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Sucralfate is an oral gastrointestinal medication
Medication

A pharmaceutical drug, also referred to as medicine or medicament, can be loosely defined as any substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease....
 primarily indicated for the treatment of active duodenal ulcers. Brand names include Sucramal in Italy; Carafate in U.S.A.; Sucral and Pepsigard in India; Sutra in parts of South-East Asia, Sulcrate in Canada; and Antepsin in Turkey. Sucralfate is also used for the treatment of gastroesophageal reflux disease
Gastroesophageal reflux disease

Gastroesophageal reflux disease ', Gastro-oesophageal reflux disease ', Gastric reflux disease, or Acid reflux disease is defined as chronic symptoms or mucosal damage produced by the abnormal reflux in...
 (GERD
Gerd

Ger?r is a j?tunn in Norse Mythology most well known as the wife of the Norse Mythology god Freyr. Her brilliant, naked arms illuminate air and sea....
) and stress
Stress (medicine)

Stress is a biological term which refers to the consequences of the failure of a human or animal body to respond appropriately to emotional or body threats to the organism, whether actual or imagined....
 ulcers
Peptic ulcer

A peptic ulcer, also known as ulcus pepticum, PUD or peptic ulcer disease, is an ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful....
. Unlike the other classes of medications used for treatment of peptic ulcers, sucralfate is a sucrose
Sucrose

Sucrose is a disaccharide of glucose and fructose, with the molecular formula C12H22O11. Its systematic name is a-D-glucopyranosyl- -?-D-fructofuranoside ....
 sulfate
Sulfate

In inorganic chemistry, a sulfate is a salt of sulfuric acid....
-aluminium
Aluminium

Aluminium or aluminum is a silvery white and ductile member of the boron group of chemical elements. It has the symbol Al; its atomic number is 13....
 complex
Complex (chemistry)

In chemistry, a complex, also called a "coordination compound" or "metal complex", is a structure consisting of a central atom or molecule connected to surrounding atoms or molecules....
 that binds to the hydrochloric acid
Hydrochloric acid

Hydrochloric acid is the solution of hydrogen chloride in water. It is a highly corrosive, strong acid mineral acid and has major industrial uses....
 in the stomach
Stomach

In most mammals, the stomach is a hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication....
 and acts like an acid buffer
Buffering agent

A buffering agent adjusts the pH of a solution. The function of a buffering agent is to drive an acidic or basic solution to a certain pH state and prevent a change in this pH....
 with cytoprotective
Cytoprotectant

A cytoprotectant is any medication that combats Gastric ulcers not by reducing gastric acid but by increasing mucosal protection.Drugs that work in this manner include carbenoxolone, deglycyrrhizinised liquorice, sucralfate , misoprostil and bismuth chelate ....
 properties.






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Sucralfate is an oral gastrointestinal medication
Medication

A pharmaceutical drug, also referred to as medicine or medicament, can be loosely defined as any substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease....
 primarily indicated for the treatment of active duodenal ulcers. Brand names include Sucramal in Italy; Carafate in U.S.A.; Sucral and Pepsigard in India; Sutra in parts of South-East Asia, Sulcrate in Canada; and Antepsin in Turkey. Sucralfate is also used for the treatment of gastroesophageal reflux disease
Gastroesophageal reflux disease

Gastroesophageal reflux disease ', Gastro-oesophageal reflux disease ', Gastric reflux disease, or Acid reflux disease is defined as chronic symptoms or mucosal damage produced by the abnormal reflux in...
 (GERD
Gerd

Ger?r is a j?tunn in Norse Mythology most well known as the wife of the Norse Mythology god Freyr. Her brilliant, naked arms illuminate air and sea....
) and stress
Stress (medicine)

Stress is a biological term which refers to the consequences of the failure of a human or animal body to respond appropriately to emotional or body threats to the organism, whether actual or imagined....
 ulcers
Peptic ulcer

A peptic ulcer, also known as ulcus pepticum, PUD or peptic ulcer disease, is an ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful....
. Unlike the other classes of medications used for treatment of peptic ulcers, sucralfate is a sucrose
Sucrose

Sucrose is a disaccharide of glucose and fructose, with the molecular formula C12H22O11. Its systematic name is a-D-glucopyranosyl- -?-D-fructofuranoside ....
 sulfate
Sulfate

In inorganic chemistry, a sulfate is a salt of sulfuric acid....
-aluminium
Aluminium

Aluminium or aluminum is a silvery white and ductile member of the boron group of chemical elements. It has the symbol Al; its atomic number is 13....
 complex
Complex (chemistry)

In chemistry, a complex, also called a "coordination compound" or "metal complex", is a structure consisting of a central atom or molecule connected to surrounding atoms or molecules....
 that binds to the hydrochloric acid
Hydrochloric acid

