Sucralfate (Antepsin)

Active substance and amount. Each tablet contains 1 g of sucralfate; each 5 ml of the suspension contains 1 g of sucralfate.

Indications. It is used as a cytoprotective agent in the treatment and prevention of ulcers of the stomach and bowel, reflux oesophagitis, and bleeding from stress ulcers.

Presentation and storage. Supplied in blister packs of 60 tablets containing 1 g of sucralfate, and in 250 ml bottles containing 1 g of sucralfate in each 5 ml. Its shelf life is 24 months and it should be stored below 30 degrees, at room temperature.

How it works. After sucralfate is taken by mouth it covers the ulcerated area and acts as a protection. The proteins in the ulcerated area carry a positive charge. Sucralfate, once taken by mouth, reacts with stomach acid (HCl) and breaks down into its polyanions. These polyanions are negatively charged compounds and set up a mutual attraction with the positively charged proteins in the ulcerated area. In this way a thick, sticky layer forms over the ulcerated area, and through this layer the aggressive factors — stomach acid (HCl), pepsin, bile acid, painkillers, alcohol and the like — are prevented from reaching it.

Warnings and precautions. Duodenal ulcer is a chronic, recurring condition. Short-term treatment with sucralfate brings about complete healing of the ulcer. It should not, however, be thought that the treatment will change how often or how severely duodenal ulcers occur later on. For that reason the frequency and severity of the relapses that will occur can be prevented by maintenance treatment. Since there are no adequate controlled studies in pregnant women or women who are breastfeeding, it should be used only where it is really necessary.

Side effects. The side effects of sucralfate are very few. The side effects seen most often are constipation, nausea, itching, dizziness and drowsiness. But these effects are very short-lived.