(sucralfate)

Brand Name

Carafate

Availability

• Tablets: 1 gram
• Suspension: 0.2 g/mL, 1 g/10mL in 420 mL (also comes in 10 mg/10mL unit dose cups).

Pharmacology

Sucralfate, a sucrose aluminum hydroxide compound, is an anti-ulcer agent which binds to the surface of ulcers and forms a protective barrier. While the actual mechanism of action is unknown, sucralfate has been shown to exert its effect locally rather than systemically.

Sucralfate is minimally absorbed from the gastrointestinal tract following oral dosing (about 3-5% absorbed), and excreted in urine unchanged. Any of the drug remaining converts to sucrose sulfate in the gut by reacting with hydrochloric acid and is then excreted in feces.

A single dose of sucralfate, after taken orally, may last as long as 6 hours.

*Note: Reproduction studies in mice and rats produced no evidence of impaired fertility or teratogenicity even at high doses. However, it is unknown if the drug is excreted in breast milk.

Indications

Used to treat conditions associated with oral, esophageal, stomach or duodenal ulceration (e.g., oral burns, toxin ingestion, kidney failure, hepatic failure, megaesophagus).

*Note: recommended to be used concurrently with long term use of glucocorticoids (e.g., prednisone/prednisolone), or NSAIDs (e.g., piroxicam) in conditions where such treatment is required.

Drug Interactions or Contraindications

• Concomitant use of sucralfate may decrease the absorption and/or concentrations of some medications. It has been recommended to administer sucralfate 2 hours before or after any of the following:
  • fluoroquinolones (e.g., ciprofloxacin and enrofloxacin)
  • Tetracyclines
  • Theophylline
  • Digoxin
  • Cimetidine
  • Ketoconazole
  • levothyroxine
  • fat soluable vitamins (A, D, E, K)

• Avoid using in rats whose GI (little to no passage of stool) transit time is decreased (e.g., megacolon).

Adverse Reactions

A small amount of accidental overdosing is not likely to cause a problem. Studies show that laboratory animals having received an oral dose of 12 grams/kg demonstrated no incidence of mortality.

GI: constipation, gastric discomfort, diarrhea, nausea

Signs of nausea in pet rats:

• Gaping (of mouth)
• Loss of appetite
• Malaise
• Pica (a compulsive eating of non-food substances)

Dosage Recommendations

25 mg/kg to 50 mg/kg, PO, q6hr to q8hr  ^{32, 41, 42, 44}

or

25 mg/kg to 100 mg/kg, PO, q8hr to q12hr  ^{34 35, 41, 44}

Considerations

• Store tablets and suspension in a closed container at room temperature. Shake suspension before administering.