title: Silver products for medical indications: risk-benefit assessment.
abstract: BACKGROUND
  Legitimate medicinal use of silver-containing products has dramatically diminished over the last several decades. Recently, however, some manufacturers have begun to enthusiastically promote oral colloidal silver proteins as mineral supplements and for prevention and treatment of many diseases. Indiscriminate use of silver products can lead to toxicity such as argyria.
  
  
  OBJECTIVE
  To assist health care professionals in a risk versus benefit assessment of over-the-counter silver-containing products, we herein examine the following issues: historical uses, chemistry, pharmacology, clinical toxicology, case reports of adverse events in the literature, and the recent promotion of over-the-counter silver products. Other sources of silver exposure (including environmental and dietary) and EPA exposure standards are discussed. A list of currently available silver products is provided for easy reference and screening.
  
  
  CONCLUSIONS
  We emphasize the lack of established effectiveness and potential toxicity of these products.
authors.affiliation: Center of Drug Evaluation and Research, Food and Drug Administration, Rockville, Maryland, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Fung
authors.forename: D L
authors.initials: DL
authors.lastname: Bowen
mesh_terms: D000818:Animals; D001129:Argyria / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008452:Maximum Allowable Concentration; D018570:Risk Assessment; D018030:Silver Compounds / Q000009:adverse effects / Q000737:chemistry / Q000506:poisoning* / Q000627:therapeutic use; D012836:Silver Proteins / Q000737:chemistry; D016896:Treatment Outcome
chemical_list: D018030:Silver Compounds; D012836:Silver Proteins