How does this medication work? What will it do for me?

Silver sulfadiazine belongs to the class of medications called topical antibiotics. It is used to treat and prevent infection of skin wounds, especially in victims of serious burns. It may also be used in leg ulcers, skin grafts, surgical incisions, and minor cuts and scrapes. It is applied directly to the wounded area and works by stopping the action of bacteria that may cause infection.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Flamazine is a white cream, containing 1% w/w of silver sulfadiazine. Nonmedicinal ingredients: cetyl alcohol, distilled water, glycerol stearate, liquid paraffin, polysorbate 60, polysorbate 80, and propylene glycol.

How should I use this medication?

Burns: Clean burn wounds and apply silver sulfadiazine over all the affected areas to a depth of 3 mm to 5 mm.

One way to apply the cream is with a sterile gloved hand or a sterile nonmetallic spatula. Where necessary, reapply the cream to any area from which it has been removed by activity. Reapply the cream at least every 24 hours.

For hand burns and finger injuries, a recommended method is to apply the medication to the burn and then enclose the hand in a clear plastic bag or glove, which is then closed at the wrist. Change the dressing every 3 days or whenever there is a lot of drainage in the bag.

Silver sulfadiazine cream is also used for treatment of leg ulcers. Clean leg ulcer and fill the cavity with silver sulfadiazine to a depth of at least 3 mm to 5 mm. Avoid applying the silver sulfadiazine to the surrounding skin. Apply appropriate dressing to the area and change every 2 or 3 days.

Ask your health care professional about the best way to apply the cream and care for the affected area.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, apply it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not apply a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Silver sulfadiazine should not be used by anyone who:

  • is allergic to silver sulfadiazine or to any of the ingredients of the medication
  • is a premature infant or newborn in their first month of life
  • is currently on sulfonamide therapy
  • is pregnant at term

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • burning feeling on treated area(s)
  • itching or skin rash

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • ashen-grey discolouration of the skin
  • blistering, peeling, or loosening of skin
  • bloody or cloudy urine
  • chills or fever
  • cough
  • decreased amount of urine or less frequent urination
  • increased sensitivity of skin to sunlight, especially for patients with burns on large areas
  • intense itching of burn wounds
  • pain at site of application
  • painful or difficult urination
  • red skin lesions, often with a purple centre
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots on lips or in mouth
  • swollen glands
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergy to sulfonamides: People who have previously shown sensitization reactions to sulfonamides should exercise caution in the use of silver sulfadiazine.

Glucose 6 phosphate dehydrogenase deficiency: Silver sulfadiazine should be used with caution by patients with a history of G-6-PD (glucose 6 phosphate dehydrogenase) deficiency, as hemolysis (breakdown of blood cells) may occur.

Liver and kidney function: Silver sulfadiazine should be used with caution by patients with significant liver or kidney impairment.

Oral hypoglycemic agents and phenytoin: In patients with large area burns where serum sulfadiazine levels may approach therapeutic levels, the action of antidiabetic agents and phenytoin may be increased and it is recommended that blood levels be monitored.

Pregnancy: The safety of silver sulfadiazine has not been established for use during pregnancy. Silver sulfadiazine should only be used by badly burned pregnant women if the benefits outweigh the risks. Silver sulfadiazine should not be used by a pregnant woman near term.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are using silver sulfadiazine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

What other drugs could interact with this medication?

There may be an interaction between silver sulfadiazine and any of the following:

  • antidiabetes medications
  • cimetidine
  • enzymatic debriding agents
  • phenytoin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.