Last update: Aug. 27, 2019

Αργυρούχος Σουλφαδιαζίνη

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

Since the last update we have not found published data on its excretion in breast milk.

10% of sulfadiazine and 1% of silver pass into the systemic circulation by absorption through skin damaged by burns or ulcers (AEMPS 2014). The most common side effect is leucopenia (Fuller 2009). It may cause haemolysis in patients with glucose-6-phosphate dehydrogenase deficiency and kernicterus in the neonatal period (Fuller 2009).

High plasma levels of silver (Brouillard 2018, Choi 2018, Moiemen 2011, Lewis 2010), even more than 100 times higher than normal (Wan 1991) have been measured in patients treated for burns or ulcers with a body surface area exceeding 20% with potential clinical toxicity ( Mintz 2008, Browning 2008, Lansdown 2004, Tsipouras 1995, Coombs 1992).

Furthermore, it has been widely used for topical umbilical cord care (Glosan 2013, Ahmadpour 2006) with no reported side effects and its use is permitted after two months of life (Bristol 2012).

During breastfeeding it may be advisable not to use it on skin areas greater than 20% and for short periods.

Do not apply on the chest to prevent the infant from ingesting it; if necessary, apply after breastfeeding and clean well with water before the next feed.

If used during breastfeeding, it is advisable not to apply over a wide area (greater than 20%) or for prolonged periods to avoid systemic absorption. To be avoided in neonatal period and if there is glucose-6-phosphate dehydrogenase deficiency.

List of WHO essential medicines: compatible with breastfeeding (WHO / UNICEF 2002).

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Αργυρούχος Σουλφαδιαζίνη is Sulfadiazine Silver in Greek.

Is written in other languages:

Αργυρούχος Σουλφαδιαζίνη is also known as

Group

Αργυρούχος Σουλφαδιαζίνη belongs to this group or family:

Tradenames

Main tradenames from several countries containing Αργυρούχος Σουλφαδιαζίνη in its composition:

Pharmacokinetics

Variable Value Unit
Molecular weight 357 daltons
T1/2 10 hours

References

  1. Brouillard C, Bursztejn AC, Latarche C, Cuny JF, Truchetet F, Goullé JP, Schmutz JL. Silver absorption and toxicity evaluation of silver wound dressings in 40 patients with chronic wounds. J Eur Acad Dermatol Venereol. 2018 Dec;32(12):2295-2299. Abstract
  2. Choi H, Castillo B, Seminario-Vidal L. Silver absorption in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis treated with silver-impregnated dressings. A case series. Int Wound J. 2018 Dec;15(6):1049-1051. Abstract
  3. AEMPS. Sulfadiazina argéntica. Ficha técnica. 2014 Full text (in our servers)
  4. Golshan M, Hossein N. Impact of ethanol, dry care and human milk on the time for umbilical cord separation. J Pak Med Assoc. 2013 Abstract
  5. Bristol. Silver Sulfadiazine. Drug Summary. 2012 Full text (in our servers)
  6. Moiemen NS, Shale E, Drysdale KJ, Smith G, Wilson YT, Papini R. Acticoat dressings and major burns: systemic silver absorption. Burns. 2011 Abstract
  7. Lewis N, Kolimarala V, Lander A. Conservative management of exomphalos major with silver dressings: are they safe? J Pediatr Surg. 2010 Abstract
  8. Fuller FW. The side effects of silver sulfadiazine. J Burn Care Res. 2009 Abstract
  9. Browning JC, Levy ML. Argyria attributed to silvadene application in a patient with dystrophic epidermolysis bullosa. Dermatol Online J. 2008 Abstract
  10. Mintz EM, George DE, Hsu S. Silver sulfadiazine therapy in widespread bullous disorders: potential for toxicity. Dermatol Online J. 2008 Abstract
  11. Ahmadpour-Kacho M, Zahedpasha Y, Hajian K, Javadi G, Talebian H. The effect of topical application of human milk, ethyl alcohol 96%, and silver sulfadiazine on umbilical cord separation time in newborn infants. Arch Iran Med. 2006 Abstract
  12. Lansdown AB, Williams A. How safe is silver in wound care? J Wound Care. 2004 Abstract
  13. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  14. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001 Feb;17(1):54-65. Abstract
  15. Tsipouras N, Rix CJ, Brady PH. Solubility of silver sulfadiazine in physiological media and relevance to treatment of thermal burns with silver sulfadiazine cream. Clin Chem. 1995 Abstract
  16. Coombs CJ, Wan AT, Masterton JP, Conyers RA, Pedersen J, Chia YT. Do burn patients have a silver lining? Burns. 1992 Abstract
  17. Wan AT, Conyers RA, Coombs CJ, Masterton JP. Determination of silver in blood, urine, and tissues of volunteers and burn patients. Clin Chem. 1991 Abstract
  18. Boosalis MG, McCall JT, Ahrenholz DH, Solem LD, McClain CJ. Serum and urinary silver levels in thermal injury patients. Surgery. 1987 Abstract
  19. Wang XW, Wang NZ, Zhang OZ, Zapata-Sirvent RL, Davies JW. Tissue deposition of silver following topical use of silver sulphadiazine in extensive burns. Burns Incl Therm Inj. 1985 Abstract
  20. Lockhart SP, Rushworth A, Azmy AA, Raine PA. Topical silver sulphadiazine: side effects and urinary excretion. Burns Incl Therm Inj. 1983 Abstract

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