Sucralfate
Sucralfate
Carafate
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Summary
Classes
Common uses
Duodenal ulcer (active treatment and maintenance)0, Stress ulcer prophylaxis0, Radiation-induced oral mucositis (off-label slurry)0, Bile reflux gastritis0
Pharmacy
Starting dose
1 g PO QID on an empty stomach (1 hour before meals and at bedtime); 1 g BID for maintenance
Preparations
1 g tablets; 1 g/10 mL suspension
US FDA Max
4 g/d typical
Pharmacology
Routes
Oral
Onset
Mucosal protection within hours; ulcer healing over 2-4 weeks
Duration
6 hours per dose
Half-life
Not meaningfully described — sucralfate is essentially non-absorbed[1]
Bioavailability
<5% systemic absorption (this is the safety basis)[1]
Pregnancy
Generally considered safe due to minimal systemic absorption.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Sucralfate is a complex of sucrose octasulfate and polyaluminum hydroxide; in the acidic gastric environment it polymerizes into a viscous, sticky gel that selectively binds ulcer crater protein exudates, forming a physical protective barrier over ulcer beds without changing acid secretion.0 Also stimulates local prostaglandin and mucus production. Substantial impact on absorption of co-administered drugs (binds tetracyclines, fluoroquinolones, digoxin, levothyroxine, warfarin) — separate dosing windows by ≥2 hours. Aluminum accumulation in advanced CKD is the systemic-toxicity concern[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Carafate (sucralfate), Allergan, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/019183s050lbl.pdf