Hydrochloric acid is the solution of hydrogen chloride in water. It is a highly corrosive, strong acid mineral acid and has major industrial uses....
 in the stomach
Stomach

In most mammals, the stomach is a hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication....
 and acts like an acid buffer
Buffering agent

A buffering agent adjusts the pH of a solution. The function of a buffering agent is to drive an acidic or basic solution to a certain pH state and prevent a change in this pH....
 with cytoprotective
Cytoprotectant

A cytoprotectant is any medication that combats Gastric ulcers not by reducing gastric acid but by increasing mucosal protection.Drugs that work in this manner include carbenoxolone, deglycyrrhizinised liquorice, sucralfate , misoprostil and bismuth chelate ....
 properties. Sucralfate was approved by the Food and Drug Administration
Food and Drug Administration

The U.S. Food and Drug Administration is an Government agency of the United States Department of Health and Human Services and is responsible for regulating and supervising the safety of foods, dietary supplements, Medications, vaccines, Biopharmaceutical, blood transfusion, medical devices, Electromagnetic radiation-emitting devices, veteri...
 (FDA) in 1981
1981 in science

The year 1981 in science and technology involved many significant events, listed below....
.

Mechanism of action

Sucralfate is a locally acting substance
Chemical substance

A chemical substance is a material with a specific Empirical formula. It is a concept that became firmly established in the late eighteenth century after work by the chemist Joseph Proust on the composition of some pure chemical compounds such as basic copper carbonate....
 that in an acidic environment (pH < 4), reacts with hydrochloric acid
Hydrochloric acid

Hydrochloric acid is the solution of hydrogen chloride in water. It is a highly corrosive, strong acid mineral acid and has major industrial uses....
 in the stomach
Stomach

In most mammals, the stomach is a hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication....
 to form a cross-linking, viscous
Viscosity

Viscosity is a measure of the Drag of a fluid which is being deformed by either shear stress or extensional stress. In everyday terms , viscosity is "thickness"....
, paste-like material capable of acting as an acid buffer
Buffering agent

A buffering agent adjusts the pH of a solution. The function of a buffering agent is to drive an acidic or basic solution to a certain pH state and prevent a change in this pH....
 for as long as 6 to 8 hours after a single dose
Dose

Dose means quantity in the following fields:In nutrition, medicine, and toxicology:* Dose , the quantity of something that may be ingestion by or Drug delivery to an organism, or that an organism may be exposed to....
. It also attaches to proteins on the surface of ulcers, such as albumin and fibrinogen, to form stable insoluble complexes. These complexes serve as protective barriers at the ulcer surface, preventing further damage from acid
Acid

An acid is traditionally considered any chemical compound that, when dissolved in water, gives a solution with a hydrogen ion Activity greater than in pure water, i.e....
, pepsin
Pepsin

Pepsin is an enzyme that is released by the gastric chief cells in the stomach and which degrades food proteins into peptides. Pepsin was discovered in 1836 by Theodor Schwann who also coined this enzyme's name from the Greek language word pepsis, meaning digestion ....
, and bile
Bile

Bile or gall is a bitter yellow or green fluid secreted by hepatocytes from the liver of most vertebrates. In many species, bile is stored in the gallbladder between meals and upon eating is discharged into the duodenum where the bile aids the process of digestion of lipids....
. In addition, it prevents back diffusion
Diffusion

Molecular diffusion, often called simply diffusion, is a net transport of molecules from a region of higher concentration to one of lower concentration by random molecular motion....
 of hydrogen
Hydrogen

Hydrogen is the chemical element with atomic number 1. It is represented by the chemical symbol H. At standard temperature and pressure, hydrogen is a colorless, odorless, nonmetallic, tasteless, highly combustion and explosive Diatomic molecule gas with the molecular formula H2....
 ions, and adsorbs both pepsin and bile acid
Bile acid

Bile acids are steroid acids found predominantly in the bile of mammals. In humans, taurocholic acid and glycocholic acid represent approximately eighty percent of all bile acids....
s. Recently, it has been indicated that sucralfate also stimulates the increase of prostaglandin
Prostaglandin

A prostaglandin is any member of a group of lipid compounds that are derived enzymatically from fatty acids and have important functions in the animal body....
 E2, epidermal growth factor
Epidermal growth factor

Epidermal growth factor or EGF is a growth factor that plays an important role in the regulation of cell growth, proliferation, and Cellular differentiation by binding to its receptor Epidermal growth factor receptor....
s (EGF), bFGF), and gastric mucus
Gastric juice

Gastric juice is a strong acidic liquid, pH 1 to 3 in humans, which is close to being colourless. The hormone gastrin is released into the bloodstream when peptides are detected in the stomach....
.

