Sucralfate is a medication used to treat ulcers in the stomach and duodenum. It works by forming a protective coating over the ulcer, which helps it heal by shielding the area from stomach acid and digestive enzymes.
This medication acts mainly in the digestive tract and is only minimally absorbed by the body. Because of this, it generally causes few side effects and is considered safe for most people.
Sucralfate is available in tablets and oral suspension forms. It is typically used for up to eight weeks but may sometimes be continued longer to help prevent ulcers from returning.
Indications for use
Sucralfate is approved by the FDA for the short-term treatment of active duodenal ulcers, usually for up to eight weeks. It may also be used to maintain healing and prevent ulcer recurrence after treatment.
Off-label, sucralfate can be prescribed for other conditions such as gastric ulcers, stress ulcer prevention in hospitalized patients, radiation-induced gastritis, and as part of combination therapy for Helicobacter pylori infection.
Because it acts locally, sucralfate is often a good choice for people who cannot tolerate acid-suppressing drugs. It is also considered safe for use during pregnancy and breastfeeding, as very little of the medication is absorbed into the bloodstream.
How to take it
Sucralfate should be taken as directed by a healthcare provider. It works best when taken on an empty stomach, before meals and at bedtime.
1. Tablets
Sucralfate tablets should be swallowed whole with a small amount of water. The usual adult dose is 1 gram four times daily, taken one hour before meals and again at bedtime.
2. Oral suspension
The oral suspension should be shaken well before use to make sure the medication is evenly mixed. It should also be taken on an empty stomach before meals and at bedtime. It is typically prescribed as 1 gram, or 10 ml, taken four times daily, before meals.
3. Maintenance therapy
After ulcers have healed, a maintenance dose of 1 gram twice daily may be prescribed to help prevent recurrence.
To avoid drug interactions, sucralfate should be taken at least two hours before or after other medications. It can reduce the absorption of certain drugs, including fluoroquinolones, tetracyclines, digoxin, warfarin, and levothyroxine.
Possible side effects
Sucralfate is generally well tolerated, but mild side effects may occur. The most common is constipation, affecting about 2% of people. Other possible effects include nausea, dry mouth, indigestion, and stomach discomfort.
Rare allergic reactions such as rash, itching, swelling of the lips or face, or difficulty breathing can happen. In severely ill patients, sucralfate has occasionally been linked to bezoar formation, especially in those with reduced stomach movement or feeding tubes.
Because it contains aluminum, people with kidney problems or those taking sucralfate long term may be at risk of aluminum buildup, which can lead to toxicity.
Contraindications for use
Sucralfate should not be used by anyone allergic to the medication or its ingredients. People with chronic kidney disease or those on dialysis should use it with caution, since aluminum can accumulate and cause serious complications like bone or brain disorders. In these cases, close monitoring is important, and other treatment options may be considered.
Sucralfate is considered safe during pregnancy and breastfeeding because it is only minimally absorbed and does not pass significantly into breast milk.