Sucralfate
- Class: Mucosal protectant
- Used for: ulcers
- Say it: soo-KRAL-fate
- Forms: tablet, oral liquid
SUCRALFATE SUGAR-COATS the ulcer — a sticky dressing laid over the raw patch.
The sugar is real chemistry: it is a sucrose derivative. The same stickiness that coats the ulcer binds other tablets, so space it two hours from everything else.
In an acid stomach it becomes a sticky paste that binds to the ulcer base. It changes no secretion and blocks no receptor — the protection is purely physical, which is why acid is needed for it to work at all.
Side effects
Common: constipation, dry mouth, nausea
Serious: aluminum build-up in kidney failure
Typical dose
1 g four times daily, before meals and at bedtime
Needs an acid stomach to work, so do not give it within two hours of a proton pump inhibitor — or of any other tablet.
Check yourself
Why must sucralfate be separated from other oral medicines?
- It binds them physically in the gut and prevents their absorption
- It induces liver enzymes that clear them faster
- It raises stomach pH so they are destroyed
- It competes for the same renal transporter
Show answer
A. It binds them physically in the gut and prevents their absorption
The interaction is mechanical, not metabolic. The same stickiness that lets sucralfate coat an ulcer makes it bind levothyroxine, fluoroquinolones, digoxin and phenytoin — which is why spacing the doses is an effective fix.
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