sucralfate

CLINICAL USE

Treatment of peptic ulcer and chronic gastritisProphylaxis of stress ulceration in seriously ill patients

DOSE IN NORMAL RENAL FUNCTION

4 g daily in 2–4 divided doses Prophylaxis of stress ulceration: 1 g 6 times dailyMaximum 8 g daily

PHARMACOKINETICS

Molecular weight :2086.7

%Protein binding :No data

%Excreted unchanged in urine : 3.5

Volume of distribution (L/kg) :No data

half-life – normal/ESRD (hrs) :No data

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : 4 g daily

10 to 20 : 2–4 g daily

<10 : 2–4 g daily

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in GFR <10 mL/min

HD :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Not dialysed. Dose as in GFR=10–20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsReduced absorption of digoxin, tetracyclines, quinolones, coumarins and phenytoin – give 2 hours after sucralfate

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

Sucralfate exerts its action at the site of the ulcer, and is minimally absorbed (3–5%) from the GI tract as sucrose sulphateIn normal renal function, any aluminium which is absorbed is excreted in the urineTablets may be dispersed in 10–15 mL of water

OTHER INFORMATION

Sucralfate should be used with caution in renal impairment as aluminium may be absorbed and accumulateIn severe renal impairment and patients receiving dialysis, sucralfate should be used with extreme caution and only for short periodsAbsorbed aluminium is bound to plasma proteins and is not dialysableUse of other aluminium-containing products with sucralfate can increase the total body burden of aluminium

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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