Sucralfate (Antepsin)

Sucralfate is a drug that helps protect damaged surfaces in the stomach and duodenum. It can be used particularly to treat duodenal ulcers.

It is not a drug that directly and strongly suppresses stomach acid. It sticks to damaged tissue and forms a protective layer.

Sucralfate is not a steroid (cortisone) or an antibiotic. It is not addictive.

How does sucralfate work?

The inner lining of the stomach and duodenum is normally covered by a layer that protects it against stomach acid and digestive juices.

When this protective structure breaks down, sores called ulcers can develop.

In an acidic environment, sucralfate sticks to damaged surfaces and forms a protective barrier.

This barrier helps the ulcerated area be less affected by substances such as stomach acid, pepsin and bile salts.

This creates better conditions for the sore to heal.

The main effect of sucralfate is not to stop acid production but to protect the damaged surface.

What is it used for?

Duodenal ulcer

The best-known use of sucralfate is duodenal ulcer.

By protecting the ulcerated surface, the drug can help the sore heal.

Today, proton pump inhibitors are used more often to treat ulcers. However, sucralfate can be considered as an alternative treatment in certain patients.

Stomach ulcer

It can also be used in some patients to treat stomach ulcers.

However, the cause of a stomach ulcer must always be assessed.

For example, Helicobacter pylori infection or the use of some painkillers can cause ulcers to develop.

Sucralfate does not get rid of the bacterium Helicobacter pylori.

Gastritis and irritation of the stomach lining

In some patients sucralfate can be used because of damage to or irritation of the stomach lining.

However, it is not needed in every patient with gastritis. Different treatments may be preferred depending on the cause of the gastritis.

Reflux disease

Sucralfate can have a protective effect on the irritated surface of the gullet.

Even so, it is not one of the main drugs recommended for the routine treatment of gastro-oesophageal reflux disease.

For inflammation of the gullet caused by reflux, proton pump inhibitors are generally more effective.

In special situations such as pregnancy, the treatment options can be assessed separately by the doctor.

How is sucralfate taken?

Sucralfate can be taken by mouth as a tablet or a suspension.

For the drug to show its protective effect, it is usually recommended to take it on an empty stomach.

It is often taken about an hour before meals and, where needed, before bed. However, how often it is taken and the dose can vary with the disease being treated and the product’s instructions.

• Take the drug at the dose your doctor recommends.
• Follow the instructions for the tablet or suspension form.
• It may need to be taken at a different time from other medicines.
• Do not take a double dose to make up for a missed one.
• The length of treatment should be decided by the doctor.

Can sucralfate be taken with other medicines?

Sucralfate can bind to some medicines in the digestive tract and reduce their absorption.

Interactions can occur particularly with the following medicines:

• Levothyroxine
• Some antibiotics such as ciprofloxacin
• Tetracycline antibiotics
• Digoxin
• Phenytoin
• Some other medicines taken by mouth

For many medicines a gap of at least two hours from sucralfate may be needed. However, longer gaps are recommended for some medicines.

For example, a longer gap is generally needed when it is used together with levothyroxine.

For this reason, patients who take medicines regularly should plan with their doctor or pharmacist at what times to take sucralfate.

What are the side effects of sucralfate?

Sucralfate is generally well tolerated.

Its most common side effect is constipation.

Other possible side effects:

• Nausea
• Dry mouth
• Abdominal discomfort
• Wind and bloating
• Dizziness

Rarely, allergic reactions can occur.

Very little sucralfate is absorbed into the body. Even so, because it contains aluminium, some patients need particular care.

Can it be used by people with kidney disease?

Sucralfate contains aluminium.

In people with normal kidney function, a large part of the aluminium taken in can be cleared from the body.

However, in patients with advanced kidney failure, particularly with long-term use, there can be a risk of aluminium building up.

For this reason, people with advanced kidney disease should not use sucralfate without a doctor’s advice.

Can it be used in pregnancy and breastfeeding?

Very little sucralfate is absorbed from the bowel.

For this reason, it is one of the drugs a doctor may consider for some stomach and reflux complaints in pregnancy.

However, as with any drug in pregnancy, whether it is needed and how safe it is should be assessed individually.

During breastfeeding, too, a doctor’s advice should be sought.

Is sucralfate the same as the stomach-protecting drugs?

No.

Proton pump inhibitors such as lansoprazole, pantoprazole and omeprazole strongly reduce the production of stomach acid.

Sucralfate, instead of suppressing stomach acid, forms a protective layer on the damaged surface.

For this reason the two groups of drugs have different mechanisms of action and uses.

Although they can be taken together in some patients, this is not always necessary.

Frequently asked questions

Does sucralfate reduce stomach acid?

It does not reduce stomach acid strongly. Its main effect is to protect the ulcerated or damaged surface.

Should sucralfate be taken on an empty or a full stomach?

It is usually taken on an empty stomach. The instructions for the product used and the doctor’s advice should be followed.

Does sucralfate help reflux?

In some patients it can protect the irritated surface. However, it is not the first-choice drug for the routine treatment of reflux disease.

Are sucralfate and lansoprazole the same?

No. Lansoprazole reduces acid production. Sucralfate forms a protective layer over the damaged surface.

Does sucralfate cause constipation?

Yes. Constipation is one of its most commonly reported side effects.

Can sucralfate be taken for a long time?

The length of treatment depends on the disease. Long-term use needs particular care in patients with kidney disease.

Does sucralfate kill the bacterium Helicobacter pylori?

No. It does not get rid of Helicobacter pylori infection. Treating the bacterium needs suitable combinations of antibiotics.

Important: This page has been prepared to give general health information. The dose of sucralfate, when it is taken and the gap between it and other medicines can vary from patient to patient. People with kidney disease or who take medicines regularly in particular should continue treatment under a doctor’s supervision.