Sucralfate
CARAFATE
What it isSucrose-aluminum complex forming a physical mucosal barrier; duodenal ulcer and off-label mucositis.
Why this oneIt acts locally with essentially no systemic absorption, useful when acid suppression is unwanted.
What limits itIt binds many drugs in the gut, so separate administration; frequent empty-stomach dosing hurts adherence, and aluminum accumulates in renal failure.
FDA-approved for
- duodenal ulcer (1981)
Off-label
- radiation proctitis
- aphthous and chemotherapy-related mucositis
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Active duodenal ulcer | Adults | 1 g QID on empty stomach | 1 g QID × 4-8 weeks | |
| Maintenance therapy | Adults | 1 g BID | 1 g BID |
Renal Use with caution in chronic renal failure/dialysis — impaired aluminum excretion, risk of accumulation.
Hepatic Undefined
Instructions
- Take on an empty stomach.
- Antacids may be used for pain but not within ½ hour before or after sucralfate.
- Not for intravenous administration.
Cautions
- Aluminum accumulation/toxicity in chronic renal failure or dialysis
- Bezoar formation (esp. delayed gastric emptying or enteral tube feeding)
- Hypersensitivity reactions (dyspnea, angioedema, anaphylaxis)
Adverse reactions
- Constipation (most common)
- Diarrhea, nausea, vomiting, dry mouth, indigestion, flatulence
- Dizziness, headache, insomnia
- Pruritus, rash
Pregnancy Category B; no fetal harm in animal studies; use only if clearly needed.
Lactation Undefined
NO BOXED WARNINGS
Principal riskBinds other drugs in the gut; separate dosing
Cost, est. cash$5–$150/month
Generic entry1996
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.
Mechanism of action: Sucralfate ballicule
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