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Sucralfate, sold under various brand names, is a used to treat , gastroesophageal reflux disease (GERD), radiation proctitis, and and to prevent . Its usefulness in people infected by H. pylori is limited. It is used by mouth (for upper GIT ulcers) and rectally (for radiation proctitis).

Common side effects include . Serious side effects may include formation and . Use appears to be safe in and . How it works is unclear but is believed to involve binding to the ulcer and protecting it from further damage.

Sucralfate was approved for medical use in the United States in 1981. It is available as a generic medication.

(2025). 9780857113382, Pharmaceutical Press.
In 2022, it was the 214th most commonly prescribed medication in the United States, with more than 1million prescriptions.


Medical uses
Sucralfate is used for the treatment of active not related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs), as the mechanism behind these ulcers is due to acid oversecretion. It is not FDA approved for , but is widely used because of evidence of efficacy. The use for sucralfate in peptic ulcer disease has diminished recently, but it is still the preferred agent for prevention.

Sucralfate has also been used for the following conditions:

  • Active not related to NSAID use
  • Maintenance therapy for resolved
  • not related to NSAID use and due to GERD—Triple combination therapy with + + sucralfate can significantly improve and quality of life and was more cost-effective than combination group.
  • and due to radiation or —The 2013 guidelines of the International Society of Oral Oncology does not recommended sucralfate for the prevention of in head and neck cancer patients receiving or due to a lack of efficacy found in a randomized controlled trial.
  • Gastro-esophageal reflux disease during —First-line drug therapy combined with lifestyle and diet modification.
  • —The use of sucralfate rather than H2 antagonists for stress ulcer prophylaxis, and measures to prevent aspiration, such as continuous suctioning, have been shown to reduce the risk of ventilator-associated pneumonia (VAP). Sucralfate is less effective for prophylaxis against gastrointestinal bleeding than either a PPI or H2-blocker.  For that reason, it is not commonly used for stress ulcer prophylaxis.
  • Prevention of formation—Sucralfate has an inhibitory effect on stricture formation in experimental burns and can be used in the treatment of corrosive burns to enhance healing and suppress stricture formation
  • from ulcerative colitis
    (2014). 9781607952169, PMPH-USA. .
  • Rectal bleeding due to proctitis from radiation to treat , , and colon.
    • Grade 1 experienced immediate relief with sucrasulfate for 1 month.
    • Grade 2 bleeding, sucrasulfate enema] and/or were effective.
    • Grade 3 bleeding lasted for 1 year despite frequent transfusions and coagulation.
    • Grade 2 and 3 rectal bleeding occurred in 8.5% of people. The most significant was the ICRU-CRBED. Prompt treatment with a combination of sucrasulfate enema and coagulation is effective in controlling Grade 1 and 2 rectal bleeding without the development of or stricture.
  • Treatment of anastomotic ulcer after gastric bypass surgery
  • Sucralfate suspension is recommended by the US-based National Capital Poison Center (Poison Control) as an intervention for known or suspected button battery ingestions to reduce the risk and severity of injury to the prior to the battery's endoscopic removal.
  • Protection against ventilator-associated pneumonia - Reductions in gastric acidity and volumes increase bacterial overgrowth and the incidence of ventilator-associated pneumonia. Sucralfate may be considered to have the advantage over H2-blockers and PPIs in this regard because sucralfate does not change the pH of gastric fluid. A majority of meta-analyses found that sucralfate therapy decreased the incidence of ventilator-associated pneumonia compared to H2-antagonists.


Side effects
The most common seen is (2–3%). Less commonly reported side effects (<0.5%) include , , , (dry mouth), and formation. Use of this drug is not recommended for people with chronic kidney failure, as it might cause aluminium accumulation and toxicity. A few well-controlled studies have been carried out investigating the safety and efficacy of sucralfate in children and pregnant women (Pregnancy Category B).


Mechanism of action
Sucralfate is a locally acting substance that in an acidic environment (pH < 4) reacts with hydrochloric acid in the to form a cross-linking, , paste-like material capable of acting as an for as long as 6 to 8 hours after a single dose. It also attaches to on the surface of ulcers, such as and , to form stable complexes. These complexes serve as protective barriers at the ulcer surface, preventing further damage from , , and . In addition, sucralfate prevents back of , and absorbs both pepsin and .

It has been thought that sucralfate also stimulates the production of E2, epidermal growth factors (EGF), , and .


Pharmacokinetics
  • Onset: 1–2 hr (initial onset for peptic ulcer disease (PUD))
  • Absorption: <5% Orally
  • Duration: Up to 6 hours due to high affinity for defective mucosa ()
  • : 5%, sucralfate is considered non-systemic, sucrose octasulfate: 5%, aluminum: 0.005%
  • Metabolism: Not metabolized, excreted unchanged in urine
  • Excretion: Primarily in feces as unchanged drug


Society and culture

Brand names
Brand names include Carafate in the US, Sucramal in Italy, Sucrafil, Sufrate, Sucralpro, Sucralcoat, Pepsigard, Sucral, Hapifate, Sucralpro tablets and Sucralpro cream in India, Sutra or Musin in parts of South-East Asia, Sulcrate in Canada, Discral (sucralfato) in México, Ulsanic in South Africa and Israel, Andapsin in Sweden, Antepsin in Turkey, Sucracell in India, and Ulsidex in Indonesia

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