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Overview: Silver sulfadiazine cream is used to help prevent and treat infections in serious burns. It works to stop the growth of bacteria in wounds. Common side effects include burning, itching, discoloration, or a rash where the cream is applied. Rarely, it can cause severe skin reactions or problems with your blood, liver, or kidneys. Contact your health care provider right away if you notice unusual bruising or bleeding, fever, urine changes, yellowed eyes or skin, or stomach pain.

Uses

What is silver sulfadiazine used for?

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

Silver sulfadiazine may not be the right medicine for some of the infections listed above, depending on which germs are causing the infection. Bacteria in some locations may have become resistant to silver sulfadiazine, which will make it not work as well.

Silver sulfadiazine may also be used for other conditions as determined by your health care provider.

How does silver sulfadiazine work (mechanism of action)?

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

How is silver sulfadiazine supplied (dosage forms)?

Brands and other names

  • Silvadene
  • SSD
  • Thermazene

Dosage forms and strengths

  • 1% cream

How should I store silver sulfadiazine?

Silver sulfadiazine should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 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 silver sulfadiazine are pain, stinging, itching, rashes, or discoloration where the cream is applied to the skin. Tell your health care provider if you have any of these side effects that bother you.

There may be other side effects of silver sulfadiazine that are not listed here. Contact your health care provider if you think you are having a side effect. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at 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 silver sulfadiazine are described below, along with what to do if they happen.

Severe Allergic Reactions. Silver sulfadiazine can cause allergic reactions, which can be serious. Stop using 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 or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Severe Skin Reactions. 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 get a rash, stop using silver sulfadiazine and call your health care provider right away. Get emergency help right away if you have any of the following symptoms.

  • Painful skin that looks burned and peels off
  • Flat rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Flu-like symptoms including fever, chills, and muscle aches

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

  • Reduced need to pee
  • Sudden weight gain
  • Swelling in your feet, ankles, or legs 
  • Weakness or unusual tiredness
  • Trouble catching your breath or chest pain
  • Confusion
  • Nausea
  • Seizures

Blood Disorders. 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 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 silver sulfadiazine may lead to an infection with another type of germ, such as fungi. Call your health care 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 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 silver sulfadiazine products they stock.

Term or Near Term Pregnancy. Do not use 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 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 silver sulfadiazine unless it has been prescribed to you by a health care provider. Use it as prescribed.

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

Keep silver sulfadiazine out of the reach of children.

Silver sulfadiazine is only for use on the skin. Do not get 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 health care provider before using silver sulfadiazine?

Tell your health care 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 know if silver sulfadiazine is right for you.

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

Sulfa Allergy. Tell your health care provider if have a sulfa allergy. A sulfa allergy is a rash or more serious reaction to sulfa, or sulfonamide, medicines. Your health care provider can let you know if it is safe for you to use silver sulfadiazine cream.

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

Pregnancy. It is not known if or how silver sulfadiazine could affect pregnancy or harm a fetus. Tell your health care provider if you are or plan to become pregnant. Your health care provider will let you know if you should use silver sulfadiazine while you are pregnant or trying to get pregnant. Severe side effects can occur in a fetus if the mother uses silver sulfadiazine near the due date. 

Breastfeeding. It is not known if silver sulfadiazine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Because of the possibility of serious side effects, your health care provider will let you know if you should stop breastfeeding or stop using silver sulfadiazine.

Interactions

Does silver sulfadiazine interact with foods or drinks?

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

It is unknown if drinking alcohol will affect silver sulfadiazine.

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

Silver sulfadiazine may interact with certain medicines. Always tell your health care 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 silver sulfadiazine.

Does 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 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 silver sulfadiazine, even if your symptoms get better. This will reduce the risk that future infections are resistant to silver sulfadiazine or other similar medicines.