Sucral-D

Domperidone (5mg/5ml) + Sucralfate (500mg/5ml)
Price: ₹105 - ₹145 for 200 ml bottle
Mfr: Dr. Reddy's Laboratories Ltd. | Form: Oral Suspension

📋 Clinical Overview

A fixed-dose combination oral suspension containing a prokinetic agent (Domperidone) and a gastroprotective, ulcer-healing agent (Sucralfate). Domperidone acts as a dopamine D2 receptor antagonist, increasing lower esophageal sphincter pressure, enhancing gastric motility, and accelerating gastric emptying. Sucralfate is a complex of sucrose octasulfate and aluminum hydroxide that forms a viscous, adhesive barrier over ulcers and erosions, protecting them from acid, pepsin, and bile salts, and stimulating local prostaglandin and growth factor production for healing. This combination is primarily used for the symptomatic relief and treatment of gastroesophageal reflux disease (GERD) and gastritis, addressing both dysmotility and mucosal injury.

💊 Dosage & Administration

Adult: 10 ml (containing Domperidone 10 mg + Sucralfate 1000 mg) three times a day, 15-30 minutes before meals and at bedtime. Maximum daily dose: Domperidone 30 mg, Sucralfate 4 g.

Note: SHAKE THE BOTTLE WELL BEFORE EACH USE. Measure dose accurately with the provided measuring cup or oral syringe. Take 15-30 minutes BEFORE meals and at bedtime. For optimal effect of Sucralfate, administer on an empty stomach (at least 1 hour before or 2 hours after meals and other medications). Do not take antacids within 30 minutes before or after taking this suspension.

⚠️ Contraindications

  • Known hypersensitivity to Domperidone, Sucralfate, or any excipient
  • Conditions where gastrointestinal stimulation might be dangerous (e.g., gastrointestinal hemorrhage, mechanical obstruction, perforation)
  • Prolactin-releasing pituitary tumor (prolactinoma)
  • Moderate or severe hepatic impairment
  • Co-administration with potent CYP3A4 inhibitors (e.g., ketoconazole, fluconazole, clarithromycin, ritonavir) that significantly increase domperidone plasma levels
  • Existing or history of ventricular arrhythmias, heart failure, significant electrolyte disturbances, or congenital long QT syndrome

🔬 Mechanism of Action

The combination exerts a dual action: Domperidone acts peripherally on the gastrointestinal tract and chemoreceptor trigger zone (CTZ) to promote motility and reduce nausea/vomiting. Sucralfate provides a physical-chemical barrier at the ulcer site, offering cytoprotection and promoting healing.

🤕 Side Effects

  • Headache
  • Dry mouth
  • Diarrhea or constipation
  • Abdominal cramps
  • Dizziness
  • Skin rash or itching

🤰 Special Populations

Pregnancy: Category C (US FDA). Domperidone: Animal studies show potential risk; no adequate well-controlled studies in pregnant women. Sucralfate: Category B. Minimal systemic absorption. Use only if the potential benefit justifies the potential risk to the fetus. Not recommended for routine use.

Driving: Domperidone may cause dizziness, drowsiness, or blurred vision in some individuals. Patients should not drive or operate machinery until they are sure they are not affected.

🔄 Drug Interactions

Ketoconazole, Fluconazole, Itraconazole, VoriconazolePotent CYP3A4 inhibitors. Markedly increase Domperidone plasma levels, increasing risk of QT prolongation and serious arrhythmias.Contraindicated
Clarithromycin, Erythromycin, TelithromycinCYP3A4 inhibitors and also prolong QT interval. Synergistic risk of life-threatening arrhythmias.Contraindicated
Protease Inhibitors (Ritonavir, Saquinavir)Potent CYP3A4 inhibitors. Increase Domperidone levels significantly.Contraindicated
Antacids (Aluminum/Magnesium hydroxide)May interfere with the polymerization and adhesion of Sucralfate. Reduced efficacy.Major
Warfarin, Digoxin, Phenytoin, Levothyroxine, Quinolones (Ciprofloxacin), TetracyclinesSucralfate significantly decreases absorption of these drugs by binding to them or forming complexes. Administer these drugs at least 2 hours before or 6 hours after Sucralfate.Major
Anticholinergics (Atropine, Dicyclomine) & Opioid AnalgesicsAntagonize the prokinetic effect of Domperidone.Moderate
Dopamine Agonists (Bromocriptine, Levodopa)Domperidone may antagonize their therapeutic effect in Parkinson's disease.Moderate

🔁 Alternatives to Sucral-D

Same composition (Domperidone (5mg/5ml) + Sucralfate (500mg/5ml)), different brands:

Sucramper Sucraday-D Sucrafil-D Sucrapro-D