Mafenide

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

Mafenide is used in the treatment of:

• Bacterial Infections
• Wound Infection

Mafenide is used in the prevention of:

• Septicemia

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

(MA fe nide)

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Cream, External, as acetate [strength expressed as base]:

Sulfamylon: 85 mg/g (56.7 g, 113.4 g, 453.6 g) [contains methylparaben, propylparaben, sodium metabisulfite]

Packet, External, as acetate:

Sulfamylon: 50 g (1 ea, 5 ea)

Generic: 50 g (1 ea [DSC], 5 ea [DSC])

There are no dosage adjustments provided in the manufacturer's labeling.

Acidosis: When acidosis becomes difficult to control, discontinuing treatment for 24 to 48 hours may aid in restoring acid-base balance

Cream: Avoid exposure to excessive heat (>40°C [>104°F]).

Powder for solution: Prior to reconstitution, store powder at 15°C to 30˚C (59°F to 86˚F). Store prepared solution at 20°C to 25˚C (68°F to 77˚F); excursions permitted between 15°C and 30°C (59°F and 86°F). May store at 15°C to 30˚C (59°F to 86˚F) for limited periods. Solution may be stored in unopened containers for up to 28 days; once container is open, discard unused portion within 48 hours.

Concerns related to adverse effects:

• Acid-base imbalance: Mafenide and its metabolite inhibit carbonic anhydrase; metabolic acidosis may occur. Symptoms may include compensatory hyperventilation; risk is increased in patients with impaired renal function. Some patients experience masked hyperventilation and respiratory alkalosis; etiology is unknown. Monitor acid-base balance, especially in patients with extensive second-degree or partial-thickness burns and in patients with pulmonary or renal dysfunction.

• Sulfonamide allergy: Chemical similarities are present among sulfonamides, sulfonylureas, carbonic anhydrase inhibitors, thiazides, and loop diuretics (except ethacrynic acid). Use in patients with sulfonamide allergy is specifically contraindicated in product labeling, however, a risk of cross-reaction exists in patients with allergy to any of these compounds; avoid use when previous reaction has been severe.

• Superinfection: Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months postantibiotic treatment.

Disease-related concerns:

• G6PD deficiency: Use caution in patients with G6PD deficiency; hemolytic anemia with DIC (including fatalities) has been reported with use, presumably related to G6PD deficiency.

• Renal impairment: Use with caution in burn patients with acute renal impairment; accumulation of parent drug and metabolite may enhance carbonic anhydrase inhibition and increase risk of metabolic acidosis.

Concurrent drug therapy issues:

• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.

Dosage forms specific issues:

• Sulfites: Some dosage forms contain sulfites which may cause allergic-type reactions (including anaphylaxis) as well as life-threatening or less severe asthmatic episodes in certain individuals; consider discontinuation of therapy if allergic reactions occur.

Adverse events were not observed in animal reproduction studies using an oral preparation. The manufacturer does not recommended use in women of childbearing potential unless the burn area covers >20% of the total body surface or when benefits of treatment outweigh possible risks to the fetus.