soo-KRAL-fate

Therapeutic Classification: antiulcer agents

Pharmacologic Classification: gi protectants

• Short-term management of duodenal ulcers.
• Maintenance (preventive) therapy of duodenal ulcers.

Unlabeled Uses:

• Management of gastric ulcer or gastroesophageal reflux.
• Prevention of gastric mucosal injury caused by high-dose aspirin or other NSAIDs in patients with rheumatoid arthritis or in high-stress situations (e.g., intensive care unit). Suspension: Mucositis/stomatitis/rectal or oral ulcerations from various etiologies.

• Aluminum salt of sulfated sucrose reacts with gastric acid to form a thick paste, which selectively adheres to the ulcer surface.

• Protection of ulcers, with subsequent healing.

Absorption: Systemic absorption is minimal (<5%).

Distribution: Unknown.

Metabolism/Excretion: >90% is eliminated in the feces.

Half-life: 6–20 hr.

(mucosal protectant effect)

Contraindicated in:

• Hypersensitivity.

Use Cautiously in:

• Renal failure (accumulation of aluminum can occur)
• Diabetes (↑ risk of hyperglycemia with suspension)
• Impaired swallowing (↑ risk of tablet aspiration).

Derm: pruritus, rash.

Endo: hyperglycemia (with suspension).

GI: constipation, diarrhea, dry mouth, gastric discomfort, indigestion, nausea.

Neuro: dizziness, drowsiness.
Misc: (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA)HYPERSENSITIVITY REACTIONS .

Drug-Drug:

• May ↓ absorption of phenytoin, fat-soluble vitamins, or tetracycline.
• ↓effectiveness when used with antacids or cimetidine.
• ↓absorption of fluoroquinolones (separate administration by 2 hr).

Treatment of Ulcers

• PO (Adults): 1 g 4 times daily, given 1 hr before meals and at bedtime; or 2 g twice daily, on waking and at bedtime.
• PO (Adults): 1 g twice daily, given 1 hr before a meal.

Gastroesophageal Reflux

• PO (Adults): 1 g 4 times daily, given 1 hr before meals and at bedtime.
• PO (Children): 40–80 mg/kg/day divided every 6 hr, given 1 hr before meals and at bedtime.

Stomatitis

• PO (Adults and Children): 5–10 mL of suspension, swish and spit or swish and swallow 4 times daily.

Proctitis

• Rect (Adults): 2 g of suspension given as an enema once or twice daily.

(Generic available)

• Oral suspension (cherry flavor): 1 g/10 mL; 200 mg/mL;
• Tablets: 1 g;

• Assess patient routinely for abdominal pain and frank or occult blood in the stool.

• PO: Administer on an empty stomach, 1 hr before meals and at bedtime. Tablet may be broken or dissolved in water before ingestion. Shake suspension well before administration.
  • Oral suspension is only for oral use; do not administer IV. Shake well before use. Store at room temperature, do not freeze.
  • If antacids are also required for pain, administer 30 min before or after sucralfate dose.

• Advise patient to continue with course of therapy for 4–8 wk, even if feeling better, to ensure ulcer healing. If a dose is missed, take as soon as remembered unless almost time for next dose; do not double doses.
• Advise patient that increase in fluid intake, dietary bulk, and exercise may prevent drug-induced constipation.
• Emphasize the importance of routine examinations to monitor progress.

• Decrease in abdominal pain.
  • Prevention and healing of duodenal ulcers, seen by x-ray examination and endoscopy.

Carafate

Cytogard, Sulcrate, Sulcrate Plus