Sucralfate

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Sucralan, Sucralbene, Sucralfat, Sucramed, Ulcogant; Bulgaria: Sucralfat; Czech Republic: Ulcogant, Venter; Denmark: Antepsin; Estonia: Venter; Finland: Alsucral, Antepsin; France: Keal, Sucralfate, Ulcar; Germany: Sucrabest, Sucralfat, Ulcogant; Greece: Peptonorm; Hungary: Alusulin, Ulcogant, Venter; Ireland: Antepsin; Italy: Antepsin, Citogel, Crafilm, Gastrogel, Sucralfato, Sucralfin, Sucramal, Sucrate, Sucroril, Sugar, Sugast, Suril, Ulcrast; Latvia: Venter; Lithuania: Venter; Luxembourg: Keal, Sucrabest, Ulcogant; Malta: Antepsin; Netherlands: Sucralfaat, Ulcogant; Poland: Alsucral, Sucralfate, Suratio, Ulcogant, Ulgastran, Venter; Portugal: Cinebil, Sucralfato, Ulcermate, Ulcermin, Ulcimer; Romania: Gastrofait, Sucralan, Venter; Slovakia: Venter; Slovenia: Venter; Spain: Urbal; Sweden: Andapsin; UK: Antepsin.

North America

Canada: Sucralfate, Sulcrate; USA: Carafate, Sucralfate.

Latin America

Argentina: Antepsín, Netunal, Sucralfato, Sucralmax; Brazil: Sucrafilm; Mexico: Apo-Lato, Duodenel, Sucralfato, Unival.

Asia

Japan: Altsamin, Basic Aluminum Sucrose Sulfate, Bingast, Muttermin, Ohnesmin, Ritaalumin, Shualmin, Sucralfate, Teigast, Tunalmin, Ulban A, Ulcerlmin, Yuwan.

Drug combinations

Chemistry

Sucralfate: Al~8~(OH)~16~(C~12~H~14~O~35~S~8~)[Al(OH)~3~]~x~[H~2~O]~y~ in which x=8 to 10, and y=22 to 31. α-D-Glucopyranoside, β-D-fructofuranosyl-, octakis(hydrogen sulfate), aluminum complex. CAS-54182-58-0 (1976).

Pharmacologic Category

Antiulcer Agents and Acid Suppressants; Protectants. (ATC-Code: A02BX02).

Mechanism of action

Anionic sulfated disaccharide. Pepsin inhibitor. Does not affect gastric acid output or concentration. Does not neutralize acidity of gastric contents. Reacts with hydrochloric acid in stomach. Forms highly condensed, viscous, adhesive, paste-like substance which buffers acid (14-16 mEq of in vitro acid-neutralizing capacity per 1 g dose). Binds to surface of gastric and duodenal ulcers with greater affinity for ulcer site than normal GI mucosa. Also binds to acute gastric erosions produced by alcohol or other drugs (e.g. aspirin). Binds electrostatically to positively-charged protein molecules in damaged mucosa of GI tract, forming insoluble, stable complexes which form adherent, protective barrier at ulcer site. Allows ulcer to heal by protecting ulcer site from ulcerogenic properties of pepsin, acid, and bile. Prevents back-diffusion of hydrogen ions and adsorbs pepsin and bile acids. May decrease rate of gastric emptying.

Therapeutic use

Short-term (≤8 weeks) management of duodenal ulcers. Maintenance therapy for duodenal ulcers.

Pregnancy and lactiation implications

Teratogenic effects not observed in animal studies. Only minimally absorbed following oral administration. Excretion in breast milk unknown (use with caution in nursing women).

Unlabeled use

Gastric ulcers. Stomatitis due to cancer chemotherapy and other causes of esophageal and gastric erosions. Gastroesophageal reflux disease, esophagitis. NSAID mucosal damage. Prevention of stress ulcers. Postsclerotherapy for esophageal variceal bleeding.

Contraindications

Hypersensitivity to sucralfate or any component of the formulation.

Warnings and precautions

As sucralfate acts locally at the ulcer, successful therapy with sucralfate should not be expected to alter posthealing frequency of recurrence or severity of duodenal ulceration. Use with caution in chronic renal failure; sucralfate is an aluminum complex, small amounts of aluminum are absorbed following oral administration and its excretion may be decreased in chronic renal failure. Due to potential for sucralfate to alter absorption of some drugs, separate administration should be considered when alterations in bioavailability are believed to be critical.

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