BMA Concise Guide to Medicine & Drugs

Sucralfate

Brand name Antepsin

Used in the following combined preparations None

QUICK REFERENCE

Drug group Ulcer-healing drug

Overdose danger rating Low

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Sucralfate, a drug partly derived from aluminium, is prescribed to treat gastric and duodenal ulcers. It is particularly used to prevent stress-induced ulcers in patients who are seriously ill. The drug does not neutralize stomach acid, but it forms a protective barrier over the ulcer that protects it from attack by digestive juices, giving it time to heal.

If it is necessary during treatment to take antacids to relieve pain, they should be taken at least half an hour before or after taking sucralfate.

There are a few reports of seriously ill patients developing bezoars (balls of indigestible material) in their stomachs while on sucralfate. The safety of the drug for long-term use has not yet been confirmed. Therefore, courses of more than 12 weeks are not recommended.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, liquid.

Frequency and timing of doses 2–6 x daily, 1 hour before each meal and at bedtime, at least 2 hours after food. The tablets may be dispersed in a little water before swallowing.

Dosage range 4–8g daily.

Onset of effect Some improvement may be noted after one or two doses, but it takes a few weeks for an ulcer to heal.

Duration of action Up to 5 hours.

Diet advice Your doctor will advise if supplements are needed.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Do not make up the dose you missed. Take your next dose on your original schedule.

Stopping the drug Do not stop the drug without consulting your doctor; symptoms may recur.

Exceeding the dose An occasional unintentional extra dose is unlikely to be a cause for concern. But if you notice any unusual symptoms, or if a large overdose has been taken, notify your doctor.

POSSIBLE ADVERSE EFFECTS

Most people do not experience any adverse effects with sucralfate. The most common is constipation, which will diminish as your body adjusts to the drug; indigestion is also common. Rarely, diarrhoea, dry mouth, and headache may occur; discuss with your doctor if these are severe. Nausea, rash, itching, dizziness, or vertigo are also rare side effects; you should consult your doctor if they occur.

INTERACTIONS

General note Sucralfate may reduce the absorption and effect of a range of drugs, including ranitidine, digoxin, phenytoin, warfarin, levothyroxine, and antibacterials. Take these and other medications at least 30 minutes before or 2 hours after sucralfate.

Antacids and other indigestion remedies These reduce the effectiveness of sucralfate and should be taken at least 30 minutes before or after sucralfate.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have a long-term kidney problem.

· You are taking other medicines.

Pregnancy Safety in pregnancy not established, although so little is absorbed into the body that it is probably safe. Discuss with your doctor.

Breast-feeding It is not known whether the drug passes into breast milk. Discuss with your doctor.

Infants and children Not usually prescribed.

Over 60 No special problems.

Driving and hazardous work Usually no problems, but sucralfate may cause dizziness in some people.

Alcohol Avoid. Alcohol may counteract the beneficial effect of this drug.

PROLONGED USE

Not usually prescribed for periods longer than 12 weeks at a time. Prolonged use may lead to deficiencies of vitamins A, D, E, and K.