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Sucralfate : Use, Side Effect, Mechanism Action, Interaction and other Information


What is Sucralfate Use for?

Sucralfate comes under anti ulcer drug. It is use for the treatment of duodenal ulcer. FDA gives approval for the treatment of gastric ulcer. It prevents mucosal injury.
This medicine widely use for the treatment of peptic ulcer disease, Stress ulcer, duodenal ulcer, Gastro-esophageal reflux disease (GERD), Aphthous stomatitis, stomatitis, Proctitis, Ulcerative colitis, after gastric bypass surgery and many other cases.
Sucralfate Suspension image
Sucralfate Suspension

Doctor prescribe this medicine combine with other medicine to pregnancy time because at the pregnant women are changes their lifestyle by modify food and medication for better growth of a child.
 This medicine is use for the treatments of Aphthous stomatitis and stomatitis. Both of the diseases are Oral cancer occur due to Radiation and chemotherapy. But this medicine is not permitted to use for this disease by the International Society of Oral Oncology.
Sucralfate is Use for the treatment of Stress ulcer Instead of H2 antagonist because of it protect the Pulmonary aspiration. This medicine is less effective than gastrointestinal bleeding so that it use is limited.

This medicine very use full for the treatment of rectal bleeding. Those patients are suffering cervix cancer, prostate cancer, and colon cancer and they treatment through radiation doctor prescribe this medicine for stop the bleeding.

Sucralfate is used for the treatment of esophageal burn by any corrosive substance. It helps to increase the healing process of mucosal membrane and Reduce the stricture formation.
That patient suffers Gastric ulcer due to Gastro-esophageal reflux combination of the medicine Lansoprazole, Cisapride and sucralfate are best treatment. If the patient suffer gastric ulcer due to Nonsteroidal anti-inflammatory then this combination is not good choice.
Doctor Prescribe this medicine to the Patients are suffering ventilator-associate pneumonia. It is more beneficial than proton pump Inhibitor and PPIs because it does not change PH in the stomach and decrease the incidence of ventilator-associated pneumonia.
The topical formulation of this drug is use for burns, bedsores, diabetic, radiation ulcer, excoriated skin etc.

Sucralfate Side Effect      

As like other drug sucralfate have some side effects. If patients showing the effect like a rash, swallowing, breathing problem or swelling of lips, face, throat, tongue Immediate informed to doctor or pharmacist.
Those people have the allergy to this medicine immediate intimate to the doctor to change the medication.
Some common side effect are showing during continue of the medication don’t panic . these symptoms automatically go away. If these symptoms are not clear Inform the doctor.
Constioation
Diarrhoea
Indigestion
Stomach ache
Being sick
Vomiting
Nausea
Feelling dizzy
Drowsy
Being unsteady on your feet
Back pain
Dry mouth
Headache
Itching
Sucralfate tablets may causes the blockage in the digestive tract.
This medicine chances of aluminum formation So that Bone are affected.
Thinning of Bone
Softening of bone
Impairment of Brain
Composition of blood may change

Sucralfate Mechanism of action

Sucralfate come under Ulcer protective like other drugs like bismuth subcitrate and Colloidal. Chemically it is complex of sulfated sucrose and aluminum hydroxide. This medicine is given orally. In the acid medium it turn in the gel which is helps to coat around ulcer crater for more than 6 hour . which is form barrier which may act as a mucosal defense. So H+ ion are not enters in to this membrane.

Sucralfate is polymerized at PH less than 4 and formation of sticky gel which is very consistency. This gel are very like to attach duodenal ulcer base because the electrostatic  charge of this drug helps to bind with ulcerate tissue. And creating a barrio which helps to direct contact of acid , pepsin and bile. So patients are taking food and digested in the stomach without vomiting
This medicine have no neutralizing the acid but help to delays the gastric emptying. itself it remains more time in the stomach. It does not affect the secretion of gastric acid.
Sucralfate is structurally related to heparin but it does not show the mechanism of anticoagulant activity. Similarly it is structurally similar to Sucrose but not showing any property of sugar. This drug is reacted with hydrochloric acid to produce sticky gel.  
This drug helps to cure the gastric erosions produce by ethanol and anti-inflammatory drug. It create barrio between affected cell and food. It may stimulate the production of stomach prostaglandin E2 (PG) , epidermal growth factor(EGF) and gastric mucus production.

