other sulfonamides including antibacterials, thiazide diuretics, and sulfonylurea antidiabetics; but data on the likelihood of cross-allergies are inconsistent. Incorporation of the silver ions can lead to local argyria (discoloration of the skin), especially if the treated area is exposed to ultraviolet light. Generalised argyria with silver accumulation in kidneys, liver, and retina has only been found in association with excessive long-term use, or repeated use on severe and heavily inflamed burns. Possible consequences of generalised argyria include interstitial nephritis and anemia. Interactions Proteases such as trypsin and clostridiopeptidase, which are contained in ointments used for the removal of dead skin on wounds, can be inhibited by silver ions if applied simultaneously. When silver sulfadiazine is absorbed in significant amounts, it can increase effects and side effects of some drugs such as vitamin K antagonists. Pharmacokinetics The chemical is poorly soluble, and has only very limited penetration through intact skin. However, contact with body fluids produces free sulfadiazine which can then be systemically absorbed and distributed; it undergoes glucuronidation in the liver and is also excreted unaltered in urine. Only when applied to large-area (especially second- and third-degree) burns or other lesions is absorption into the body a problem. Names Brand names include Silvadene (a genericized trademark), Silverex, Silverol, Silveleb, Silvazine, Flamazine, Thermazene, BurnHeal, Silvozin Tulle Dressing and SSD. See also Sulfadiazine References External links Silver compounds Sulfonamide antibiotics Antiseptics Pfizer brands Pyrimidines World Health Organization essential medicines Wikipedia medicine articles ready to translate