sucralfate

Sucralfate (Carafate) is a unique oral drug that is used for treating ulcers of the upper gastrointestinal tract.

• Carafate is used for the treatment of peptic ulcer disease and to prevent recurrent ulcers after the healing of the ulcer has been achieved.
• Carafate also has been used to relieve or prevent ulcers caused by nonsteroidal anti-inflammatory drugs (NSAIDs) but is less effective than misoprostol (Cytotec).
• Carafate also is used in the treatment of patients with gastroesophageal reflux disease (GERD).
• Off-label uses are to prevent stress ulcers, which are ulcers associated with high degrees of physical stress (for example, extensive burns, surgery, and overwhelming infection) in hospitalized patients.

What brand names are available for sucralfate (Carafate)?

Carafate

Is sucralfate (Carafate) available as a generic drug?

Yes

Do I need a prescription for sucralfate (Carafate)?

Yes

Carafate is well tolerated. Constipation is the most frequent side effect.

Other side effects include:

• Headache
• Dizziness
• Insomnia
• Diarrhea
• Nausea
• Vertigo
• Indigestion
• Dry mouth
• Dizziness
• Vomiting
• Flatulence

• The recommended dose for treatment of active ulcers is 1 gram four times daily for 4-8 weeks.
• Carafate is administered on an empty stomach, at least one hour before meals, for best results.
• The dose for maintenance (preventing recurrent ulcers) is 1 gram twice daily.

When administered with other drugs sucralfate may bind to the drugs in the stomach and reduce the absorption of the drugs.

Sucralfate reduces the absorption of:

• dolutegravir (Tivicay),
• cimetidine (Tagamet),
• digoxin (Lanoxin),
• ketoconazole (Nizoral),
• levothyroxine (Synthroid),
• phenytoin (Dilantin),
• quinidine (Quinidex, Quinaglute),
• ranitidine (Zantac),
• tetracycline,
• theophylline (Theo-Dur, Uniphyl, others), and
• all of the fluoroquinolone antibiotics, including ciprofloxacin (Cipro), norfloxacin (Noroxin), ofloxacin (Floxin), and lomefloxacin (Maxaquin).

All of these medications should be taken at least two hours before sucralfate.

It is possible, if not likely, that many other drugs will interact similarly with sucralfate. Therefore, it probably is prudent to take all medications at least 2 hours before sucralfate.

• Sucralfate itself is not teratogenic (causing congenital deformities) in animals, even in doses considerably higher than those used in humans. Although some animal data demonstrate concern for the effects of aluminum during pregnancy, all human data show no ill effect on the fetus. Sucralfate is considered safe during pregnancy.
• Minimal if any sucralfate penetrates breast milk because so little is absorbed from the gastrointestinal tract. Although there are no data, sucralfate is considered safe in nursing mothers.

• Tablets: 1 gm
• Suspension: 1g/10 ml.

• Tablets and suspension should be kept at room temperature, between 15 C and 30 C (59 F and 86 F).
• The suspension should not be frozen and should be shaken before each use.

Sucralfate is a unique oral drug that is used for treating ulcers of the upper gastrointestinal tract.

Chemically, sucralfate is a complex of the disaccharide sugar, sucrose, combined with sulfate and aluminum. It is minimally absorbed into the body, and its actions are entirely on the lining of the stomach and duodenum. Although its mechanism of action is not entirely understood, the following actions are thought to be important for its beneficial effects:

1. sucralfate binds to the surface of ulcers (attaching to exposed proteins) and coats the ulcer, thus protecting the ulcer surface to some extent from further injury by acid and pepsin;
2. sucralfate directly inhibits pepsin (an enzyme that breaks apart proteins) in the presence of stomach acid;
3. sucralfate binds bile salts coming from the liver via the bile thus protecting the stomach lining from injury caused by the bile acids;
4. sucralfate may increase prostaglandin production, and prostaglandins are known to protect the lining of the stomach.

Sucralfate was approved by the FDA in 1981.