Clinical uses

The only FDA-approved indication for sucralfate is for the treatment of active duodenal ulcers not related to NSAID usage because the mechanism
Mechanism of action

In pharmacology, the term mechanism of action refers to the specific biochemical interaction through which a Medication substance produces its pharmacological effect....
 behind these ulcers is secondary to acid oversecretion. It is not technically approved for gastric ulcers because the main mechanism is not due to acid oversecretion but rather from diminished protection. The use for sucralfate in peptic ulcer disease has diminished recently, but it is still the preferred agent for stress
Stress (medicine)

Stress is a biological term which refers to the consequences of the failure of a human or animal body to respond appropriately to emotional or body threats to the organism, whether actual or imagined....
 ulcer prophylaxis
Prophylaxis

Prophylaxis is any medical or public health procedure whose purpose is to prevent, rather than treat or cure a disease. Roughly, prophylactic measures are divided between primary prophylaxis and secondary prophylaxis ....
.

  • Active duodenal ulcer not related to NSAID use -- 1 g PO four times a day given 1 hr before meals and at bedtime for 4-8 weeks 'Tablet Available as well'
  • Maintenance therapy for resolved duodenal ulcers -- 1 g PO bid on empty stomach
    Stomach

    In most mammals, the stomach is a hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication....
  • Gastric ulcer not related to NSAID use and gastritis
    Gastritis

    Gastritis is an inflammation of the lining of the stomach, and has many possible causes. The main acute causes are excessive alcohol consumption or prolonged use of nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen....
     due to GERD
    Gastroesophageal reflux disease

    Gastroesophageal reflux disease ', Gastro-oesophageal reflux disease ', Gastric reflux disease, or Acid reflux disease is defined as chronic symptoms or mucosal damage produced by the abnormal reflux in...
     -- 1 g PO four times a day 1 hr before meals and at bedtime. Triple combination therapy
    Combination therapy

    In contemporary usage, the expression combination therapy most often refers to the simultaneousadministration of two or more medications to treat a single disease, but the expression is also used when other types of therapy are used at the same time....
     with lansoprazole
    Lansoprazole

    Lansoprazole is a proton pump inhibitor which prevents the stomach from producing acid. It is manufactured by a number of companies worldwide under several brand names ....
     + cisapride
    Cisapride

    Cisapride is a parasympathomimetic which acts as a serotonin 5-HT4 receptor agonist. Stimulation of the serotonin receptors increases acetylcholine release in the enteric nervous system....
     + sucralfate can significantly improve symptoms and quality of life
    Quality of life

    Quality of life is the degree of well-being felt by an individual or group of people.Quality of life cannot be measured directly, however the perception of QOL is made up of of two components: the physical and the psychological....
     and was more cost-effective than ranitidine
    Ranitidine

    Ranitidine hydrochloride is a histamine H2-receptor antagonist that inhibits gastric acid production. It is commonly used in treatment of peptic ulcer disease and gastroesophageal reflux disease ....
     combination group. [Journal of Zhejiang University 2003 Sep-Oct; 4(5): 602-6]
  • Aphthous ulcer
    Aphthous ulcer

    An aphthous ulcer, also known as canker sore, is a type of oral ulcer, which presents as a painful open sore inside the mouth or upper throat, caused by a break in the mucous membrane....
     and stomatitis
    Stomatitis

    Stomatitis is an inflammation of the mucous lining of any of the structures in the mouth, which may involve the cheeks, gums, tongue, lips, throat, and roof or floor of the mouth....
     due to radiation
    Radiation therapy

    Radiation therapy is the medicine use of ionizing radiation as part of cancer oncology to control malignant cell s . Radiotherapy may be used for curative or Adjuvant chemotherapy cancer treatment....
     or chemotherapy
    Chemotherapy

    Chemotherapy, in its most general sense, refers to treatment of disease by chemicals that kill cells, specifically those of micro-organisms or cancer....
     -- 5-10 mL PO suspension
    Suspension (chemistry)

    In chemistry, a suspension is a heterogeneous fluid containing solid particles that are sufficiently large for sedimentation. Usually they must be larger than 1 micrometre....
     swish and spit/swallow four times a day.
  • Proctitis
    Proctitis

    Proctitis is an inflammation of the anus and the lining of the rectum, affecting only the last 6 inches of the rectum....
     from radiation or ulcerative colitis
    Ulcerative colitis

    Ulcerative colitis is a form of inflammatory bowel disease . Ulcerative colitis is a form of colitis, a disease of the intestine, specifically the large intestine or colon , that includes characteristic Peptic ulcer, or open sores, in the colon....
     -- 3 g/15 mL rectal suspension
    Suspension (chemistry)

