosis (skin death),
  • redness,
  • burning sensation of the treated area(s),
  • itching,
  • rash, and
  • brownish-gray skin discoloration.

Rarely, a drop in white blood cells has been reported with silver sulfadiazine therapy. Drop in white blood counts peak within 2-4 days of starting treatment and usually return to normal limits following 2-3 days of onset.

Patients are advised to speak to their pharmacist or doctor for a complete list of side effects, including those caused by sulfonamides.



PREPARATIONS: 1% topical cream

STORAGE: Cream should be stored at room temperature between 15 C to 30 C (59 F to 86 F).

DOSING: For adults, adolescents, children, and infants = 2 months:

  • After cleaning and debridement, silver sulfadiazine may be applied to the affected area(s) to a thickness of approximately 1.6 mm (1/16 of an inch) once or twice daily.
  • The cream may be reapplied whenever necessary to affected area(s) if it is removed by activity or washing.
  • Silver sulfadiazine is not recommended for use in premature neonates or neonates < 2 months of age.

DRUG INTERACTIONS: No significant drug interactions with oral medications have been reported with silver sulfadiazine use. However, as with all medications, patients must check with their doctor or pharmacist before starting any new medications for possible interactions with any current drug regimens.

PREGNANCY: Use of topical silver sulfadiazine has not been adequately evaluated in pregnant women. Due to the lack of conclusive safety data, silver sulfadiazine should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. Silver sulfadiazine is classified as FDA pregnancy risk category B (animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women).

NURSING MOTHERS: It is not known if silver sulfadiazine is excreted in breast milk. However, silver sulfadiazine is a sulfonamide and oral sulfonamides are excreted into breast milk and increase the risk of kernicterus, a rare type of brain damage in newborns caused by very high levels of bilirubin. Therefore, use of silver sulfadiazine in females who are breastfeeding is not recommended.

REFERENCE: FDA Prescribing Information.

Medically Reviewed by a Doctor on 2/4/2015

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