Sulfacetamide is a sulfonamide antibiotic that is used alone or combined with other medicines for the treatment of cutaneous and ocular conditions.

Sulfacetamide Uses:

• Acne (Klaron lotion, topical suspension):

  • Treatment of acne vulgaris.

• Bacterial infections (cream, wash, Ovace Plus lotion and foam):

  • Treatment of bacterial infections of the skin.

• Scaling dermatoses (cream, shampoo, wash, Ovace Plus lotion and foam):

  • Treatment of scaling dermatoses (seborrheic dermatitis and seborrhea sicca [dandruff]).

It is also used in combination with prednisolone as eye ointment (Blephamide) and suspension for ocular inflammatory conditions.

Sulfacetamide Dose in Adults

Topical Sulfacetamide Dose in the treatment of Acne:

• Klaron lotion, topical suspension:

  • Apply a thin film to affected area twice per day.

Topical Sulfacetamide Dose in the treatment of bacterial infections: 

• Cream, Ovace Plus lotion:

  • do Apply to affected areas twice per day for 8 to 10 days.

• Foam:

  • Apply to affected areas 1 to 3 times per day

• Wash:

  • Apply to affected areas 1 to 2 times daily for 8 to 10 days.

Topical Sulfacetamide use in patients with Scaling dermatoses: 

• Cream, Ovace Plus lotion:

  • Apply to affected areas twice daily for 8 to 10 days.
  • Dosing interval may be lengthened as eruption subsides.
  • Applications once or twice weekly, or every other week may be used for prevention.
  • If treatment needs to be reinitiated, start therapy as a twice-daily regimen.

• Foam:

  • Apply to affected areas 1 to 3 times per day

• Shampoo:

  • Wash hair at least twice weekly.

• Wash:

  • Ovace Plus Wash Liquid, Ovace Plus Wash cleansing gel, Ovace wash:

    • Wash affected areas twice with a 10- to 20-second interval between washings;
    • repeat twice daily for 8 to 10 days.
    • Dosing interval may be lengthened as eruption subsides.
    • Applications once or twice weekly, or every other week may be used for prevention.
    • If treatment needs to be reinitiated, start therapy as a twice-daily regimen.

  • SEB-Prev:

    • Wash affected areas twice daily for 8 to 10 days.
    • Dosing interval may be lengthened as eruption subsides.
    • Applications once or twice weekly, or every other week may be used for prevention.
    • If treatment needs to be reinitiated, start therapy as a twice-daily regimen.

Sulfacetamide Dose in Childrens

Sulfacetamide Dose in the treatment of Acne:

• Children ≥12 years and Adolescents:

  • Topical: Lotion 10%:

    • Apply a thin film to the affected area twice per day

Sulfacetamide use in the treatment of Seborrheic dermatitis, including seborrhea sicca:

Children ≥12 years and Adolescents: Topical:

• Cream, Lotion 9.8%:

  • Apply to affected areas twice daily for 8 to 10 days.
  • Dosing interval may be lengthened as eruption subsides.
  • Applications once or twice weekly, or every other week may be used for prevention.
  • If treatment needs to be reinitiated, start therapy as a twice-daily regimen.

• Foam:

  • Apply to affected areas 1 to 3 times per  day

• Gel, Wash:

  • Wash affected area twice with a 10- to 20-second interval between washings;
  • repeat application twice per day for 8 to 10 days.
  • Dosing interval may be lengthened as eruption subsides.
  • Applications once or twice weekly, or every other week may be used for prevention.
  • If treatment needs to be reinitiated, start therapy as a twice-daily regimen.

• Shampoo:

  • Wash hair at least twice weekly

Sulfacetamide Dose in the treatment of Secondary Cutaneous Bacterial infections:

• Children ≥12 years and Adolescents: Topical:

  • Cream, Lotion 9.8%:

    • Apply to affected areas twice per day for 8 to 10 days

  • Foam:

    • Apply to affected areas 1 to 3 times per  day

  • Gel:

    • Wash affected area once a day for 8 to 10 days

  • Wash:

    • Wash affected area once or twice a day for 8 to 10 days

Pregnancy Risk Factor C

• Studies on animal reproduction have not been done.
• It is unknown how much sulfacetamide is available in the body after topical application.
• Systemic sulfonamides may cause kernicterus in the baby if they are taken during pregnancy.

Sulfacetamide use during breastfeeding:

• Breast milk excretes small amounts of sulfonamides taken orally. It is not known whether sulfacetamide topically excreted in breastmilk.
• Breast-feeding with systemic sulfonamides can cause kernicterus in newborns.

Sulfacetamide Dose in Kidney impairment:

Not mentioned in the manufacturer's labeling.

