Drug Interaction Report

ADJUST DOSING INTERVAL: Antacid-induced gastric pH changes may reduce binding of sucralfate with the gastrointestinal mucosa resulting in reduced therapeutic efficacy. In addition, aluminum may accumulate in patients with renal failure who are concomitantly taking sucralfate with aluminum-containing antacids.

MANAGEMENT: Sucralfate and antacid doses should be separated by at least half an hour.

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.