Drug Interaction Report

ADJUST DOSING INTERVAL: Sucralfate may interfere with the absorption of oral phenytoin and may reduce its therapeutic effect. Sucralfate may interact in a similar way with other oral hydantoins.

MANAGEMENT: Patients should be advised to take phenytoin at least two hours before or 6 hours after sucralfate and to notify their physician if loss of seizure control occurs.

ADJUST DOSING INTERVAL: The administration of sucralfate with enteral nutrition may result in precipitation and the formation of bezoars that may obstruct feeding tubes. The proposed mechanism is the formation of an insoluble aluminum-protein complex between the aluminum in the sucralfate and the protein in the enteral feeding. In addition, sucralfate may not become activated due to the alkaline pH of enteral nutrition products.

MANAGEMENT: Some experts recommend separating the sucralfate doses from enteral feedings by at least 1 hour. Alternatively, consideration may be given to proton pump inhibitors or H2 antagonists.