-
Hemodialysis (caution)
- Risk of Aluminum accumulation
- Sucralfate is a nonabsorbable, aluminum salt of sucrose orasulfate
- Polymerizes atlow pH (e.g. Stomach acid)
- Sucralfate is negatively charged and binds positively charged Proteins on mucosal surface
- Creates a protective coating that overlies the mucosa, and prevents mucositis and Peptic Ulcer formation
- May also stimulate mucus production by triggering local Prostaglandin E2 release
- Adult
- Take 1 gram orally four times daily at one hour before meals and at bedtime
- May decrease to twice daily for maintenance therapy
- Child (off label)
- Age <6 years
- Give 40 to 80 mg/kg/day divided four times daily up to 500 mg orally every 6 hours
- Age >6 years
- Give 1 gram orally four times daily at one hour before meals and at bedtime
- Pregnancy Category B
- Unknown safety in Lactation
- Absorption of only 3 to 5%
-
Antacids
- Avoid within 30 minutes of Sucralfate
- Sucralfate requires an acidic environment to activate (polymerize)
- May interfere with absorption of other drugs (take Sucralfate 2 hours before or after)
- Antifungals (Ketoconazole, Itraconazole)
- Cimetidine
- Digoxin
- Fluoroquinolones (Ciprofloxacin, Norfloxacin)
- Levothyroxine
- Phenytoin
- Ranitidine
- Tetracycline
- Warfarin
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 94
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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