ATC Class: A02BX02
VA Class: GA302
CAS Number: 54182-58-0
Uses for Sucralfate
Conventional antiulcer therapy, including sucralfate therapy, is associated with a high rate of ulcer recurrence (e.g., 60–100% per year) in patients with initial or recurrent duodenal ulcer and documented Helicobacter pylori infection.100 132 136 140 144 146 154 All such patients should receive anti-infective therapy for treatment of the infection;128 132 144 145 146 choice of a particular regimen should be based on current data on optimal therapy.128 132 140 145 165 166
Efficacy of short-term sucralfate similar to that of cimetidine in adults with duodenal ulcer.a
Conventional antiulcer therapy, including sucralfate therapy, is associated with a high rate of ulcer recurrence (e.g., 60–100% per year) in patients with initial or recurrent gastric ulcer and documented H. pylori infection.100 132 136 140 144 146 154 All such patients should receive anti-infective therapy for treatment of the infection;128 132 144 145 146 choice of a particular regimen should be based on current data on optimal therapy.128 132 140 145 165 166
Has been used as an oral suspension† for prevention and treatment of chemotherapy-induced mucositis†.100 101 102 103 104 108 Results have been conflicting;101 additional study necessary.100 104 106 107
Sucralfate Dosage and Administration
Equivalence of sucralfate suspension and tablets not demonstrated.b
Agitate suspension well prior to administration of each dose.b
Maintenance of HealingOral
1 g 4 times daily.a
Select dosage with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.b
Cautions for Sucralfate
Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger adults; select dosage with caution.b
Substantially eliminated by kidneys; assess renal function periodically since geriatric patients are more likely to have decreased renal function.b
Common Adverse Effects
Interactions for Sucralfate
Effects on GI Absorption of Drugs
May bind to a number of drugs in the GI tract, reducing extent of absorption.a b c Instruct patients to administer other drugs at least 2 hours before sucralfate and monitor patients appropriately if alteration in bioavailability of the other drug(s) is critical.a b c
Fluoroquinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
Binding to ulcer site persists for up to 6 hours.a
Minimally distributed into tissues.a
Reacts with hydrochloric acid in the stomach to form sucrose sulfate, which is not metabolized.a
Excreted principally in feces (>90%) and urine (3–5%) as sucrose sulfate within 48 hours.a
Tight containers at room temperature.a
Binds to surface of gastric and duodenal ulcers with greater affinity for ulcer site than normal GI mucosa; also binds to acute gastric erosions produced by alcohol or other drugs (e.g., aspirin).a
Binds electrostatically to positively charged protein molecules in damaged mucosa of the GI tract, forming insoluble, stable complexes which form an adherent, protective barrier at the ulcer site.a b c
May decrease rate of gastric emptying.a
Advice to Patients
Importance of shaking suspension well prior to each use.b
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and dietary or herbal supplements, as well as any concomitant illnesses (e.g., renal failure).a b c
Importance of informing patients of other important precautionary information. (See Cautions.)
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
500 mg/5 mL
Carafate (with methylparaben)
Eon, Martec, Teva, UDL, Warrick, Watson
This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 02/2013. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.
Carafate 1GM/10ML Suspension (AXCAN PHARMA US): 420/$99.99 or 1260/$285.96
Carafate 1GM Tablets (AXCAN PHARMA US): 30/$53.99 or 90/$142.98
Sucralfate 1GM/10ML Suspension (PHARMACEUTICAL ASSOCIATES): 10/$13.99 or 50/$39.97
Sucralfate 1GM Tablets (WATSON LABS): 90/$41.99 or 270/$108.97
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS Drug Information. © Copyright, 1959-2013, Selected Revisions June 1, 2008. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.
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a. AHFS drug information 2007. McEvoy GK, ed. Sucralfate. Bethesda, MD: American Society of Health-System Pharmacists; 2007:2983-5.
b. Axcan Scandipharm Inc. Carafate (sucralfate) suspension prescribing information. Birmingham, AL; 2004 Apr.
c. Axcan Scandipharm Inc. Carafate (sucralfate) tablets prescribing information. Birmingham, AL; 2004 Mar.
d. Konturek SJ, Kwiecien N, Obtulowicz W et al. Double blind controlled study on the effect of sucralfate on gastric prostaglandin formation and microbleeding in normal and aspirin treated man. Gut. 1986; 27:1450-6. [PubMed 3492413]