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sucralfate (soo KRAL fayt)
What is sucralfate?
Sulcrafate is a sugary drug that binds up with protein-like material in the base of intestinal ulcers. It is not an antacid nor does it reduce stomach acidity. Very little of the drug is absorbed into the body.
What is it used for?
Sucralfate is approved by the FDA for healing of duodenal ulcers. However, physicians also use it for ulcers or erosions in the mouth, esophagus (food pipe), and stomach, although its effectiveness in these areas has never been clearly proven.
How do I take it?
Follow your physician’s instructions carefully. For the best effect, take sucralfate on an empty stomach, one hour before or two hours after each meal and at bedtime. Swallow the tablet whole, do not alter or chew. With the liquid, do not drink or eat for at least one hour after taking. Take the full course prescribed. Do not stop just because symptoms improve. Keep all medications away from children. Never share your medications with anyone else.
What do I do for a missed dose?
If you miss a dose of this medicine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and return to your regular schedule. Do not double up on this medicine.
Are there interactions with food or beverages?
It is best to take the drug on an empty stomach so it can reach and coat the ulcer base. Food in the stomach may prevent this from occurring. Preferably, take the tablet with water. There are no known interactions with food or alcohol, but it is best to avoid alcohol because of its irritant effect on the stomach. Nicotine can delay ulcer healing and reduce effectiveness of this drug.
Are there interactions with other drugs?
An interaction generally means that one drug may increase or decrease the effect of another drug. Also, the more medications a person takes, the more likely there will be a drug interaction. It is best to take other medications at least 1 hour before taking sucralfate as this drug may interfere with absorption of other drugs.
Interactions with this drug may occur with the following:
- cimetidine (Tagamet)
- ciprofloxacin (Cipro)
- digoxin (Lanoxin)
- enoxacin (Penetrex)
- ketoconazole (Nizoral)
- norfloxacin (Noroxin)
- ofloxacin (Floxin)
- quinidine (Quinaglute)
- phenytoin (Dilantin)
- tetracycline (Achromycin)
- blood thinners (Coumadin)
- antacids (Maalox, Mylanta)
Is there a problem if I have another disorder or disease?
At times, a drug may have a different or enhanced effect when other diseases are present. At other times, the drug may worsen or effect another disease. Since there is a small amount of aluminum absorbed from sucralfate, patients in kidney failure or who are on dialysis should be careful using it long-term.
What about allergies?
People who have known allergies or asthma may be at an increased risk for a reaction from any new medication. The physician should always know a patient’s allergy history. Signs of an allergic reaction are skin rash, hives or itching. Of course, a person should not take sucralfate if there has been a previous reaction to this or a similar drug.
What if I’m pregnant, considering pregnancy or breast-feeding?
Most females now know that, if possible, no drug, including alcohol, should be taken during pregnancy or lactation. The potential danger, of course, is an injury to the baby. However, some drugs are much safer than others in this regard. So, the FDA has a grading system for each drug which reflects what is known medically. It ranks. drugs from A, where medical studies show no evidence for danger to the fetus or mother, to B, C, D and X, where the medical evidence indicates that the risk to the fetus outweighs any benefit to the mother. Sucralfate is ranked B. Always consult your physician before taking any drug during or when planning pregnancy.
What are the effects on sexual function?
There are no known adverse effects of sulcralfate on sexual function.
Are there other precautions?
Long-term use may impair the absorption of the fat soluble vitamins A, D, E, and K. Discuss this with your physician.
How long is it safe to take sucralfate?
Treatment for 6 to 8 weeks is needed to heal an active duodenal ulcer. Use beyond 8 weeks should be determined by your physician.
How about side effects?
Adverse reactions can occur with any drug, even over-the-counter medications. Some of these are mild such as a stomach upset, which may be avoided by taking the medication with food. Minor reactions may go away on their own but if they persist, contact the physician. For major reactions, the patient should contact the physician immediately.
For sucralfate, the following are the observed side effects:
- stomach cramps
- back pain
- dry mouth
A physician’s comment…
The whole issue of healing peptic ulcers has undergone tremendous change. In over 90% of cases, stomach and duodenal ulcers are caused either by the Helicobacter pylori bacteria or arthritis drugs such as ibuprofen, Advil, Motrin and Naprosyn. There are now extemely potent drugs available to reduce stomach acid, which is the injurious agent necessary for an ulcer. Antibiotics cure H. pylori caused ulcers and stopping the above arthritis drugs allows ulcers to heal on their own. Still, sucralfate may have a place in the treatment of an acute ulcer where a major complication such as bleeding is feared. The liquid is also comforting in some ulcers of the mouth and esophagus.