Silver sulfadiazine
Also known as: Flamazine · Sulfadiazine silver · SSD
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Burns and superficial wound infections | Apply a thin layer (approx 1.5 mm thick) to the affected area | topical | sid to bid | Until healing is satisfactory | 🌍 EU |
- Burns and superficial wound infections: Clean and debride wound before application. Apply using sterile technique.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Burns and superficial wound infections | Apply a thin layer (approx 1.5 mm thick) to the affected area | topical | sid to bid | Until healing is satisfactory | 🌍 EU |
- Burns and superficial wound infections: Clean and debride wound before application. Apply using sterile technique.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Silver sulfadiazine is a topical antimicrobial agent widely used in veterinary medicine for the treatment and prevention of infection in second- and third-degree burns, as well as other superficial skin infections and wounds.
Clinical Pearl: It is highly effective against a broad spectrum of bacteria, including Pseudomonas aeruginosa, and some yeasts. It is particularly valued for burn management due to its soothing cream base and broad-spectrum efficacy.
Mechanism of action
Slowly releases silver ions in concentrations that are toxic to bacteria and yeasts. The sulfadiazine component also provides local anti-infective qualities by inhibiting bacterial folic acid synthesis.
→ Silver ions bind to bacterial DNA and cell membranes → disruption of cellular metabolism and structural integrity → cell death. → Sulfadiazine competitively inhibits dihydropteroate synthase → prevents bacterial folic acid synthesis.
Safety & warnings
Contraindications
- Hypersensitivity to sulfonamides
- Use in pregnant or premature animals (theoretical risk of kernicterus)
Adverse effects
- Local irritation
- Erythema
- Skin discoloration (argyria) with prolonged use
- Delayed wound healing (in some cases)
Precautions
Avoid contact with eyes. Use with caution in patients with known sulfonamide hypersensitivity. May impair the action of topical proteolytic enzymes used for wound debridement. Systemic absorption can occur if applied to very large burn areas, potentially leading to systemic sulfonamide effects.
Drug interactions
Silver may inactivate the enzymes, reducing their debriding efficacy.
May increase the risk of leukopenia if significant systemic absorption occurs.
Monitoring
- Wound healing progress
- Signs of local irritation or hypersensitivity
- Complete blood count (CBC) if applied to very large areas for prolonged periods (due to theoretical risk of leukopenia)
Pharmacokinetics
Absorption
Minimal systemic absorption from intact skin; however, up to 10% of sulfadiazine and 1% of silver may be absorbed from extensive burn wounds.
Distribution
Primarily local tissue distribution at the site of application.
Metabolism
Absorbed sulfadiazine is metabolized in the liver.
Elimination
Absorbed sulfadiazine is excreted primarily in the urine.
Overdose
Overdose is highly unlikely with topical application. Ingestion of large amounts (e.g., if a pet licks a large treated area) may cause mild gastrointestinal upset or, rarely, systemic sulfonamide toxicity (crystalluria). Treatment is symptomatic and supportive.
Available products
Formulations
- 1% cream (water-soluble)
Human-labeled
- Flamazine 1% cream
Regulatory status
Human approved products are frequently used extra-label in veterinary medicine.
Human products used off-label under the cascade.
Flamazine is a human POM product often used off-label under the prescribing cascade.
No regulatory data for: 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store at room temperature, away from direct light and heat. Do not freeze.
Client information
Apply exactly as directed by your veterinarian.
- Clean the wound as instructed before applying the cream.
- Wear gloves when applying to prevent spreading infection to the wound and to avoid staining your hands.
- Prevent your pet from licking the treated area; an Elizabethan collar (cone) is usually necessary.
Contact your vet if the wound worsens, looks redder, has a foul odor, or if your pet develops a rash.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.