II. Indications

  1. Sulfadiazine Systemic
    1. Toxoplasmosis Prevention and Treatment
  2. Silver Sulfadiazine Topical Cream (Silvadene, SSD)
    1. Burn Management

III. Contraindications

  1. Severe Renal Insufficiency
  2. Infants age <2 months old (risk of Kernicterus with systemic Sulfadiazine)

IV. Mechanism

V. Medications

  1. Sulfadiazine Systemic
    1. See Toxoplasmosis
    2. Use limited to Toxoplasmosis Prevention and management (combined with Pyrimethamine and leucovorin)
  2. Silver Sulfadiazine Topical Cream (Silvadene, SSD)
    1. Topical Cream used in Burn Injury
    2. See Burn Management

VI. Dosing

  1. Systemic Sulfadiazine
    1. See Toxoplasmosis
  2. Silver Sulfadiazine Topical (Silvadene Cream)
    1. See Burn Management

VII. Adverse Effects

  1. See Sulfadiazine
  2. Crystalluria
    1. Sulfadiazine is more likely to precipitate in acidic urine
    2. Maintain oral hydration
    3. Reduce dose in Renal Insufficiency

VIII. Drug Interactions

  1. Warfarin
    1. Increases INR
  2. Increases drug levels of other medications
    1. Methotrexate
    2. Phenytoin

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Cost: Medications

silver sulfadiazine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
SILVER SULFADIAZINE 1% CREAM Generic $0.25 per gram