Sucrafen-O

Sucralfate (500mg) + Oxetacaine (10mg)
Price: ₹120 - ₹150 for 10 tablets strip
Mfr: Cipla Ltd | Form: Tablet

📋 Clinical Overview

A fixed-dose combination of a cytoprotective agent (Sucralfate) and a potent local anesthetic (Oxetacaine) used for the symptomatic relief and healing of acid-peptic disorders. Sucralfate forms a protective barrier over ulcers/erosions, while Oxetacaine provides rapid, topical analgesia by inhibiting nerve conduction at the site of application.

💊 Dosage & Administration

Adult: 1 tablet (500mg + 10mg) four times daily: one hour before meals and at bedtime. For GERD, often taken 1 hour after meals and at bedtime. Maximum: 4 tablets/day.

Note: Tablet must be taken on an empty stomach (at least 1 hour before or 2 hours after food). Swallow whole with a full glass of water. Do not crush or chew. Maintain at least a 2-hour gap between this medication and other drugs (especially antacids, PPIs, H2 blockers, tetracyclines, fluoroquinolones) as it interferes with their absorption.

⚠️ Contraindications

  • Known hypersensitivity to Sucralfate, Oxetacaine, or any component
  • Patients with porphyria (Oxetacaine is a PABA derivative)

🔬 Mechanism of Action

Sucralfate: In the acidic environment of the stomach, it polymerizes to form a viscous, adhesive gel-like substance that binds selectively to ulcer craters and erosions, creating a physical barrier against acid, pepsin, and bile salts. It also stimulates local prostaglandin synthesis, bicarbonate secretion, and binds epidermal growth factor (EGF), concentrating it at the ulcer site to promote healing. Oxetacaine: A surface anesthetic that stabilizes neuronal membranes by inhibiting sodium ion influx required for the initiation and conduction of nerve impulses, thereby providing rapid topical analgesia to the esophageal and gastric mucosa.

🤕 Side Effects

  • Constipation (most common, 2-5%)
  • Nausea
  • Dry mouth (due to Oxetacaine)
  • Headache
  • Dizziness
  • Epigastric discomfort

🤰 Special Populations

Pregnancy: Category B. Sucralfate is not absorbed systemically; Oxetacaine absorption is minimal. Use only if clearly needed. Considered relatively safe for short-term use in pregnancy for severe gastritis.

Driving: Oxetacaine may rarely cause dizziness. Patients should not drive or operate machinery if they experience dizziness.

🔄 Drug Interactions

Antacids (Aluminum/Magnesium hydroxide)Reduced efficacy of Sucralfate (alters gastric pH)Major
Proton Pump Inhibitors (Omeprazole, Pantoprazole)PPIs may reduce Sucralfate efficacy (need acidic pH). Administer Sucralfate 2 hours before PPI.Moderate
H2 Blockers (Ranitidine, Famotidine)Similar to PPIs. Stagger administration.Moderate
Tetracycline antibiotics (Doxycycline)Markedly reduced absorption of tetracycline.Major
Fluoroquinolones (Ciprofloxacin, Levofloxacin)Reduced absorption of fluoroquinolone, leading to therapeutic failure.Major
DigoxinReduced absorption of Digoxin.Moderate
PhenytoinReduced absorption of Phenytoin.Moderate
Thyroxine (Levothyroxine)Reduced absorption of Thyroxine.Major
WarfarinPotential reduction in Warfarin absorption; monitor INR.Moderate
KetoconazoleReduced absorption of Ketoconazole.Major

🔁 Alternatives to Sucrafen-O

Same composition (Sucralfate (500mg) + Oxetacaine (10mg)), different brands:

Muconorm-O Sucraday-O Sucralox-O Sucraforce-O