Sulfamylon (Mafenide) - Topical

What Is Sulfamylon?

Sulfamylon (mafenide) is a topical medication used to put on burn wounds to prevent infection. It blocks the growth of bacteria and fungus that may infect skin or wounds trying to recover from severe burns

Sulfamylon is available both as a cream and a solution. The solution is made by mixing a packet of Sulfamylon powder with water before being applied to the skin.

Drug Facts

Generic Name: Mafenide

Brand Name: Sulfamylon

Drug Availability: Prescription

Administration Route: Topical

Therapeutic Classification: Antibacterial

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Mafenide

Dosage Form: Cream, powder for solution

What Is Sulfamylon Used For?

The Food and Drug Administration (FDA) approved the solution form of Sulfamylon as an antibacterial product to control infection under moist dressings over meshed autografts on excised burn wounds. 

An excised burn wound is one where damaged skin is removed. A skin graft, or autograft, is when healthy skin is taken from another part of the body and put over the burn wound. Sulfamylon would be applied over this skin graft under a clean dressing.

The cream form of Sulfamylon is approved for adjunctive (add-on) therapy for people with second and third-degree burns. Adjunctive means that people with these types of severe burns may need other treatments or medications in addition to Sulfamylon cream.

Sulfamylon (Mafenide) Drug Information - Illustration by Zoe Hansen

Verywell / Zoe Hansen

How to Take Sulfamylon

For the topical solution form, a healthcare provider will mix the packet of powder with one liter of either water or normal saline. This form is only used in the hospital. Sulfamylon cream may be used in the hospital or prescribed for you to use at home.

Make sure to wash your hands and put on sterile gloves before applying Sulfamylon cream. Keep the burn area covered with cream at all times. Use it as often as necessary to keep a layer on the burn that is 1/16 inch thick, usually once or twice a day. You may need to apply more as needed if the cream is removed by bathing or other activities. You will usually not need to put any dressings or coverings over Sulfamylon cream, but if your healthcare provider has directed you to cover the burn area, use only a thin dressing.

The length of time that people continue using Sulfamylon cream varies. Usually, you can stop using it once burns show good healing progress.

Storage

Store Sulfamylon at room temperature (68 degrees to 77 degrees F) with the lid. 

If you’re traveling by plane, keep Sulfamylon in your carry-on luggage with the lid on tight so that pressure changes don’t cause leaks. Avoid exposing Sulfamylon to very hot or cold temperatures (below 40 degrees F or above 104 degrees F).

How Long Does Sulfamylon Take to Work?

Sulfamylon does not directly act to heal your burn more quickly, but preventing the growth of bacteria in and around your burn can promote faster healing since infection would cause the wound to heal more slowly. Healing time will depend on the burn's size and severity, but you can usually expect good improvement within five days.

What Are the Side Effects of Sulfamylon?

Like other medications, Sulfamylon may cause side effects. 

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Sometimes it can be difficult to tell whether a skin reaction or symptom is a side effect caused by Sulfamylon or simply a result of the burn wound. A burning sensation or rash may occur with the use of Sulfamylon. Let your healthcare provider know if you notice these side effects and if they seem severe or unsafe.

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or think you’re having a medical emergency. 

Serious side effects and their symptoms include:

  • Metabolic acidosis and hyperventilation: Sulfamylon can interfere with some chemical processes in your body. It may throw off a system called acid-base balance. Let your healthcare provider know if you begin to breathe more quickly than usual (hyperventilation), as this may be a sign of metabolic acidosis. Other symptoms are confusion, headache, and a fast heartbeat.
  • Anemia: This is a lowering of red blood cells. This side effect is thought to be related to a genetic disorder called G6PD deficiency. People without this G6PD enzyme may be more likely to experience blood and clotting issues when using mafenide.

Report Side Effects

Sulfamylon may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Sulfamylon Should I Take?


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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For topical dosage form (cream):
    • For bacterial or fungus infection:
      • Adults and children 2 months of age and over—Use one or two times a day.
      • Infants and children up to 2 months of age—Use is not recommended.
  • For topical dosage form (solution):
    • For bacterial or fungus infection:
      • Adults and children 3 months of age and over—Use every 4 to 8 hours each day as needed to keep the dressing wet.
      • Infants and children up to 3 months of age—Use is not recommended.

Modifications

Sulfamylon is established as safe in children as young as three months old.

