Dosing and uses of Carafate (sucralfate)
Adult dosage forms and strengths
tablet
- 1g
oral suspension
- 1000mg/10mL
Duodenal Ulcer
1 g PO q6hr initially; maintenance: 1 g PO q12hr
Take on empty stomach 1 hour before or 2 hours after meals
Stress Ulcer (Off-label)
Prophylaxis
1 g PO q6hr for 4-8 weeks
Take on empty stomach 1 hour before or 2 hours after meals
Epidermolysis Bullosa (Orphan)
Treatment of oral ulcerations and dysphagia in patients with epidermolysis bullosa
Orphan indication sponsor
- Darby Pharmaceuticals, Inc, 100 Banks Ave, Rockville Centre, NY 11570
Oral Complications After Bone Marrow Transplantation (Orphan)
Treatment of oral complications of chemotherapy in bone marrow transplant recipients
Orphan indication sponsor
- Darby Pharmaceuticals, Inc, 100 Banks Ave, Rockville Centre, NY 11570
Dosing Modifications
Renal failure: Use with caution; aluminum salt may accumulate
Pediatric dosage forms and strengths
Active Duodenal Ulcer (Off-label)
40-80 mg/kg/day PO divided q6hr
Stomatitis (Off-label)
500-1000 mg PO q6hr; 1g/10mL suspension q6hr; swish and spit or swish and swallow the suspension
Gastric Ulcer (Off-label)
40-80 mg/kg/day PO divided q6hr or 0.5-1 g PO q6hr
Carafate (sucralfate) adverse (side) effects
1-10%
Constipation (2%)
<1%
Diarrhea
Dizziness
Dry mouth
Flatulence
Headache
Indigestion
Insomnia
Nausea
Vertigo
Vomiting
Frequency not defined
Bezoars formation
Gastrointestinal discomfort
Postmarketing Reports
Hypersensitivity reactions
Hyperglycemia
Warnings
Contraindications
Documented hypersensitivity
Cautions
Not expected to alter posthealing frequency of recurrence or severity of duodenal ulceration; acts locally at the ulcer
Do not take antacids within 30 minutes of sucralfate dose
Aluminum absorption is increased;, use with caution in patients with chronic renal failure or udnergoing dialysis
Potential significant drug interactions possible; consult drug interaction database
Use tablet with caution in patients with conditions that may impair swallowing, or with altered gag/cough reflex
Hyperglycemia has been reported when drug is used in patients with diabetes
Sucralfate may alter absorption of some drugs; take other medications 2 hours before taking sucralfate
Pregnancy and lactation
Pregnancy category: B
Lactation: Probably safe because drug is minimally absorbed; unknown whether drug is excreted in breast milk
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Carafate (sucralfate)
Mechanism of action
Forms ulcer-adherent complex; protects ulcer from acid, pepsin, and bile salts, thus allowing it to heaL
Absorption
Bioavailability: 5% (sucralfate is considered nonsystemic); sucrose octasulfate, 5%; aluminum, 0.005%
Onset: 1-2 hr
Duration: Up to 6 hr
Metabolism
Not metabolized
Elimination
Dialyzable: Yes
Excretion: Primarily urine (as unchanged drug)
