Sucralfate

Indications

Sucralfate is used for: Peptic ulcer, Chronic gastritis, GI haemorrhage from stress ulceration

Adult Dose

Oral Chronic gastritis; Peptic ulcer Adult: 1 g 4 times daily or 2 g bid for 4-8 wk, may extend up to 12 wk if necessary. Maintenance dose of 1 g bid may be given to prevent the recurrence of duodenal ulcers. Max: 8 g daily. Prophylaxis of gastrointestinal haemorrhage from stress ulceration Adult: 1 g 6 times daily. Not to exceed 8 g daily.

Child Dose

Oral Chronic gastritis; Peptic ulcer Child: 1 mth-2 yr: 250 mg 4-6 times daily; 2-12 yr: 500 mg 4-6 times daily and 12-18 yr: 1 g 4-6 times daily. Prophylaxis of gastrointestinal haemorrhage from stress ulceration Child: 1 mth-2 yr: 250 mg 4-6 times daily; 2-12 yr: 500 mg 4-6 times daily and 12-18 yr: 1 g 4-6 times daily.

Renal Dose

Renal failure: Use with caution; aluminum salt may accumulate

Administration

Should be taken on an empty stomach. Take on an empty stomach 1 hr before or 2 hr after meals.

Contra Indications

Hypersensitivity.

Precautions

Systemic aluminum toxicity may occur in patients with chronic renal failure. Neonates, children; pregnancy and lactation. Lactation: Probably safe because drug is minimally absorbed; unknown whether drug is excreted in breast milk

Pregnancy-Lactation

Pregnancy category: B Lactation: Probably safe because drug is minimally absorbed; unknown whether drug is excreted in breast milk

Interactions

Avoid antacids within 30 min of sucralfate admin. May reduce absorption of tetracyclines, ranitidine, ketoconazole, theophylline, phenytoin, cimetidine and digoxin (ensure a dosing interval of at least 2 hr between admin of sucralfate and other non-antacid medications).

Adverse Effects

Side effects of Sucralfate : 1-10% Constipation (2%) <1% Diarrhea, Dizziness, Dry mouth, Flatulence, Headache, Indigestion, Insomnia, Nausea, Vertigo, Vomiting Frequency Not Defined Bezoars formation, Gastrointestinal discomfort

Mechanism of Action

Sucralfate protects GI lining against peptic acid, pepsin and bile salts by binding with positively-charged proteins in exudates forming a viscous paste-like adhesive substance thus forming a protective coating.