sucralfate (Rx)

Brand and Other Names:Carafate
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 1g

oral suspension

  • 1000mg/10mL

Duodenal Ulcer

1 g PO q6hr initially; maintenance: 1 g PO q12hr

Take on empty stomach 1 hour before or 2 hours after meals

Stress Ulcer (Off-label)

Prophylaxis

1 g PO q6hr for 4-8 weeks

Take on empty stomach 1 hour before or 2 hours after meals

Epidermolysis Bullosa (Orphan)

Treatment of oral ulcerations and dysphagia in patients with epidermolysis bullosa

Orphan indication sponsor

  • Darby Pharmaceuticals, Inc, 100 Banks Ave, Rockville Centre, NY 11570

Oral Complications After Bone Marrow Transplantation (Orphan)

Treatment of oral complications of chemotherapy in bone marrow transplant recipients

Orphan indication sponsor

  • Darby Pharmaceuticals, Inc, 100 Banks Ave, Rockville Centre, NY 11570

Dosing Modifications

Renal failure: Use with caution; aluminum salt may accumulate

Active Duodenal Ulcer (Off-label)

40-80 mg/kg/day PO divided q6hr

Stomatitis (Off-label)

500-1000 mg PO q6hr; 1g/10mL suspension q6hr; swish and spit or swish and swallow the suspension

Gastric Ulcer (Off-label)

40-80 mg/kg/day PO divided q6hr or 0.5-1 g PO q6hr

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Interactions

Interaction Checker

and sucralfate

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Contraindicated (0)

              Serious - Use Alternative (2)

              • digoxin

                sucralfate will decrease the level or effect of digoxin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Measure serum digoxin concentrations before initiating concomitant drugs; continue monitoring and increase digoxin dose by approximately 20% to 40% as necessary

              • dolutegravir

                sucralfate will decrease the level or effect of dolutegravir by cation binding in GI tract. Avoid or Use Alternate Drug. Administer dolutegravir 2 hr before or 6 hr after taking medications containing polyvalent cations

              Monitor Closely (13)

              • bictegravir

                sucralfate will decrease the level or effect of bictegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Bictegravir can be taken under fasting conditions 2 hr before antacids containing Al, Mg, or Ca. Routine administration of bictegravir simultaneously with, or 2 hr after, antacids containing Al, Mg, or Ca is not recommended.

              • ciprofloxacin

                sucralfate decreases levels of ciprofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. The oral absorption of ciprofloxacin may be significantly reduced by sucralfate secondary to chelation within the GI tract. To help avoid interactions due to chelation, ciprofloxacin should be taken 2 hours before or 6 hours after administration of sucralfate.

              • delafloxacin

                sucralfate will decrease the level or effect of delafloxacin by cation binding in GI tract. Modify Therapy/Monitor Closely. Oral delafloxacin form chelates with alkaline earth and transition metal cations. Administer oral delafloxacin at least 2 hr before or 6 hr after these agents.

              • fleroxacin

                sucralfate decreases levels of fleroxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • furosemide

                sucralfate decreases effects of furosemide by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Simultaneous administration of sucralfate and furosemide Injection may reduce the natriuretic and antihypertensive effects of furosemide; patients receiving both drugs should be observed closely to determine if desired diuretic and/or antihypertensive effect of furosemide achieved; intake of furosemide and sucralfate should be separated by at least 2 hr.

              • gemifloxacin

                sucralfate decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • ketoconazole

                sucralfate decreases levels of ketoconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • levofloxacin

                sucralfate decreases levels of levofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • moxifloxacin

                sucralfate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • ofloxacin

                sucralfate decreases levels of ofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • sodium sulfate/?magnesium sulfate/potassium chloride

                sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of sucralfate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sodium sulfate/potassium sulfate/magnesium sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of sucralfate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • vitamin D

                vitamin D increases levels of sucralfate by Other (see comment). Use Caution/Monitor. Comment: Avoid coadministration. Vitamin D analogs may increase the absorption of aluminum from sucralfate. .

              Minor (12)

              • aluminum hydroxide

                sucralfate increases levels of aluminum hydroxide by pharmacodynamic synergism. Minor/Significance Unknown. Additive aluminum content.

              • anagrelide

                sucralfate decreases levels of anagrelide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • demeclocycline

                sucralfate decreases levels of demeclocycline by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • doxycycline

                sucralfate decreases levels of doxycycline by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • ethotoin

                sucralfate decreases levels of ethotoin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • fosphenytoin

                sucralfate decreases levels of fosphenytoin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • lansoprazole

                sucralfate decreases levels of lansoprazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Separate by 30 minutes.

