Sucralfate is a complex salt of sucrose sulfate and aluminum hydroxide. It is a locally acting, non-systemic, cytoprotective anti-ulcer agent. In the Indian context, it is widely used for the management of gastroduodenal ulcers and related conditions. Its 7% w/w formulation is typically found in topical oral gels for the treatment of oral mucositis, aphthous ulcers, and other inflammatory oral lesions. It acts by forming a protective, adherent barrier over ulcerated or inflamed mucosa, promoting healing.
Adult: Apply a small amount (approx. 1 cm strip) of gel directly to the affected area 3-4 times daily, preferably after meals and at bedtime. Do not swallow.
Note: 1. Rinse mouth with water before application. 2. Dry the affected area gently with a clean gauze. 3. Apply a thin layer directly onto the ulcer using a clean finger or cotton swab. 4. Do not eat or drink for at least 30 minutes after application to allow the barrier to form. 5. For best results, use after meals and at bedtime.
Sucralfate polymerizes in the acidic environment of the stomach or at an ulcer site, forming a viscous, adhesive, paste-like substance. This complex binds selectively to proteins at the base of ulcers and erosions (e.g., albumin, fibrinogen), creating a physical barrier that lasts for several hours. This barrier protects the underlying mucosa from further injury by pepsin, bile acids, and gastric acid. It also has mild anti-peptic activity.
Pregnancy: Category B: Animal reproduction studies have not shown a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women. Use only if clearly needed. Topical application minimizes systemic exposure.
Driving: No effect. Sucralfate does not cause drowsiness.
| Antacids containing aluminum | Increased risk of aluminum toxicity, especially in renal impairment. | Moderate |
| Oral Tetracyclines (e.g., Doxycycline), Fluoroquinolones (e.g., Ciprofloxacin) | Sucralfate can significantly reduce absorption of these antibiotics if taken orally. For topical gel, this interaction is not relevant unless the gel is swallowed. | Major (for oral ingestion) |
| Phenytoin, Digoxin, Levothyroxine, Warfarin | Sucralfate (oral forms) can decrease absorption of these drugs. Administer these drugs at least 2 hours apart from oral sucralfate. | Moderate (for oral ingestion) |
| Citrate salts (e.g., in potassium citrate) | Increased aluminum absorption, risk of toxicity. | Moderate |
Same composition (Sucralfate (7% w/w)), different brands: