Carafate (sucralfate) for Ulcers: Side Effects & Dosage

What is Carafate (sucralfate)?

Carafate is a unique oral drug that is
used for treating ulcers of the upper gastrointestinal tract.

Is Carafate (sucralfate) available as a generic drug?

Yes

Do I need a prescription for Carafate (sucralfate)?

Yes

What are the uses for Carafate (sucralfate)?

Carafate is used for the treatment of
peptic ulcer
disease and to prevent recurrent ulcers after healing of the ulcer has been
achieved.
Carafate also has been used to relieve or
prevent ulcers caused by nonsteroidal anti-inflammatory
drugs (NSAIDs), but is less effective than
misoprostol (Cytotec).
Carafate also is used in the treatment of patients with
gastroesophageal reflux disease (GERD).
Off-label uses are to prevent
stress ulcers, which are ulcers associated with
high degrees of physical
stress (for example, extensive
burns, surgery, and overwhelming
infection) in hospitalized patients.

QUESTION

GERD is the back up of stomach acid into the esophagus.
See Answer

What are the side effects of Carafate (sucralfate)?

Carafate is well tolerated. Constipation is the most
frequent side effect.

Other side effects include:

What is the dosage for Carafate (sucralfate)?

The recommended dose for treatment of active ulcers is 1 gram
four times daily for 4-8 weeks.
Carafate is administered on an empty stomach,
at least one hour prior to meals, for best results.
The dose for maintenance (preventing
recurrent ulcers) is 1 gram twice daily.

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Which drugs or supplements interact with Carafate (sucralfate)?

When administered with other drugs sucralfate may
bind to the drugs in the stomach and reduce absorption of the drugs. Sucralfate
reduces the absorption of:

dolutegravir (Tivicay),
cimetidine (Tagamet),
digoxin (Lanoxin),
ketoconazole
(Nizoral),
levothyroxine (Synthroid),
phenytoin (Dilantin),
quinidine (Quinidex,
Quinaglute),
ranitidine (Zantac),
tetracycline,
theophylline (Theo-Dur, Uniphyl,
others), and
all of the fluoroquinolone antibiotics, including
ciprofloxacin (Cipro),
norfloxacin (Noroxin),
ofloxacin (Floxin), and lomefloxacin (Maxaquin).

All of these medications should be taken at least two hours prior to sucralfate.

It
is possible, if not likely, that many other drugs will interact similarly with sucralfate. Therefore, it probably is prudent to take all medications at least 2
hours prior to sucralfate.

Is Carafate (sucralfate) safe to use during pregnancy or while breastfeeding?

Sucralfate itself is not teratogenic (causing congenital
deformities) in animals, even in doses considerably higher than those used in
humans. Although some animal data demonstrate concern for the effects of
aluminum during
pregnancy, all human data show no ill-effect on the fetus. Sucralfate is considered safe during pregnancy.
Minimal if any sucralfate penetrates into
breast milk
because so little is absorbed from the
gastrointestinal tract. Although there
are no data, sucralfate is considered safe in nursing mothers.

What else should I know about Carafate (sucralfate)?

What preparations of Carafate (sucralfate) are available?

Tablets: 1 gm
Suspension: 1g/10 ml.

How should I keep Carafate (sucralfate) stored?

Tablets and suspension should be kept at room temperature,
between 15 C and 30 C (59 F and 86 F).
The suspension should not be frozen and should be
shaken prior to each use.

How does Carafate (sucralfate) work?

Sucralfate is a unique oral drug that is
used for treating ulcers of the upper gastrointestinal tract.

Chemically, sucralfate is
a complex of the disaccharide sugar, sucrose, combined with sulfate and
aluminum. It is minimally absorbed into the body, and its actions are entirely
on the lining of the stomach and duodenum. Although its mechanism of action is
not entirely understood, the following actions are thought to be important for
its beneficial effects:

sucralfate binds to the surface of ulcers (attaching to exposed
proteins) and coats the ulcer, thus protecting the ulcer surface to some
extent from further injury by acid and pepsin;
sucralfate directly inhibits pepsin (an enzyme that breaks apart
proteins) in the presence of stomach acid;
sucralfate binds bile salts coming from the liver via the bile
thus protecting the stomach lining from injury caused by the bile acids;
sucralfate may increase prostaglandin production, and
prostaglandins are known to protect the lining of the stomach.

When was Carafate (sucralfate) approved by the FDA?

Sucralfate was approved by the FDA in 1981.