Pharm

Sucralfate

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Sucralfate, Carafate

  • See Also
  1. Antacid
  • Indications
  1. Peptic Ulcer Disease
  2. Pill Esophagitis
  • Contraindications
  1. Hemodialysis (caution)
    1. Risk of Aluminum accumulation
  • Mechanism
  1. Sucralfate is a nonabsorbable, aluminum salt of sucrose orasulfate
    1. Polymerizes atlow pH (e.g. Stomach acid)
  2. Sucralfate is negatively charged and binds positively charged Proteins on mucosal surface
    1. Creates a protective coating that overlies the mucosa, and prevents mucositis and Peptic Ulcer formation
    2. May also stimulate mucus production by triggering local Prostaglandin E2 release
  • Dosing
  1. Adult
    1. Take 1 gram orally four times daily at one hour before meals and at bedtime
    2. May decrease to twice daily for maintenance therapy
  2. Child (off label)
    1. Age <6 years
      1. Give 40 to 80 mg/kg/day divided four times daily up to 500 mg orally every 6 hours
    2. Age >6 years
      1. Give 1 gram orally four times daily at one hour before meals and at bedtime
  • Adverse Effects
  1. Constipation
  • Safety
  1. Pregnancy Category B
  2. Unknown safety in Lactation
  • Pharmacokinetcs
  1. Absorption of only 3 to 5%
  • Drug Interactions
  1. Antacids
    1. Avoid within 30 minutes of Sucralfate
    2. Sucralfate requires an acidic environment to activate (polymerize)
  2. May interfere with absorption of other drugs (take Sucralfate 2 hours before or after)
    1. Antifungals (Ketoconazole, Itraconazole)
    2. Cimetidine
    3. Digoxin
    4. Fluoroquinolones (Ciprofloxacin, Norfloxacin)
    5. Levothyroxine
    6. Phenytoin
    7. Ranitidine
    8. Tetracycline
    9. Warfarin
  • Resources
  1. Sucralfate Tablet (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c87c6b50-6977-4fa7-ae98-40c0753f7aee
  • References
  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 94
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia