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Sucralfate

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Mode of action

Exact mechanism unclear. Has following actions:

  • in presence of gastric acid forms a complex with mucosal proteins and proteinaceous exudate at ulcer site - adheres to ulcer
  • adsorbs gastrin and bile salts
  • increases synthesis of prostaglandins

Indications

  • stress ulcer prophylaxis (inferior to H2 antagonists)
  • peptic ulcer disease
  • topical treatment of stomatitis
  • oesophagitis

Pharmacokinetics

  • poorly absorbed (<5%) from GI tract
  • absorbed drug is eliminated unchanged by kidney

Adverse effects

  • dizziness
  • vertigo
  • aluminium toxicity (in patients with renal impairment)
  • hypophosphataemia
  • GI upset including decreased gastric emptying, constipation, diarrhoea, nausea

Drug interactions

  • Decreases bioavailability of:
    • cimetidine, ranitidine
    • phenytoin
    • fat soluble vitamins (A,D,E,K)
    • digoxin
    • theophylline
    • ciprofloxacin, norfloxacin
    • itraconazole, ketoconazole
  • Drugs which reduce gastric acid decrease effectiveness of sucralfate
 

©Charles Gomersall, April, 2014 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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