              • minocycline

                sucralfate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • oxytetracycline

                sucralfate decreases levels of oxytetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • phenytoin

                sucralfate decreases levels of phenytoin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • tetracycline

                sucralfate decreases levels of tetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • warfarin

                sucralfate decreases levels of warfarin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

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              Adverse Effects

              1-10%

              Constipation (2%)

              <1%

              Diarrhea

              Dizziness

              Dry mouth

              Flatulence

              Headache

              Indigestion

              Insomnia

              Nausea

              Vertigo

              Vomiting

              Frequency Not Defined

              Bezoars formation

              Gastrointestinal discomfort

              Postmarketing Reports

              Hypersensitivity reactions

              Hyperglycemia

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              Warnings

              Contraindications

              Documented hypersensitivity

              Cautions

              Not expected to alter post healing frequency of recurrence or severity of duodenal ulceration; acts locally at the ulcer

              Do not take antacids within 30 minutes of sucralfate dose

              Aluminum absorption is increased; use with caution in patients with chronic renal failure or undergoing dialysis

              Potential significant drug interactions possible; consult drug interaction database

              Use tablet with caution in patients with conditions that may impair swallowing, or with altered gag/cough reflex

              Hyperglycemia has been reported when drug is used in patients with diabetes

              Sucralfate may alter absorption of some drugs; take other medications 2 hours before taking sucralfate

              Fatal complications, including pulmonary and cerebral emboli reported with inappropriate intravenous administration of oral suspension; administer oral suspension only by oral route; not for intravenous administration

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              Pregnancy & Lactation

              Pregnancy category: B

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

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Forms ulcer-adherent complex; protects ulcer from acid, pepsin, and bile salts, thus allowing it to heal

              Absorption

              Bioavailability: 5% (sucralfate is considered nonsystemic); sucrose octasulfate, 5%; aluminum, 0.005%

              Onset: 1-2 hr

              Duration: Up to 6 hr

              Metabolism

              Not metabolized

              Elimination

              Dialyzable: Yes

              Excretion: Primarily urine (as unchanged drug)

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              sucralfate oral
              -
              100 mg/mL suspension
              sucralfate oral
              -
              1 gram tablet
              sucralfate oral
              -
              1 gram tablet
              sucralfate oral
              -
              1 gram tablet
              sucralfate oral
              -
              1 gram tablet
              sucralfate oral
              -
              1 gram tablet
              sucralfate oral
              -
              100 mg/mL suspension
              Carafate oral
              -
              1 gram tablet
              Carafate oral
              -
              100 mg/mL suspension

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              sucralfate oral

              SUCRALFATE SUSPENSION - ORAL

              (sue-KRAL-fate)

              COMMON BRAND NAME(S): Carafate

              USES: This medication is used to treat ulcers in the intestines. Sucralfate forms a coating over ulcers, protecting the area from further injury. This helps ulcers heal more quickly.

              HOW TO USE: Shake the bottle well before each dose. Take this medicine by mouth, usually 2 teaspoonfuls 4 times daily, on an empty stomach at least 1 hour before a meal, or as directed by your doctor.The dosage is based on your medical condition and response to therapy.Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day. It is important to continue taking this medication even if you do not feel ulcer pain. Do not stop taking this medication without consulting your doctor. It may take 4 to 8 weeks for your ulcer to heal completely.Some medications may not work as well if you take them at the same time as sucralfate. They may need to be taken at a different time of the day than the time you take sucralfate. Ask your doctor or pharmacist for help making a dosing schedule that will work with all your medications.Antacids can be used with this medicine, but they should be taken at least 30 minutes before or after sucralfate.Inform your doctor if your condition persists or worsens after you have been taking sucralfate for 4 weeks.

              SIDE EFFECTS: Constipation, dry mouth, upset stomach, gas, and nausea may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if these unlikely but serious side effects occur: an unusual/persistent feeling of fullness in the stomach, nausea/vomiting/stomach pain especially after meals.A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking sucralfate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, stomach/intestine problems (e.g., delayed gastric emptying), tube feeding.Kidney function declines as you grow older. This medication contains aluminum, which is normally removed by your kidneys. Elderly people may be at greater risk for developing high aluminum levels while using this drug with other products that contain aluminum (e.g., antacids).If you are pregnant, tell your doctor before using sucralfate.It is not known if this medication passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: antacids that contain aluminum, certain antibiotics (including quinolones such as ciprofloxacin/levofloxacin/ofloxacin, tetracyclines), digoxin, ketoconazole, penicillamine, phenytoin, quinidine, thyroid medications (such as levothyroxine, liothyronine).

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Your doctor may recommend some lifestyle changes such as stress-reducing programs, diet changes and exercise to assist in treatment and prevention of ulcers. This medicine should not be injected into your veins. Do not share this medication with others.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

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              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.