Pharmacokinetics

After taking this medicine orally less than 5% is absorbed in to systemic circulation. This medication heals the gastric ulcer and duodenal ulcer within 4 weeks. Those patient are smoking habits they are taking a long time to cure the disease. This medicine is more effective as compare to H2 blocker or PPIs.
This drug is well tolerated. Binding to ulcer cell up to 6 an hour if patients is taking 1 gm tablets. This medicine is execrated through urine after 48 hours. And some of this drug are eliminated through bile.   

Dosage of sucralfate

Always take this medicine as per the doctor or pharmacist Instruction.
For healing of duodenal ulcer 1 gm tablet is taken 1 hour before taking food for 4-8 weeks. At the time of taking this medicine do not take antacid because this medicine mechanism depends on the PH of the stomach. After taking of food this medicine does not work.
The recomanded dose is two tablets in the morning after waking up and two tablets at bedtime. The maximum dose is 4-8 tablets per day. Or you can take one tablets before taking food, four time per day.
Sucralfate and oxetacaine suspension
Sucralfate and oxetacaine suspension

How to take sucralfate tablet?
Whole Tablet can be swallowed or you can disperse the tablet in 10 to 15 ml water before taking food. Under the 14 year age group patient are not take this tablet.
If you take more tablets at a time contact with your doctor or pharmacist immidiadely to avoid any interaction. If you forget to take the tablet do not take an extra tablet in the next dose it causes serious side effect.

Warning and precaution

Before taking this tablet you must take the advice of your doctor
Pregnant women or plan to pregnant or breastfeeding women
Patients are suffering from kidney problem
If patients are taking other medicine which is containing Citrates, aluminum.
Other medicine like cimetidine or ranitidine.
Those patient are taking antibiotics like tetracycline, ciprofloxacin or norfloxacin.
Psychotic patients are taking Sulpiride.
Heart patient are taking Digoxin or Quinidine.
Epilepsy patients taking phenytoin.
Blood clotting medicine like warfarin.
Asthma patients taking theophylline.
Thyroid patients taking Levothyroxine.
Fungal infection use for ketoconazole.

Drug Interaction

Sucralfate interact with H2 antagonist and decrease the dissolution as per the various study conducted in rats, dogs and cats.

This drug has the capacity to bind other drugs easily like tetracyclines, digoxin, fluoroquinolones and aminophylline. So don’t give this medicine within 2 hours after administering of this medicine.

Sucralfate can bind with or change the absorption rate of fat-soluble vitamin A, vitamin D, Vitamin E and Vitamin K. So if patient are taking this these vitamin to consult your doctor or pharmacist to avoid these side effects.

This medicine hampers the phenytoin absorption rate so the doctor recommended that don’t take this two drug at a single time. The time interval between these two drugs is minimum of of 2 hours.

1-thyroxine absorption is also reduced if you take along with this medicine.
Sucralfate interact with many other medicines and reduce the absorption of the drug. Antacids are reduce the absorption and efficacy of this medicine. Sucralfate is formation of ammonium in the stomach so at that time don’t take any ammonium content food and drug to avoid reaction.

History of sucralfate

Sucralfate was developed in 1968 Japan as a selective ulcer protecting agent. This drug is development by helps of other country like United state of America. Know this medicine is use world wide as nonsystemic  site Protector.
Scientist are try to develop the such a molecule to cure Peptic ulcer disease. This drug is fully develop in Japan and clinical application is also performe.




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