The use of Sulfamylon has not been specifically studied enough to know if older adults (aged 65 years and older) might respond differently.

Sulfamylon should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. A study performed in pregnant rats using high oral doses of Sulfamylon revealed no evidence of harm to the fetus due to Sulfamylon. However, there are no adequate studies regarding the use of Sulfamylon in pregnant humans. 

It is also unknown whether this medication shows up in human breast milk, but many drugs do. You and your healthcare provider will decide whether you should discontinue nursing or discontinue Sulfamylon.

Missed Dose

A layer of Sulfamylon about 1/16 inch thick should be covering the burn area at all times. After you bathe, or if the medicine comes off somehow, reapply it to the burn area right away.

Overdose: What Happens If I Take Too Much Sulfamylon?

If you use only a thin 1/16 inch layer of Sulfamylon cream as directed, you shouldn’t be too concerned about using too much or overdosing. Let your healthcare provider know right away if you notice side effects that you think are severe, like a fast heart rate or breathing more quickly than usual.

What Happens If I Overdose on Sulfamylon?

If you think you or someone else may have used too much or accidentally swallowed Sulfamylon, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses, has a seizure, has trouble breathing, or can’t wake up after using too much or accidentally swallowing Sulfamylon, call 911 immediately.

Precautions

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It is important that your doctor check your progress at regular visits.

If your skin infection or burn does not improve within a few days or if your more serious burns or burns over larger areas do not improve within a few weeks, or if they become worse, check with your doctor.

What Are Reasons I Shouldn’t Take Sulfamylon?

Before using this medication, you should let your healthcare provider know if you have a genetic disorder called G6PD deficiency. Using Sulfamylon with this disorder can cause dangerous changes in red blood cell counts (anemia) and clotting and bleeding problems.

Sulfamylon contains a sulfite called sodium metabisulfite, a chemical that can cause severe allergic reactions in people with sulfite sensitivities. This is different from a sulfa allergy, but if you have had a severe reaction to sulfa drugs, you should still let your healthcare provider know as there may be some cross-reactivity.

What Other Medications Interact With Sulfamylon?

A few drugs that may interact with Sulfamylon include:

  • PenG, BENPEN (benzylpenicillin)
  • Aczone (dapsone) 
  • Nexstellis, Drovelis, Lydisilka (estetrol)
  • Magnesium
  • Dolocaine, Prilox (Prilocaine)

Let your healthcare provider know which other medicines you take, especially other drugs you apply topically, like creams or gels.

What Medications Are Similar to Sulfamylon?

Some medications that are also used for preventing infections and promoting healing in skin wounds include:

Frequently Asked Questions

  • What is Sulfamylon used for?

    Sulfamylon is used to prevent the growth of bacteria and fungus in moderate and severe burn wounds. It does not directly cause burns to heal, but preventing infection in and around burn wounds will promote quicker healing.

  • What are the side effects of Sulfamylon?

    You may experience a burning sensation or rash-like effect where you apply Sulfamylon. This is common and not a cause for alarm unless it is severe. In rare cases, Sulfamylon may cause metabolic acidosis, which can cause you to breathe faster than usual.

  • How do I safely stop taking Sulfamylon?

    Keep using Sulfamylon as long as your healthcare provider instructs you. You will likely be able to stop taking the medication once your burn wound has healed significantly, usually in about five days.

How Can I Stay Healthy While Taking Sulfamylon?

Moderate and severe burn wounds are often traumatic and painful. It can be tough to wait for a painful wound like a burn to heal, but keeping the area clean and hydrated will best promote healing. Wear loose-fitting clothing like light cotton over the burn area. Tighter clothes and harsher fabrics can irritate skin and delay wound healing.

It’s important to bathe daily, so that burn wounds stay clean and can heal as quickly as possible. But remember to reapply Sulfamylon after bathing to maintain a thin, 1/16 inch layer on your burn at all times. When used outside the hospital, you usually won’t put a dressing over Sulfamylon cream, but ask your healthcare provider to be sure.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Sulfamylon (mafenide acetate, usp)® for 5% topical solution label.

  2. U.S. National Library of Medicine. DailyMed. Sulfamylon - mafenide acetate cream label.

  3. DrugBank. Mafenide.

By Sara Hoffman, PharmD
Sara is a clinical pharmacist that believes everyone should understand their medications, and aims to achieve this through her writing.