Sulfacetamide Dose in liver disease:

Not mentioned in the manufacturer's labeling.

Side effects of Sulfacetamide:

• Dermatologic:

  • Burning Sensation Of Skin
  • Erythema
  • Pruritus
  • Stevens-Johnson Syndrome
  • Stinging Of The Skin
  • Toxic Epidermal Necrolysis

• Hematologic & Oncologic:

  • Agranulocytosis
  • Aplastic Anemia
  • Hematologic Abnormality

• Hepatic:

  • Fulminant Hepatic Necrosis

• Hypersensitivity:

  • Hypersensitivity Reaction

• Local:

  • Local Irritation
  • Localized Edema

• Neuromuscular & Skeletal:

  • Systemic Lupus Erythematosus

Contraindications to Sulfacetamide:

• Hypersensitivity known or suspected to sulfonamides, or any component of the formulation
• Kidney disease (Ovace Plus wash, Ovace Plus lotion and Ovace Plus foam).

Notice:

• Although the FDA approved product labeling has claimed that this medication is contraindicated/not indicated with other sulfonamide-containing drug groups, the scientific basis of this statement has been challenged.
• See "Warnings/Precautions" for more detail.

Warnings and precautions

• Autoimmune effects:

  • Sulfonamides have been linked to severe reactions such as drug-induced systemic Lupus Erythematosus.

• Blood dyscrasias:

  • Sulfonamides have been linked to severe reactions such as agranulocytosis and acute hemolytic anemia.

• Dermatologic reactions

  • Sulfonamides have been linked to severe reactions such as Stevens-Johnson Syndrome, toxic epidermal necrolysis and drug fever.
  • Additionally, contact dermatitis and reddening of the skin can occur.

• Hepatic effects

  • Sulfonamides have been linked to severe reactions that include jaundice and fulminant liver necrosis.

• Hypersensitivity reactions

  • Patients who have never had sulfonamide hypersensitivity before may experience skin rash or other reactions.
  • Stop using the medication immediately if you feel hypersensitive or rash.

• Allergy to sulfonamide ("sulfa")

  • Cross-reactivity concerns have been a concern for all compounds with the sulfonamide structural (SO NH).
  • A deeper understanding of allergic mechanisms suggests that cross-reactivity between non-antibiotic and antibiotic sulfonamides is unlikely.
  • Particularly, anaphylaxis (anaphylaxis) is unlikely to occur when 2 2 antibiotic sulfonamides or antibiotics sulfonamides are combined.
  • Sulfasalazine is an antibiotic sulfonamide that has an arylamine structure. It may cross-react with antibiotic sulfonamides.
  • T-cell-mediated reactions, i.e. type IV reactions, eg. the maculopapular skin rash are less understood. It is difficult to exclude this possibility based on current knowledge.
  • Some clinicians prefer to avoid drug exposure in cases of severe reactions (Stevens Johnson syndrome/TEN).

• Systemic effects

  • Application to infected, abraded or burnt skin can increase systemic absorption.

Sulfacetamide (topical): Drug Interaction

Monitoring parameters:

• Response to therapy,
• signs of local irritation and/or sensitization, especially during long-term therapy.

How to administer Sulfacetamide?

• Topical:

  • Avoid contact with eyes and mucous membranes.

• Foam:

  • Clean affected skin thoroughly and pat dry prior to each application.
  • Shake well prior to use.
  • Dispense into palm of the hand. Massage into affected areas and wait 10 minutes; rinse thoroughly with water and pat dry.

• Lotion and topical suspension:

  • Shake well prior to use.

• Shampoo:

  • Apply to wet hair and massage vigorously into the scalp; thoroughly rinse hair.

• Wash:

  • Apply to wet skin and massage into a full lather, rinse thoroughly with plain water, and pat dry.
  • If skin dryness occurs, rinse off early or use less frequently.
  • When used for scaling dermatitis, regular shampooing after use is not necessary;
  • however, hair should be shampooed at least once a week.

Mechanism of action of Sulfacetamide:

• Interferes in bacterial growth through inhibition of bacterial folic acids synthesis by competitive antagonism with PABA

Absorption:

• Significant absorption through the skin has been reported; percutaneous absorption about 4%.

Metabolism:

• Sulfanilamide (major metabolite)

Half-life elimination:

• 7 to 13 hours

Excretion:

• Urine 0.08% to 0.33%

International Brands of Sulfacetamide:

• Klaron
• Ovace Plus
• Ovace Plus Wash
• Ovace Wash
• Seb-Prev Wash
• Sodium Sulfacetamide Wash

Sulfacetamide Brand Names in Pakistan:

No Brands Available in Pakistan.