mafenide (Rx)

Brand and Other Names:Sulfamylon
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Dosing & Uses

AdultPediatric

Burn Treatment

Cream

  • Apply to cleaned, debrided area qDay or q12hr at thickness ~1/16 inch
  • Ensure burned area covered with cream at all times-reapply PRN

Topical solution

  • Cover grafted area with 1 layer of gauze
  • Wet 8-ply burn dressing with solution until leakage observed; apply, secure & wrap as necessary
  • With irrigation tubing: keep gauze dressing wet, by irrigating with syringe or injecting solution into irrigation tubing q4hr or PRN
  • Not using irrigation tubing: moisten gauze q6-8hr or PRN
  • Wound dressings may be left undisturbed for up to 5 days

Burn Treatment

Cream

  • <2 years: Safety & efficacy not established
  • >2 years: Apply to cleaned, debrided area qDay or q12hr at thickness ~1/16 inch; ensure burned area covered with cream at all times-reapply PRN

Topical solution

  • Cover grafted area with 1 layer of gauze
  • Wet 8-ply burn dressing with soln until leakage observed; apply, secure & wrap as necessary
  • With irrigation tubing: keep gauze dressing wet, by irrigating with syringe or injecting solution into irrigation tubing q4hr or PRN
  • Not using irrigation tubing: moisten gauze q6-8hr or PRN
  • Wound dressings may be left undisturbed for up to 5 d
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Interactions

Interaction Checker

and mafenide

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (1)

              • allogeneic cultured keratinocytes and fibroblasts

                mafenide decreases effects of allogeneic cultured keratinocytes and fibroblasts by Other (see comment). Avoid or Use Alternate Drug. Comment: Mafenide acetate, a topical antimicrobial, reduces keratinocyte viability and disrupt integrity of tissue-engineered human skin substitutes composed of keratinocytes.

              Monitor Closely (1)

              • dichlorphenamide

                dichlorphenamide, mafenide. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.

              Minor (0)

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                Adverse Effects

                Frequency Not Defined

                Application site reactions

                Edema

                Facial edema

                Diarrhea

                Excoriation

                Pain

                Blisters

                Burning sensation

                Hypersensitivity

                Bone marrow suppression

                Anemia

                Eosinophilia

                Porphyria

                Hyperventilation

                Hemolytic anemia

                Allergic reactions

                Systemic acidosis with tachypnea

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                Warnings

                Contraindications

                Hypersensitivity to mafenide or any component of the formulation

                Cautions

                Hypersensitivity

                Use extreme caution in patients with sulfonamide allergy

                E. coli & Proteus spp. appear to be less sensitive

                Prolonged use may result in fungal or bacterial superinfection including C. difficile-associated diarrhea and pseudomembranous colitis

                Pregnancy/women of childbearing potential-not recommended in women of childbearing potential unless burned area >20% BSA or benefits justify possible risks to the fetus

                G-6-PD deficiency; may result in hemolytic anemia

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                Pregnancy & Lactation

                Pregnancy Category: C

                Lactation: Not known whether distributed into breast milk, discontinue drug or do not nurse

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Bacteriostatic, precise mechanism unclear-appears to interfere with bacterial folic acid synthesis; spectrum of activity includes both gram positive and negative organisms

                Pharmacokinetics

                Diffuses through devascularized areas; rapidly absorbed from burned surface

                Peak plasma time: 2-4 hr (11% cream); 2 hr (burn tissue- 11% cream); 2 hr (burn tissues-5% solution)

                Excretion: Urine

                Metabolism: Rapidly to p-carboxybenzenesulfonamide

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                mafenide topical
                -
                50 gram miscellaneous
                mafenide topical
                -
                50 gram miscellaneous
                mafenide topical
                -
                50 gram miscellaneous
                Sulfamylon topical
                -
                50 gram miscellaneous
                Sulfamylon topical
                -
                85 mg/g cream
                Sulfamylon topical
                -
                85 mg/g cream
                Sulfamylon topical
                -
                85 mg/g cream

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                mafenide topical

                MAFENIDE ACETATE SOLUTION - TOPICAL

                (MAF-en-ide AS-e-tate)

                COMMON BRAND NAME(S): Sulfamylon

                USES: This medication is used alone or with other medications to help prevent and treat wound infections in patients with severe burns. Mafenide is a drug applied to the skin that belongs to a class of drugs known as sulfa antibiotics. It works by killing bacteria that may infect an open wound. Killing bacteria helps to promote wound healing and to decrease the risk of the bacteria spreading to surrounding skin or to the blood, thereby helping to prevent a serious blood infection (sepsis).

                HOW TO USE: Follow all instructions for proper preparation and use of this drug. Consult your pharmacist.Wash hands before and after using this medication. Use with wound dressings on the skin only. Soak the dressing completely with this medication. Keep the dressing wet by applying this medication every 6 to 8 hours or as directed by your doctor.Length of treatment is based on your medical condition and response to treatment.Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day.Tell your doctor if your condition lasts or gets worse or if you notice increasing redness/tenderness of the skin around the wound.

                SIDE EFFECTS: Pain, burning, or redness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: blisters, fast breathing, nausea, vomiting, diarrhea, headache, change in alertness, shaking (tremors), seizures.Tell your doctor right away if any of these rare but very serious side effects occur: weakness, dark urine, stomach/abdominal pain, arm/leg/back pain, fast heartbeat.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before using mafenide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: lung problems (such as asthma), kidney disease, metabolism problems (such as glucose-6-phosphate dehydrogenase deficiency-G6PD), blood disorders.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

                OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later on other wounds unless told to do so by your doctor. A different medication may be necessary in that case.Laboratory and/or medical tests (such as wound cultures, acid-base balance, complete blood counts) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

                MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Store unmixed packets at room temperature between 59-86 degrees F (15-30 degrees C) away from moisture. Do not store in the bathroom.Mix the powder with the correct solution, and then close the container tightly. After mixing, if the container stays closed, you may store it for up to 28 days between 68-77 degrees F (20-25 degrees C). Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Once a container is opened for use, the solution is good for only 48 hours. Discard any unused portion. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised April 2022. Copyright(c) 2022 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

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                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.