Silver Nitrate Applicator
It is used to get rid of warts.It is used to treat skin ulcers.It is used to treat mouth sores.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Caustic agent; Hemostatic; Antiseptic
Pharmacologic Class
Astringent; Protein denaturant
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Silver nitrate applicators are small sticks with a silver nitrate tip, used to stop minor bleeding (like nosebleeds), remove unwanted skin growths (like warts or granulation tissue), or treat certain skin conditions. It works by chemically burning the tissue it touches.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided to you. It's essential to follow the instructions carefully.
Storage and Disposal
This medication will be administered in a healthcare setting, so you will not need to store it at home. A healthcare professional will be responsible for handling and disposing of the medication.
Missed Dose
Since this medication is given as needed in a healthcare setting, you will not need to worry about missing a dose. The healthcare professional will administer the medication according to your individual needs.
To use this medication correctly, follow your doctor's instructions and read all the information provided to you. It's essential to follow the instructions carefully.
Storage and Disposal
This medication will be administered in a healthcare setting, so you will not need to store it at home. A healthcare professional will be responsible for handling and disposing of the medication.
Missed Dose
Since this medication is given as needed in a healthcare setting, you will not need to worry about missing a dose. The healthcare professional will administer the medication according to your individual needs.
Lifestyle & Tips
- Store in a cool, dry place, away from light and moisture.
- Keep out of reach of children.
- Avoid contact with healthy skin, eyes, and clothing as it can cause burns and permanent staining.
- Wash hands thoroughly after use.
- If used for nosebleeds, avoid picking or blowing your nose for several hours after application.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
Apply topically to the affected area as needed, typically for 10-60 seconds, then remove. Repeat as necessary based on clinical response.
Condition-Specific Dosing:
granulation_tissue:
Apply to the hypergranulated tissue until it turns grayish-white, then rinse. Repeat every 24-48 hours if needed.
epistaxis:
Apply to the bleeding site for 10-30 seconds, ensuring direct contact. May be repeated if bleeding recurs.
warts:
Apply to the wart surface, avoiding surrounding skin. Frequency varies based on type and response.
Pediatric Dosing
Neonatal:
Use with extreme caution and minimal application time due to thinner skin and potential for systemic absorption. Not established for routine use.
Infant:
Use with extreme caution and minimal application time due to thinner skin and potential for systemic absorption. Not established for routine use.
Child:
Apply with caution and for minimal duration (e.g., 5-15 seconds) to the affected area, avoiding healthy skin. Supervision required.
Adolescent:
Similar to adult dosing, but with caution and supervision.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed (minimal systemic absorption).
Moderate:
No adjustment needed (minimal systemic absorption).
Severe:
No adjustment needed (minimal systemic absorption).
Dialysis:
No specific considerations (minimal systemic absorption).
Hepatic Impairment:
Mild:
No adjustment needed (minimal systemic absorption).
Moderate:
No adjustment needed (minimal systemic absorption).
Severe:
No adjustment needed (minimal systemic absorption).
Pharmacology
Mechanism of Action
Silver nitrate acts as a caustic agent by denaturing proteins and precipitating cellular proteins, leading to chemical cauterization and destruction of tissue. The silver ions also have antiseptic properties by interfering with bacterial enzyme systems and cell wall integrity.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption from intact skin; increased absorption from mucous membranes or broken skin.
Tmax:
Not applicable (local action).
FoodEffect:
Not applicable.
Distribution:
Vd:
Not applicable (minimal systemic absorption).
ProteinBinding:
Not applicable (minimal systemic absorption).
CnssPenetration:
No
Elimination:
HalfLife:
Not applicable (minimal systemic absorption).
Clearance:
Not applicable (minimal systemic absorption).
ExcretionRoute:
Not applicable (minimal systemic absorption).
Unchanged:
Not applicable (minimal systemic absorption).
Pharmacodynamics
OnsetOfAction:
Immediate (caustic effect).
PeakEffect:
Immediate (caustic effect).
DurationOfAction:
Effect is localized and permanent on treated tissue; hemostatic effect is immediate and sustained until clot forms.
Confidence:
Medium
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. Although many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for guidance:
Change in skin color
* Irritation at the site where the medication was applied
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor can provide medical advice on managing side effects.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. Although many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for guidance:
Change in skin color
* Irritation at the site where the medication was applied
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor can provide medical advice on managing side effects.
Seek Immediate Medical Attention If You Experience:
- Severe pain or burning that does not subside
- Excessive redness, swelling, or pus at the application site (signs of infection)
- Spreading discoloration beyond the treated area
- Allergic reaction (rare, but possible: rash, itching, swelling, severe dizziness, trouble breathing)
- If ingested, seek immediate medical attention.
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have broken skin or open wounds in the area where the medication will be applied.
This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. Additionally, share any health problems you have to ensure safe use of this medication.
To guarantee your safety, do not start, stop, or modify the dosage of any medication without first consulting your doctor. It is vital to verify that it is safe to take this medication in combination with all your other medications and health conditions.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have broken skin or open wounds in the area where the medication will be applied.
This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. Additionally, share any health problems you have to ensure safe use of this medication.
To guarantee your safety, do not start, stop, or modify the dosage of any medication without first consulting your doctor. It is vital to verify that it is safe to take this medication in combination with all your other medications and health conditions.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
To avoid staining, take precautions to protect your clothing and fabrics when handling this drug.
If swallowed, this medication can be harmful. In the event of accidental ingestion, immediately contact a doctor or a poison control center for assistance.
