sucralfate (Rx)

Brand and Other Names:Carafate
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Dosing & Uses

AdultPediatric

Dosage Forms & 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

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

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Interactions

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            Adverse 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

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            Warnings

            Contraindications

            Documented hypersensitivity

            Cautions

            Not expected to alter post healing 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 undergoing 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

            Fatal complications, including pulmonary and cerebral emboli reported with inappropriate intravenous administration of oral suspension; administer oral suspension only by oral route; not for intravenous administration

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            Pregnancy & 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.

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            Pharmacology

            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)

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            Carafate oral
            -
            1 gram tablet
            Carafate oral
            -
            100 mg/mL suspension
            sucralfate oral
            -
            1 gram tablet
            sucralfate oral
            -
            1 gram tablet
            sucralfate oral
            -
            100 mg/mL suspension
            sucralfate oral
            -
            1 gram tablet
            sucralfate oral
            -
            1 gram tablet
            sucralfate oral
            -
            1 gram tablet
            sucralfate oral
            -
            100 mg/mL suspension

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            sucralfate oral

            SUCRALFATE SUSPENSION - ORAL

            (sue-KRAL-fate)

            COMMON BRAND NAME(S): Carafate

            USES: This medication is used to treat ulcers in the intestines. Sucralfate forms a coating over ulcers, protecting the area from further injury. This helps ulcers heal more quickly.

            HOW TO USE: Shake the bottle well before each dose. Take this medicine by mouth, usually 2 teaspoonfuls 4 times daily, on an empty stomach at least 1 hour before a meal, or as directed by your doctor.The dosage is based on your medical condition and response to therapy.Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day. It is important to continue taking this medication even if you do not feel ulcer pain. Do not stop taking this medication without consulting your doctor. It may take 4 to 8 weeks for your ulcer to heal completely.Some medications may not work as well if you take them at the same time as sucralfate. They may need to be taken at a different time of the day than the time you take sucralfate. Ask your doctor or pharmacist for help making a dosing schedule that will work with all your medications.Antacids can be used with this medicine, but they should be taken at least 30 minutes before or after sucralfate.Inform your doctor if your condition lasts or gets worse after you have been taking sucralfate for 4 weeks.

            SIDE EFFECTS: Constipation, dry mouth, upset stomach, gas, and nausea may occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: an unusual feeling of fullness in the stomach that doesn't go away, nausea/vomiting/stomach pain especially after meals.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking sucralfate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, stomach/intestine problems (such as delayed gastric emptying), tube feeding.Kidney function declines as you grow older. This medication contains aluminum, which is normally removed by your kidneys. Elderly people may be at greater risk for developing high aluminum levels while using this drug with other products that contain aluminum (such as antacids).If you are pregnant, tell your doctor before using sucralfate.It is not known if this medication passes into breast milk. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: antacids that contain aluminum, certain antibiotics (including quinolones such as ciprofloxacin/levofloxacin/ofloxacin, tetracyclines), digoxin, ketoconazole, levoketoconazole, penicillamine, phenytoin, quinidine, thyroid medications (such as levothyroxine, liothyronine).

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

            NOTES: Your doctor may recommend some lifestyle changes such as stress-reducing programs, diet changes and exercise to assist in treatment and prevention of ulcers. This medicine should not be injected into your veins. Do not share this medication with others.

            MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised January 2022. Copyright(c) 2022 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.