sucralfate (Carafate)

Introduction

Tradename: Carafate.

Indications

• treatment of duodenal ulcers
• used to accelerate healing of gastric ulcers
• treatment of gastroesophageal reflux & peptic esophagitis
  • pyrosis
  • no role in treatment of GERD
• stress ulceration
  • 1st line therapy for stress ulcer prophylaxis
• topical treatment for stomatitis due to cancer chemotherapy

Contraindications

pregnancy-category B

safety in lactation ?

Dosage

• 1 g PO 1 hour before meals & QHS
• 1 gm QID or 2 g BID
• give sucralfate 1 hour before or 3-4 hours after other medicines

Tabs: 1 g.

Suspension: 1g /10 mL (420 mL).

Pharmacokinetics

• minimally absorbed from GI tract
• excreted in feces

Adverse effects

• not common (1-10%)
  • constipation
• uncommon (< 1%)
  • dizziness, sleepiness, vertigo, rash, pruritus, diarrhea, nausea, gastric discomfort, indigestion, dry mouth, back pain

Drug interactions

• sucralfate may diminish effect of warfarin
• sucralfate may diminish bioavailability of:
  • digoxin
  • quinolines
  • phenytoin
  • ketoconazole
• cimetidine

Mechanism of action

• forms an adherent complex that protects ulcer site from acidic environment
• inhibits pepsin activity
• contains aluminum

More general terms

• antiulcer agent

Component of

• Benadryl/Carafate/Mylanta
• magic mouthwash

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5311464