Sucralfate
Mechanism :
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. Sucralfate forms an ulcer-adherent complex with proteinaceous exudate at the ulcer site.
Indication :
- Stress ulcer prophylaxis
- Esophageal and gastric variceal bleeding prophylaxis
- Oesophagitis
- Upper Gl bleed of unknown cause
Contraindications :
There are no known contraindications to the use of sucralfate.
Dosing :
The safety and efficacy in children under 14 years of age is not established.
10-20 mg/kg/PO 1 hour before meal (Max: 80 mg/kg/day PO or alternatively, up to 2000 mg/day PO).
Adverse Effect :
Constipation, nausea, gastric discomfort, indigestion, flatulence, dry mouth, pruritus, rash, dizziness, insomnia, sleepiness, vertigo, back pain, headache. Hypersensitivity reactions, including urticaria (hives), angioedema, respiratory difficulty.
Interaction :
Potassium Acid Phosphate/Potassium Phosphate: Combination may decrease phosphate efficacy.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | 4 g daily |
| 10-20 | 2–4 g daily |
| <10 | 2–4 g daily |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in GFR<10 mL/min |
| HD | Not dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Unknown dialysability. Dose as in GFR<10 mL/min |
| CAV/VVHD | Not dialysed. Dose as in GFR=10– 20 mL/min |
Hepatic Dose :
No dose adjustment recommended.