Silvadene Information
Silvadene (Silver sulfadiazine) Description
Silvadene (Silver sulfadiazine) Cream 1% is a soft, white, water-miscible cream containing the antimicrobial agent silver sulfadiazine in micronized form, which has the following structural formula:
Each gram of Silvadene (Silver sulfadiazine) Cream 1% contains 10 mg of micronized silver sulfadiazine. The cream vehicle consists of white petrolatum, stearyl alcohol, isopropyl myristate, sorbitan monooleate, polyoxyl 40 stearate, propylene glycol, and water, with methylparaben 0.3% as a preservative. Silvadene (Silver sulfadiazine) Cream 1% (silver sulfadiazine) spreads easily and can be washed off readily with water.
Silvadene (Silver sulfadiazine) Clinical Pharmacology
Silver sulfadiazine has broad antimicrobial activity. It is bactericidal for many gram-negative and gram-positive bacteria as well as being effective against yeast. Results from testing are listed below.
Sufficient data have been obtained to demonstrate that silver sulfadiazine will inhibit bacteria that are resistant to other antimicrobial agents and that the compound is superior to sulfadiazine.
Studies utilizing radioactive micronized silver sulfadiazine, electron microscopy, and biochemical techniques have revealed that the mechanism of action of silver sulfadiazine on bacteria differs from silver nitrate and sodium sulfadiazine. Silver sulfadiazine acts only on the cell membrane and cell wall to produce its bactericidal effect.
Silver sulfadiazine is not a carbonic anhydrase inhibitor and may be useful in situations where such agents are contraindicated.
Silvadene (Silver sulfadiazine) Indications And Usage
Silvadene (Silver sulfadiazine) Cream 1% (silver sulfadiazine) is a topical antimicrobial drug indicated as an adjunct for the prevention and treatment of wound sepsis in patients with second- and third-degree burns.
Silvadene (Silver sulfadiazine) Contraindications
Silvadene (Silver sulfadiazine) Cream 1% (silver sulfadiazine) is contraindicated in patients who are hypersensitive to silver sulfadiazine or any of the other ingredients in the preparation.
Because sulfonamide therapy is known to increase the possibility of kernicterus, Silvadene (Silver sulfadiazine) Cream 1% should not be used on pregnant women approaching or at term, on premature infants, or on newborn infants during the first 2 months of life.
Silvadene (Silver sulfadiazine) Warnings
There is potential cross-sensitivity between silver sulfadiazine and other sulfonamides. If allergic reactions attributable to treatment with silver sulfadiazine occur, continuation of therapy must be weighed against the potential hazards of the particular allergic reaction.
Fungal proliferation in and below the eschar may occur. However, the incidence of clinically reported fungal superinfection is low.
The use of Silvadene (Silver sulfadiazine) Cream 1% (silver sulfadiazine) in some cases of glucose-6-phosphate dehydrogenase-deficient individuals may be hazardous, as hemolysis may occur.
Silvadene (Silver sulfadiazine) Precautions
If hepatic and renal functions become impaired and elimination of drug decreases, accumulation may occur and discontinuation of Silvadene (Silver sulfadiazine) Cream 1% (silver sulfadiazine) should be weighed against the therapeutic benefit being achieved.
In considering the use of topical proteolytic enzymes in conjunction with Silvadene (Silver sulfadiazine) Cream 1%, the possibility should be noted that silver may inactivate such enzymes.
Silvadene (Silver sulfadiazine) Adverse Reactions
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.
Absorption of silver sulfadiazine varies depending upon the percent of body surface area and the extent of the tissue damage. Although few have been reported, it is possible that any adverse reaction associated with sulfonamides may occur. Some of the reactions, which have been associated with sulfonamides, are as follows: blood dyscrasias including agranulocytosis, aplastic anemia, thrombocytopenia, leukopenia, and hemolytic anemia; dermatologic and allergic reactions, including Stevens-Johnson syndrome and exfoliative dermatitis; gastrointestinal reactions; hepatitis and hepatocellular necrosis; CNS reactions; and toxic nephrosis.
Silvadene (Silver sulfadiazine) Dosage And Administration
Prompt institution of appropriate regimens for care of the burned patient is of prime importance and includes the control of shock and pain. The burn wounds are then cleansed and debrided, and Silvadene (Silver sulfadiazine) Cream 1% (silver sulfadiazine) is applied under sterile conditions. The burn areas should be covered with Silvadene (Silver sulfadiazine) Cream 1% at all times. The cream should be applied once to twice daily to a thickness of approximately 1/16 inch. Whenever necessary, the cream should be reapplied to any areas from which it has been removed by patient activity. Administration may be accomplished in minimal time because dressings are not required. However, if individual patient requirements make dressings necessary, they may be used.
Reapply immediately after hydrotherapy.
Treatment with Silvadene (Silver sulfadiazine) Cream 1% should be continued until satisfactory healing has occurred, or until the burn site is ready for grafting. The drug should not be withdrawn from the therapeutic regimen while there remains the possibility of infection except if a significant adverse reaction occurs.
Silvadene (Silver sulfadiazine) How Supplied
Silvadene (Silver sulfadiazine) Cream 1% (silver sulfadiazine) is available in jars containing 50 g ( 61570-131-50), 400 g ( 61570-131-40), and 1000 g ( 61570-131-98) and tubes containing 20 g ( 61570-131-20) and 85 g ( 61570-131-85).
Silvadene (Silver sulfadiazine) References
Prescribing Information as of July 2003.
Distributed by:
Monarch Pharmaceuticals, Inc.
Bristol, TN 37620
(A wholly owned subsidiary of King Pharmaceuticals, Inc.)
Manufactured by:
King Pharmaceuticals, Inc.
Bristol, TN 37620
Silvadene (Silver sulfadiazine) Labelgraphics
Silvadene (Silver sulfadiazine) Labelgraphics
Silvadene (Silver sulfadiazine) Labelgraphics
Silvadene (Silver sulfadiazine) Labelgraphic
Silvadene (Silver sulfadiazine) Labelgraphics
