III. Contraindications

  1. Hemodialysis (caution)
    1. Risk of Aluminum accumulation

IV. 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

V. 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

VI. Adverse Effects

VII. Safety

  1. Pregnancy Category B
  2. Unknown safety in Lactation

VIII. Pharmacokinetcs

  1. Absorption of only 3 to 5%

IX. 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

XI. References

  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 94
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

sucralfate (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
SUCRALFATE 1 GM TABLET Generic $0.21 each
SUCRALFATE 1 GM/10 ML SUSP Generic $0.31 per ml
carafate (on 8/17/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
CARAFATE 1 GM TABLET Generic $0.21 each
CARAFATE 1 GM/10 ML SUSP Generic $0.31 per ml

Ontology: Sucralfate (C0038633)

Definition (NCI) A nonabsorbable, aluminum salt of sucrose orasulfate with anti-ulcer, mucosa-protective and potentially anti-mucositis activity. Negatively charged sucralfate binds, through ionic bond formation, to positively charged proteins on mucosal surfaces, thereby creating a protective coating and physical barrier. This agent may also enhance the production of prostaglandin E2 locally, thereby promoting mucus production, increasing mucosal blood flow and stimulating epithelial proliferation and may contribute to the healing of damaged mucosa.
Definition (NCI_NCI-GLOSS) A drug used to treat ulcers. It adheres to proteins at the ulcer site and forms a protective coating over the ulcer. Sucralfate is also used to treat mucositis.
Definition (MSH) A basic aluminum complex of sulfated sucrose.
Concepts Pharmacologic Substance (T121) , Carbohydrate (T118)
MSH D013392
SnomedCT 387387008, 69967001
LNC LP171641-6
English Aluminum Sucrose Sulfate, Basic Aluminum Sucrose Sulfate, Sucralfate, Sulfate, Aluminum Sucrose, Aluminum, hexadeca-mu-hydroxytetracosahydroxy(mu8-(1,3,4,6-tetra-O-sulfo-beta-D-fructofuranosyl alpha-D-glucopyranoside tetrakis(hydrogen sulfato)(8-)))hexadeca-, sucralfate, sucralfate (medication), SUCRALFATE, Sucralfate [Chemical/Ingredient], Basic aluminum sucrose sulfate, Sucralfate (product), Sucralfate (substance), Basic aluminium sucrose sulphate
Swedish Sukralfat
Czech sukralfát
Finnish Sukralfaatti
Russian ALIUMINIIA SAKHAROZOSUL'FAT, SUKRALFAT, АЛЮМИНИЯ САХАРОЗОСУЛЬФАТ, СУКРАЛФАТ
Japanese スクラルファート, スクラルフェート, 硫酸アルミニウムスクロース
Croatian SUKRALFAT
Polish Sukralfat
Spanish sucralfato (producto), sucralfato (sustancia), sucralfato, sulfato de sacarosa de aluminio básico, Sucralfato, Sulfato de Sacarosa de Aluminio
French Sucralfate
German Aluminium-Saccharosesulfat, Sucralfat
Italian Sucralfato
Portuguese Sucralfato, Sulfato de Alumínio Sucrose