If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor. You and your doctor will need to discuss the potential benefits and risks of this medication to both you and your baby.
To avoid staining, take precautions to protect your clothing and fabrics when handling this drug.
If swallowed, this medication can be harmful. In the event of accidental ingestion, immediately contact a doctor or a poison control center for assistance.
If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor. You and your doctor will need to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Local: Severe chemical burns, tissue necrosis, deep black/brown discoloration.
- Systemic (rare with topical use): Argyria (bluish-gray discoloration of skin, eyes, mucous membranes), gastrointestinal irritation (nausea, vomiting, abdominal pain) if ingested, methemoglobinemia (very rare).
What to Do:
For local burns, immediately rinse with copious amounts of water and seek medical attention. For ingestion, do NOT induce vomiting; seek immediate medical attention or call Poison Control (1-800-222-1222).
Drug Interactions
Minor Interactions
- Topical anesthetics (may reduce pain during application, but no direct interaction)
- Other topical agents (may interfere with local action or cause irritation if applied concurrently)
Monitoring
Routine Monitoring
Treated area appearance
Frequency: Immediately post-application and daily thereafter
Target: Grayish-white discoloration, cessation of bleeding, reduction in granulation tissue/wart size
Action Threshold: Persistent bleeding, no change in tissue, excessive pain, signs of infection
Pain/Discomfort
Frequency: During and after application
Target: Mild to moderate, transient pain
Action Threshold: Severe or prolonged pain, burning sensation beyond expected
Symptom Monitoring
- Pain at application site
- Burning sensation
- Skin discoloration (temporary black/brown staining)
- Signs of infection (redness, swelling, pus, warmth) if used on open wounds
- Systemic symptoms of silver toxicity (argyria - rare with topical use, but possible with extensive exposure)
Special Patient Groups
Pregnancy
Use with caution. While systemic absorption is minimal, there is limited data on topical use in pregnant women. Category C suggests animal studies have shown an adverse effect on the fetus, but there are no adequate and well-controlled studies in humans. Benefits may outweigh risks in certain situations.
Trimester-Specific Risks:
First Trimester:
Potential theoretical risk, but minimal systemic exposure limits concern.
Second Trimester:
Potential theoretical risk, but minimal systemic exposure limits concern.
Third Trimester:
Potential theoretical risk, but minimal systemic exposure limits concern.
Lactation
Use with caution. It is unknown if silver nitrate is excreted in human milk. Due to minimal systemic absorption, infant exposure is likely low, but caution is advised, especially if applied to large areas or broken skin. Avoid application to the breast area.
Infant Risk:
Low risk, but monitor for any unusual symptoms.
Pediatric Use
Use with extreme caution, especially in infants and young children, due to thinner skin which may increase the risk of systemic absorption and local irritation. Application time should be minimized. Always supervise application.
Geriatric Use
Generally safe for use in the elderly, similar to adults. No specific dose adjustments are typically needed. Caution should be exercised if skin integrity is compromised or if there are underlying conditions affecting wound healing.
Clinical Information
Clinical Pearls
- Always moisten the tip of the applicator with a drop of water before use to activate the silver nitrate, unless the area is already moist (e.g., bleeding site).
- Apply precisely to the target tissue, avoiding contact with surrounding healthy skin or mucous membranes. Use petroleum jelly or a barrier cream on surrounding skin for protection.
- The treated area will turn grayish-white immediately, then darken to black/brown over several hours or days due to the formation of silver oxide. This staining is temporary on skin but can be permanent on clothing.
- Rinse the treated area with saline or water immediately after the desired effect is achieved to stop the reaction and remove excess silver nitrate.
- Do not use on large areas or for prolonged periods due to the theoretical risk of systemic absorption and argyria.
- Not for use on eyes or deep wounds.
Alternative Therapies
- Electrocautery (for hemostasis or tissue destruction)
- Chemical cautery (e.g., trichloroacetic acid for warts)
- Pressure application (for minor bleeding)
- Topical vasoconstrictors (e.g., oxymetazoline for epistaxis)
- Cryotherapy (for warts or skin lesions)
- Surgical excision (for tissue removal)
Cost & Coverage
Average Cost:
$5 - $20 per 100 applicators
Generic Available:
Yes
Insurance Coverage:
Typically OTC, not covered by prescription insurance. May be covered by FSA/HSA.
General Drug Facts
If your symptoms or health problems do not improve or worsen over time, it is essential to contact your doctor for further evaluation and guidance.
To ensure safe use, do not share your medication with others, and never take someone else's medication. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion.
Proper disposal of unused or expired medications is crucial. Do not flush medications down the toilet or pour them down the drain unless specifically instructed to do so. If you are unsure about the correct disposal method, consult your pharmacist for guidance. Many communities have drug take-back programs, which your pharmacist can help you locate.
Some medications may come with an additional patient information leaflet. Check with your pharmacist to see if this applies to your prescription. If you have any questions or concerns about your medication, do not hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider.
In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it was ingested, as this will aid in prompt and effective treatment.
To ensure safe use, do not share your medication with others, and never take someone else's medication. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion.
Proper disposal of unused or expired medications is crucial. Do not flush medications down the toilet or pour them down the drain unless specifically instructed to do so. If you are unsure about the correct disposal method, consult your pharmacist for guidance. Many communities have drug take-back programs, which your pharmacist can help you locate.
Some medications may come with an additional patient information leaflet. Check with your pharmacist to see if this applies to your prescription. If you have any questions or concerns about your medication, do not hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider.
In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it was ingested, as this will aid in prompt and effective treatment.