Carafate

Carafate is the brand name for sucralfate, a prescription medication used as a gastroprotective agent to treat and prevent ulcers in the stomach and duodenum and to manage certain related conditions. Sucralfate is an aluminum salt of sucrose octasulfate that acts locally in the stomach.

Mechanism of action and use

In acidic environments, sucralfate forms a viscous, adhesive gel that binds to ulcers and denuded mucosa, creating a protective barrier against acid, pepsin, and bile salts. It does not inhibit acid secretion and has minimal systemic absorption. Because of its protective coating, it is commonly used for duodenal and gastric ulcers, gastritis, and esophagitis, and may be employed as an adjunct in NSAID-associated ulcer prevention or in some cases of GERD.

Administration and dosing

Carafate is typically taken on an empty stomach, about one hour before meals and at bedtime. A common adult regimen is 1 gram taken four times daily, with additional instruction to separate administration from other medications to avoid interactions. Water should be used to swallow the tablet or to mix suspensions as directed. It may be necessary to adjust timing when other drugs are used.

Contraindications and precautions

Do not use in individuals with a known allergy to sucralfate or aluminum-containing products. Use with caution in patients with renal impairment because aluminum can accumulate. Pregnancy and lactation should involve a risk-benefit discussion with a clinician.

Drug interactions and side effects

Sucralfate can interfere with the absorption of other drugs (notably tetracyclines and fluoroquinolones) and should be administered at least two hours apart from such medications. Common side effects include constipation, dry mouth, and nausea. Rare allergic reactions may occur.

Pharmacokinetics

Sucralfate is minimally absorbed systemically; the majority of the dose is excreted in feces as a complex with aluminum.