Antibiotic, Ophthalmic; Antibiotic, Topical; Cauterizing Agent, Topical; Topical
Skin Product, Antibacterial
Prevention of gonococcal ophthalmia neonatorum; cauterization of wounds and
sluggish ulcers, removal of granulation tissue and warts; aseptic prophylaxis of
Not for use on broken skin or cuts; hypersensitivity to silver nitrate or any
Do not use applicator sticks on the eyes; repeated applications of the
ophthalmic solution into the eye can cause cauterization of the cornea and
Dermatologic: Burning and skin irritation
Ocular: Chemical conjunctivitis
1% to 10%:
Dermatologic: Staining of the skin
Ocular: Cauterization of the cornea, blindness
Symptoms of overdose include pain and burning of mouth, salivation, vomiting,
diarrhea, shock, coma, convulsions, death; blackening of skin and mucous
membranes; absorbed nitrate can cause methemoglobinemia
Fatal dose is as low as 2 g
Administer sodium chloride in water (10 g/L) to cause precipitation of silver
Decreased effect: Sulfacetamide preparations are
Must be stored in a dry place; exposure to light causes silver to oxidize and
turn brown, dipping in water causes oxidized film to readily
Free silver ions precipitate bacterial proteins by combining with chloride in
tissue forming silver chloride; coagulates cellular protein to form an eschar;
silver ions or salts or colloidal silver preparations can inhibit the growth of
both gram-positive and gram-negative bacteria. This germicidal action is
attributed to the precipitation of bacterial proteins by liberated silver ions.
Silver nitrate coagulates cellular protein to form an eschar, and this mode of
action is the postulated mechanism for control of benign hematuria, rhinitis,
and recurrent pneumothorax.
Absorption: Because silver ions readily combine with protein, there is
minimal GI and cutaneous absorption of the 0.5% and 1% preparations
Elimination: Although the highest amounts of silver noted on autopsy have
been in the kidneys, excretion in urine is minimal
Neonates: Ophthalmic: Instill 2 drops immediately after birth (no later than
1 hour after delivery) into conjunctival sac of each eye as a single dose, allow
to sit for greater than or equal to 30 seconds; do not irrigate eyes following
instillation of eye drops
Children and Adults:
Ointment: Apply in an apertured pad on affected area or lesion for
approximately 5 days
Sticks: Apply to mucous membranes and other moist skin surfaces only on area
to be treated 2-3 times/week for 2-3 weeks
Topical solution: Apply a cotton applicator dipped in solution on the
affected area 2-3 times/week for 2-3 weeks
With prolonged use, monitor methemoglobin levels
|Dental Health: Local
No information available to require special precautions
Effects on Dental Treatment|
No effects or complications reported
Use as directed; do not use more often than instructed. Store container in
dry, dark place.
Sticks: Apply to mucous membranes and other moist skin surfaces to be treated
2-3 times each week for 2-3 weeks.
Solution: Apply to affected area with cotton applicator dipped in solution
2-3 times each week for 2-3 weeks.
Handle with care; silver nitrate stains skin, clothing and utensils.
Discontinue and contact prescriber if treated areas worsen or if redness, or
irritation develops in surrounding area. Pregnancy precautions: Inform
prescriber if you are or intend to be pregnant.
Silver nitrate solutions stain skin and utensils
Applicator sticks: 75% with potassium nitrate 25% (6")
Ointment: 10% (30 g)
Ophthalmic: 1% (wax ampuls)
Topical: 10% (30 mL); 25% (30 mL); 50% (30 mL)
Cushing AH and Smith S,
"Methemoglobinemia With Silver Nitrate Therapy of a Burn: Report of a Case,"
J Pediatr, 1969, 74(4):613-5.
Hammerschlag MR, Cummings C, Roblin PM, et al,
"Efficacy of Neonatal Ocular Prophylaxis for the Prevention of Chlamydial and Gonococcal Conjunctivitis,"
N Engl J Med, 1989, 320(12):769-72.
U.S. Department of Health and Human Services,
"1993 Sexually Transmitted Diseases Treatment Guidelines," MMWR Morb Mortal
Wkly Rep, 1993, 42(RR-14).
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