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Silver nitrate: Drug information

Silver nitrate: Drug information
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For additional information see "Silver nitrate: Patient drug information" and "Silver nitrate: Pediatric drug information"

For abbreviations, symbols, and age group definitions show table
Pharmacologic Category
  • Antibiotic, Topical;
  • Cauterizing Agent, Topical;
  • Topical Skin Product, Antibacterial
Dosing: Adult
Anti-infective

Anti-infective (0.5% solution): Topical: Use as directed.

Granulation tissue removal, wound cauterization

Granulation tissue removal, wound cauterization: Topical: Sticks: Apply to affected area; application may be repeated every 24 hours for a total of 3 applications for granulation tissue (Ref) or once weekly (over several weeks if needed) for pyogenic granuloma (Ref).

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Silver nitrate: Pediatric drug information")

Antiseptic, wound cauterization, degranulation of tissue

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

Adverse Reactions

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

Contraindications

There are no contraindications listed in the manufacturer’s labeling.

Warnings/Precautions

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.

Other warnings/precautions:

• Appropriate use: Do not use applicator sticks on the eyes. Do not use topical solution on mucous membranes.

Dosage Forms: US

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)

Generic Equivalent Available: US

Yes

Pricing: US

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.

Administration: Adult

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.

Administration: Pediatric

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.

Use: Labeled Indications

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.

Metabolism/Transport Effects

None known.

Drug Interactions

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 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

Mechanism of Action

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.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (BR) Brazil: Nitrato de prata;
  • (DE) Germany: Argentrix | Hoellenstein;
  • (EE) Estonia: Porgukivipulk;
  • (FI) Finland: Avoca caustic applicator;
  • (GB) United Kingdom: Avoca caustic applicator;
  • (IN) India: Silver stream;
  • (JP) Japan: Silver nitrate pfizer;
  • (PE) Peru: Nitrato de Plata;
  • (QA) Qatar: Avoca Caustic Applicator;
  • (RU) Russian Federation: Argenti nitras | Lapis pencil | Stilus lapidis
  1. Arzol (75% silver nitrate/25% potassium nitrate) silver nitrate applicator [prescribing information]. Keene, NH: Arzol Chemical Co; January 2020.
  2. Ebrahimi S, Dabiri N, Jamshidnejad E, Sarkari B. Efficacy of 10% silver nitrate solution in the treatment of common warts: a placebo-controlled, randomized, clinical trial. Int J Dermatol. 2007;46(2):215-217. [PubMed 17269982]
  3. Grafco (75% silver nitrate/25% potassium nitrate) silver nitrate applicator [prescribing information]. Atlanta, GA: GF Health Products Inc; received June 2023.
  4. Kwok CS, Gibbs S, Bennett C, Holland R, Abbott R. Topical treatments for cutaneous warts. Cochrane Database Syst Rev. 2012;(9):CD001781. [PubMed 22972052]
  5. McGrath J, Schofield O. Treatment of excessive granulation tissue with EMLA cream and 95% silver-nitrate pencils. Clin Exp Dermatol. 1990;15(6):468. doi:10.1111/j.1365-2230.1990.tb02152.x [PubMed 2279350]
  6. Quitkin HM, Rosenwasser MP, Strauch RJ. The efficacy of silver nitrate cauterization for pyogenic granuloma of the hand. J Hand Surg Am. 2003;28(3):435-438. doi:10.1053/jhsu.2003.50092 [PubMed 12772100]
  7. Silver Nitrate solution [prescribing information]. North Wales, PA: Teva Pharmaceuticals USA Inc; February 2016.
  8. Tompkins RG, Remensnyder JP, Burke JF, et al. Significant reductions in mortality for children with burn injuries through the use of prompt eschar excision. Ann Surg. 1988;208(5):577-585. [PubMed 3190284]
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