QuickView for Sucralfate (compound)

Summary
General Info

PubChem

PubChem Compound 6398588

Name:	Sucralfate
PubChem Compound ID:	6398588
Description:	A basic aluminum complex of sulfated sucrose.
Molecular formula:	C₁₁H₁₈AlO₃₈S₈^-₈
Molecular weight:	1041.75 g/mol
Synonyms:	Sucralfate; MLS000028585; SMR000058992

DrugBank

Identification

Name:	Sucralfate
Name (isomeric):	DB00364
Drug Type:	small molecule
Description:	A basic aluminum complex of sulfated sucrose.
Brand:	Carafate, Ulcerlmin, Ulcogant, Ulcerban, Sulcrate Suspension Plus, Ulcermin, Apo-sucralfate, Antepsin, Sucramal, Ulcar, Sulcrate
Category:	Anti-Ulcer Agents
CAS number:	54182-58-0

Pharmacology

Indication:	For the short-term treatment (up to 8 weeks) of active duodenal ulcer, as well as maintenance therapy for duodenal ulcer patients at reduced dosage (1 gram twice a day) after healing of acute ulcers. Also used for the short-term treatment of gastric ulcer.
Pharmacology:	Sucralfate is a prescription medication used to treat peptic ulcers. The current clinical uses of sucralfate are limited. It is effective for the healing of duodenal ulcers, but it is not frequently used for this since more effective drugs (e.g. proton pump inhibitors) have been developed. Although the mechanism of sucralfate's ability to accelerat... show more » Sucralfate is a prescription medication used to treat peptic ulcers. The current clinical uses of sucralfate are limited. It is effective for the healing of duodenal ulcers, but it is not frequently used for this since more effective drugs (e.g. proton pump inhibitors) have been developed. Although the mechanism of sucralfate's ability to accelerate healing of duodenal ulcers remains to be fully defined, it is known that it exerts its effect through a local, rather than systemic, action. Chemically, sucralfate is a complex of the disaccharide sugar, sucrose, combined with sulfate and aluminum. In acidic solutions (e.g. gastric acid) it forms a thick paste that has a strong negative charge. show less «
Mechanism of Action:	Although sucralfate's mechanism is not entirely understood, there are several factors that most likely contribute to its action. Sucralfate, with its strong negative charge, binds to exposed positively-charged proteins at the base of ulcers. In this way, it coats the ulcer and forms a physical barrier that protects the ulcer surface from further in... show more » Although sucralfate's mechanism is not entirely understood, there are several factors that most likely contribute to its action. Sucralfate, with its strong negative charge, binds to exposed positively-charged proteins at the base of ulcers. In this way, it coats the ulcer and forms a physical barrier that protects the ulcer surface from further injury by acid and pepsin. It directly inhibits pepsin (an enzyme that breaks apart proteins) in the presence of stomach acid and 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. Prostaglandins are known to protect the lining of the stomach and may also bind epithelial growth factor and fibroblast growth factor, both of which enhance the growth and repair mechanism of the stomach lining. show less «
Absorption:	Minimally absorbed from the gastrointestinal tract (up to 5% of the disaccharide component and less than 0.02% of aluminum).
Route of elimination:	The small amounts of the sulfated disaccharide that are absorbed are excreted primarily in the urine.
Half Life:	Not known.
Toxicity:	Acute oral toxicity (LD₅₀) in mice is >8000 mg/kg. There is limited experience in humans with overdosage of sucralfate. Sucralfate is only minimally absorbed from the gastrointestinal tract and thus risks associated with acute overdosage should be minimal. In rare reports describing sucralfate overdose, most patients remained asymptomatic.
Affected organisms:	Humans and other mammals

Interactions

Food interaction:

Avoid alcohol.

Take on empty stomach: 1 hour before or 2 hours after meals.

Do not take calcium, aluminum, magnesium or Iron supplements within 2 hours of taking this medication.

Take with a full glass of water.

Drug interaction:

Warfarin	Sucralfate may reduce the absorption of warfarin. Warfarin should be administered at least 2 hours before or 6 hours after sucralfate administration. Monitor for changes in prothrombin time if sucralfate is initiated, discontinued or dose changed.
Phenytoin	Sucralfate decreases the effect of hydantoin
Clodronate	Formation of non-absorbable complexes
Itraconazole	Sucralfate may decrease the absorption of itraconazole.
Fosphenytoin	Sucralfate decreases the effect of hydantoin

Warfarin	Sucralfate may reduce the absorption of warfarin. Warfarin should be administered at least 2 hours before or 6 hours after sucralfate administration. Monitor for changes in prothrombin time if sucralfate is initiated, discontinued or dose changed.
Phenytoin	Sucralfate decreases the effect of hydantoin
Clodronate	Formation of non-absorbable complexes
Itraconazole	Sucralfate may decrease the absorption of itraconazole.
Fosphenytoin	Sucralfate decreases the effect of hydantoin
Gemifloxacin	Formation of non-absorbable complexes
Cholecalciferol	Vitamin D analogs such as cholecalciferol may increase the serum concentration of sucralfate. Specifically, the absorption of aluminum from sucralfate may be increased, leading to an increase in the serum aluminum concentration. Avoid chronic and/or excessive use of aluminum and aluminum-containing products (such as sucralfate) in patients who are also taking vitamin D analogs. Any patients consuming such a combination should be monitored closely for aluminum status and signs/symptoms of aluminum-related toxicities.
Ofloxacin	Formation of non-absorbable complexes
Etidronic acid	Formation of non-absorbable complexes
Norfloxacin	Formation of non-absorbable complexes
Gatifloxacin	Formation of non-absorbable complexes
Ketoconazole	Sucralfate may decrease the absorption of ketoconazole.
Calcipotriol	Vitamin D Analogs may increase the serum concentration of Sucralfate. Specifically, the absorption of aluminum from sucralfate may be increased, leading to an increase in the serum aluminum concentration. Avoid chronic and/or excessive use of aluminum and aluminum-containing products (such as sucralfate) in patients who are also taking vitamin D analogs. Any patients consuming such a combination should be monitored closely for aluminum status and signs/symptoms of aluminum-related toxicities.
Moxifloxacin	Formation of non-absorbable complexes
Ibandronate	Formation of non absorbable complexes
Grepafloxacin	Formation of non-absorbable complexes
Trovafloxacin	Sucralfate may decrease the absorption of orally administered Trovafloxacin. The Sucralfate formulation contains aluminum ions that may intefere with Trovafloxacin absorption. Administer Trovafloxacin 2 hours before or 6 hours after the Sucralfate dose to minimize the interaction.
Levothyroxine	Sucralfate decreases the effect of levothyroxine
Ciprofloxacin	Formation of non-absorbable complexes
Levofloxacin	Formation of non-absorbable complexes
Lansoprazole	Sucralfate decreases the effect of lansoprazole

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Targets

Pepsin A

Heparin-binding growth factor 2

Pro-epidermal growth factor

Fibrinogen alpha chain

Fibrinogen beta chain [Contains: Fibrinopeptide B]

Fibrinogen gamma chain

Carriers

Serum albumin