Drug Interaction Report

Concomitant administration of diflunisal and aluminum-containing products reduces the oral bioavailability of diflunisal by up to 40%. Doses of diflunisal and aluminum-containing products should be separated by at least 2 hours to ensure adequate absorption of diflunisal. Patients should be monitored for altered clinical effects of diflunisal.

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.