Sucralfate interactions

Food & lifestyle

• food

  Moderate

  Antagonism

  The administration of sucralfate with enteral nutrition may result in precipitation and the formation of bezoars that may obstruct feeding tubes. The proposed mechanism is the formation of an insoluble aluminum-protein complex between the aluminum in the sucralfate and the protein in the enteral feeding. In addition, sucralfate may not become activated due to the alkaline pH of enteral nutrition products.

  What to do: Some experts recommend separating the sucralfate doses from enteral feedings by at least 1 hour. Alternatively, consideration may be given to proton pump inhibitors or H2 antagonists.

  1 source

  1. Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm 66 (2009): 1438-67

Conditions

Conditions in which Sucralfate needs care, as documented in this source.

• Hypophosphatemia

  Major

  Sucralfate has phosphate binding properties for which the drug is sometimes used therapeutically. However, hypophosphatemia may occur in some patients, regardless of renal status. Therapy with sucralfate should be administered cautiously in patients with preexisting hypophosphatemia. Monitoring phosphate levels in these patients is recommended.

  3 sources

  1. McCarthy DM "Sucralfate." N Engl J Med 325 (1991): 1017-25
  2. Chines A, Pacifici R "Antacid and sucralfate-induced hypophosphatemic osteomalacia: a case report and review of the literature." Calcif Tissue Int 47 (1990): 291-5
  3. "Product Information. Carafate (sucralfate)." Hoechst Marion Roussel (2001):

• Kidney Diseases

  Major

  Patients with chronic renal failure or those receiving dialysis have impaired excretion of absorbed aluminum. Additionally, aluminum does not cross dialysis membranes as it is bound to albumin and transferrin plasma proteins. Aluminum accumulation and toxicity (aluminum osteodystrophy, osteomalacia, encephalopathy), have been described in patients with renal impairment. Sucralfate must be used with caution in patients with chronic renal failure.

  7 sources

  1. McCarthy DM "Sucralfate." N Engl J Med 325 (1991): 1017-25
  2. Robertson JA, Salusky IB, Goodman WG, Norris KC, Coburn JW "Sucralfate, intestinal aluminum absorption, and aluminum toxicity in a patient on dialysis." Ann Intern Med 111 (1989): 179-81
  3. Withers DJ, Woolf AS, Kingswood JC, Tsang WN, Mansell MA "Encephalopathy in patient taking aluminium-containing agents, including sucralfate ." Lancet 2 (1989): 674
  4. Min DI, D'Elia JA "Sucralfate-associated aluminum toxicity in a patient with renal failure: treatment with deferoxamine." Clin Pharm 11 (1992): 636-9
  5. Pai S, Melethil S, Cuddy P, Hall T "Elevation of serum aluminum in humans on a two-day sucralfate regimen." J Clin Pharmacol 27 (1987): 213-5
  6. Campistol JM, Cases A, Botey A, Revert A "Acute aluminum encephalopathy in an uremic patient." Nephron 51 (1989): 103-6
  7. "Product Information. Carafate (sucralfate)." Hoechst Marion Roussel (2001):