Sucralfate Side Effects

It is possible that some side effects of sucralfate may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to sucralfate: oral suspension, oral tablet

As well as its needed effects, sucralfate may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking sucralfate, check with your doctor immediately:

Signs of aluminum toxicity
  • Drowsiness
  • convulsions (seizures)

Some sucralfate side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common
  • Constipation
Less common or rare
  • Backache
  • diarrhea
  • dizziness or lightheadedness
  • dryness of mouth
  • indigestion
  • nausea
  • skin rash, hives, or itching
  • stomach cramps or pain

For Healthcare Professionals

Applies to sucralfate: compounding powder, oral suspension, oral tablet


Sucralfate is generally very well tolerated, only 2% to 3% of patients experience side effects. Constipation and other gastrointestinal effects are the most commonly reported. Patients with renal dysfunction may be at increased risk for more serious side effects such as hypophosphatemia and aluminum intoxication.


Gastrointestinal side effects have included constipation (1% to 3%), dry mouth, nausea, vomiting, indigestion, gastric mucosal calcinosis, and rare case reports of gastroesophageal bezoars.

Case reports of gastroesophageal and esophageal bezoars have been reported in the literature. Sucralfate was usually given crushed and suspended in water. In addition, several patients were also receiving concomitant enteral feedings via a nasogastric tube. Two patients had Guillain-Barre syndrome. These factors may have contributed to bezoar formation.

In one study, calcified aluminum phosphate deposits in the gastric mucosa were present in gastric biopsies of 32.7% (18/55) of organ transplant patients taking aluminum-containing antacids or sucralfate for gastritis. This was observed in only 5.1% (3/59) of non-transplant patients. These three patients all had chronic renal failure and were on long-term aluminum-containing antacid therapy. The clinical relevance of these findings is not known.


Osteomalacia was reported in a 42-year-old female with normal renal and hepatic function. Chronic treatment of peptic ulcer disease with sucralfate resulted in severe hypophosphatemia, elevated alkaline phosphatase levels, and elevated 1,25-dihydroxyvitamin D levels. Subsequent osteomalacia and microfractures occurred.

Another report involves a 13-year-old with end-stage renal disease secondary to hemolytic uremic syndrome. This patient developed aluminum intoxication with encephalopathy as well as osteomalacia with surface stainable aluminum noted on bone biopsy.

Musculoskeletal side effects have included rare reports of bone pain and osteomalacia secondary to hypophosphatemia and aluminum toxicity.


Metabolic side effects have included hypophosphatemia and aluminum toxicity. Sucralfate has been reported to decrease the absorption of thyroxine (T4). Sucralfate suspension has been associated with hyperglycemia in diabetic patients.

Sucralfate has phosphate binding properties for which the drug is sometimes used therapeutically. However, hypophosphatemia may occur in some patients, regardless of renal function status.

In addition, each 1 gram dose of sucralfate contains approximately 200 mg of aluminum which may be absorbed. Aluminum intoxication leading to mental status changes, confusion, seizures, and encephalopathy may occur, especially in patients on concomitant aluminum-containing antacids, on chronic sucralfate, or with renal dysfunction.

Nervous system

Nervous system side effects have included headache, vertigo, dizziness, and rare reports of encephalopathy secondary to aluminum accumulation.


Dermatologic side effects have included pruritus, rash, and urticaria.


Hypersensitivity side effects have included urticaria, angioedema, rhinitis, and respiratory difficulty. Sucralfate suspension has been associated with postmarketing reports of hypersensitivity including anaphylactic reactions, dyspnea, lip swelling, edema of the mouth, pharyngeal edema, pruritus, rash, swelling of the face and urticaria.

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