Anti-infective (0.5% solution): Topical: Use as directed.
Refer to adult dosing.
(For additional information see "Silver nitrate: Pediatric drug information")
Antiseptic, wound cauterization, degranulation of tissue (warts, corns): Note: Specific application techniques, frequency, and duration may vary with specific use (eg, warts vs burns); refer to institutional protocols.
Children and Adolescents (Ref): Topical:
Sticks: Apply to mucous membranes and other moist skin surfaces only on area to be treated
Topical solution: Apply a cotton applicator dipped in solution on the affected area 2 to 3 times/week for 2 to 3 weeks
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Dermatologic: Burning sensation of skin, skin discoloration, skin irritation
Hematologic & oncologic: Methemoglobinemia
There are no contraindications listed in the manufacturer’s labeling.
Concerns related to adverse effects:
• Chemical burn: Silver nitrate is a caustic agent and inappropriate use may cause chemical burns. Skin contact time with applicator sticks should be extremely short when used in neonates or on thin delicate skin. Wear chemical-resistant gloves and other appropriate personal protective equipment while using this product. Take care to confine the silver nitrate to the area being treated by using an appropriate physical or chemical barrier to prevent staining or burning of untreated tissue.
• Skin discoloration: Prolonged use may result in skin discoloration. Silver salts stain tissue black due to deposition of reduced silver. The stain gradually disappears within a period of 2 weeks. Prolonged ingestion or absorption of silver compounds leads to deposition of silver in connective tissues, producing a slate-blue discoloration of the skin known as argyria. This discoloration may also appear on mucous membranes, such as the margins of gums. The sclera of the eye is also stained.
• Appropriate use: Do not use applicator sticks on the eyes. Do not use topical solution on mucous membranes.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Applicator sticks, topical: Silver nitrate 75% and potassium nitrate 25%
Solution, topical: 0.5% (960 mL); 10% (30 mL); 25% (30 mL); 50% (30 mL)
Misc (Arzol Silver Nit Applicators External)
75-25% (per each): $0.84
Solution (Silver Nitrate External)
0.5% (per mL): $0.10
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Topical: Applicator sticks are not for ophthalmic use. If applicator sticks are used on dry skin, dip the applicator tip in distilled, deionized, or purified water immediately before use and apply by holding, rubbing, or rotating the tip along the affected tissue. One silver nitrate applicator is generally sufficient for each application. The action of the silver nitrate can be stopped by washing the area with saline solution (0.9% sodium chloride). Using saline solution to wet the applicator tips, or residual saline from wound flushing/washing, will interfere with the action of silver nitrate resulting in cauterization failure. Only use distilled, deionized, or purified water to wet applicator tips. Blot dry wounds that have been flushed/washed with saline prior to applying silver nitrate. Apply to mucous membranes and other moist skin surfaces only on area to be treated.
For topical use only. Applicators are not for ophthalmic use. If applicator sticks are used on dry skin, dip the applicator tip in water immediately before use. Applicator sticks may be bent or shaped for easier access to target area.
Anti-infective (0.5% solution): Used as a topical anti-infective agent.
Cauterization of skin or mucous membrane; removal of warts and granulated tissue (applicator sticks): Apply to the skin for cauterization of wounds and for removal of granulation tissue and warts. On mucous membranes, may be applied to small ulcers and aphthae in the mouth resulting from injury or stomatitis, to infected tonsils, to rectal fissures and fistulae, and to vaginal or cervical ulcerations or erosions.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Cellulose (Oxidized Regenerated): Silver Nitrate may diminish the therapeutic effect of Cellulose (Oxidized Regenerated). Risk X: Avoid combination
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.
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