Does Silvadene (silver sulfadiazine) cause side effects?

Silvadene (silver sulfadiazine) is a topical (for the skin) antibiotic applied to the skin to treat and prevent wound infections associated with second- or third-degree burns

Side effects of Silvadene are uncommon and usually short-lived and may include

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

Serious side effects of Silvadene are uncommon and may include

  • skin necrosis (skin death), and rarely,
  • a drop in white blood cells.

Drug interactions of Silvadene include collagenase ointment, because Silvadene reduces its effects.

Use of topical Silvadene has not been adequately evaluated in pregnant women.

Due to the lack of conclusive safety data, Silvadene should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus.

It is unknown if Silvadene passes into 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. Use of Silvadene in females who are breastfeeding is not recommended.

What are the important side effects of Silvadene (silver sulfadiazine)?

  • Since silver sulfadiazine is applied to the surface of the skin, it rarely affects other areas of the body or causes long term side effects.
  • Most of the side effects reported with use are short lived and limited to the areas being treated.
  • Use of silver sulfadiazine may cause the treated area(s) to be more sensitive to sunlight (photosensitive or sun sensitive). To avoid sunburn, patients must take caution in protecting the affected area(s) from prolonged sun exposure.
  • 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.

Silvadene (silver sulfadiazine) side effects list for healthcare professionals

  • Several cases of transient leukopenia have been reported in patients receiving silver sulfadiazine therapy. 
  • Leukopenia associated with silver sulfadiazine administration is primarily characterized by decreased neutrophil count. Maximal white blood cell depression occurs within 2 to 4 days of initiation of therapy.
  • Rebound to normal leukocyte levels follows onset within 2 to 3 days.
  • Recovery is not influenced by continuation of silver sulfadiazine therapy.
  • An increased incidence of leukopenia has been reported in patients treated concurrently with cimetidine.
  • Other infrequently occurring events include skin necrosis, erythema multiforme, skin discoloration, burning sensation, rashes, and interstitial nephritis.
  • Reduction in bacterial growth after application of topical antibacterial agents has been reported to permit spontaneous healing of deep partial-thickness burns by preventing conversion of the partial thickness to full thickness by sepsis.
  • However, reduction in bacterial colonization has caused delayed separation, in some cases necessitating escharotomy in order to prevent contracture.

What drugs interact with Silvadene (silver sulfadiazine)?

No Information Provided

Summary

Silvadene (silver sulfadiazine) is a topical (for the skin) antibiotic applied to the skin to treat and prevent wound infections associated with second- or third-degree burns. Side effects of Silvadene are uncommon and usually short-lived and may include sun sensitivity of treated areas, redness, burning sensation of the treated area(s), itching, rash, and brownish-gray skin discoloration. Use of topical Silvadene has not been adequately evaluated in pregnant women. Due to the lack of conclusive safety data, Silvadene should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown if Silvadene passes into breast milk.

Treatment & Diagnosis

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Medically Reviewed on 6/4/2020
References
FDA Prescribing Information

Professional side effects and drug interactions sections courtesy of the U.S. Food and Drug Administration.
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