    In chemistry, a suspension is a heterogeneous fluid containing solid particles that are sufficiently large for sedimentation. Usually they must be larger than 1 micrometre....
     once or twice daily.
  • Gastro-esophageal reflux disease during pregnancy
    Pregnancy

    Pregnancy is the carrying of one or more offspring, known as a fetus or embryo, inside the uterus of a female. In a pregnancy, there can be multiple gestations, as in the case of twins or Multiple birth....
     -- first-line drug therapy
    First line treatment

    A first-line treatment or first-line therapy is a medical therapy recommended for the initial treatment of a disease, Medical sign or symptom, usually on the basis of empirical evidence for its efficacy....
     combined with lifestyle
    Lifestyle

    Lifestyle was originally coined by Austrian psychologist Alfred Adler in 1929. The current broader sense of the word dates from 1961.In sociology, a lifestyle is the way a person lives....
     and diet
    Diet (nutrition)

    In nutrition, the diet is the sum of food consumed by a person or other organism. Dietary habits are the habitual decisions an individual or culture makes when choosing what foods to eat....
     modification.
  • Stress
    Stress (medicine)

    Stress is a biological term which refers to the consequences of the failure of a human or animal body to respond appropriately to emotional or body threats to the organism, whether actual or imagined....
     ulcer
    Peptic ulcer

    A peptic ulcer, also known as ulcus pepticum, PUD or peptic ulcer disease, is an ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful....
     prophylaxis
    Prophylaxis

    Prophylaxis is any medical or public health procedure whose purpose is to prevent, rather than treat or cure a disease. Roughly, prophylactic measures are divided between primary prophylaxis and secondary prophylaxis ....
     -- The use of sucralfate rather than H2 antagonists
    Receptor antagonist

    A receptor antagonist is a type of receptor ligand or drug that does not provoke a biological response itself upon binding to a Receptor , but blocks or dampens agonist-mediated responses....
     for stress ulcer prophylaxis, and measures to prevent aspiration
    Pulmonary aspiration

    In medicine, aspiration is the entry of secretions or foreign material into the Vertebrate trachea and lungs.The patient may either inhalation the material, or it may be blown into the lungs during positive pressure ventilation or CPR....
    , such as semirecumbent positioning or continuous subglottic suctioning, have all been shown to reduce the risk
    Risk

    Risk is a concept that denotes the precise probability of specific eventualities. Technically, the notion of risk is independent from the notion of value and, as such, eventualities may have both beneficial and adverse consequences....
     of ventilator-associated pneumonia
    Ventilator-associated pneumonia

    Ventilator-associated pneumonia is a sub-type of hospital-acquired pneumonia which occurs in people who are on mechanical ventilation through an endotracheal tube or tracheostomy tube for at least 48 hours....
     (VAP
    Ventilator-associated pneumonia

    Ventilator-associated pneumonia is a sub-type of hospital-acquired pneumonia which occurs in people who are on mechanical ventilation through an endotracheal tube or tracheostomy tube for at least 48 hours....
    ).
  • Prevention of stricture
    Stricture

    Stricture may refer to:* stenosis, in medicine* a feature of the Perl programming language* tenet, in religion* Manner of articulation#Stricture, in a consonant...
     formation -- Sucralfate has an inhibitory effect on stricture
    Stricture

    Stricture may refer to:* stenosis, in medicine* a feature of the Perl programming language* tenet, in religion* Manner of articulation#Stricture, in a consonant...
     formation in experimental corrosive
    Corrosive

    A corrosive substance is one that will destroy or irreversibly damage another substance with which it comes in contact. The main hazards to people include damage to eyes, skin and tissue under the skin, but inhalation or ingestion of a corrosive substance can damage the respiratory and gastrointestinal tracts....
     burns and can be used in the treatment of corrosive esophageal
    Esophagus

    The esophagus or oesophagus , sometimes known as the gullet, is an Organ in vertebrates which consists of a Muscle tube through which food passes from the pharynx to the stomach....
     burns to enhance mucosal healing and suppress stricture formation
  • Rectal bleeding
    Rectal bleeding

    Rectal bleeding can refer to:* Lower gastrointestinal bleeding* Hematochezia* Fecal occult blood* Melena...
     and its management after irradiation
    Irradiation

    Irradiation is the process by which an item is exposed to radiation. The exposure can be intentional, sometimes to serve a specific purpose, or it can be accidental....
     for uterine
    Uterus

    The uterus is a major female hormone-responsive reproductive sex organ of most mammals, including humans. It is within the uterus that the fetus develops during gestation....
     cervical cancer
    Cervical cancer

    Cervical cancer is malignant cancer of the cervix uteri or cervical area. It may present with vaginal bleeding but symptoms may be absent until the cancer is in its advanced stages....
Grade 1 bleeding
Bleeding

Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood from the circulatory system. Bleeding can occur internally, where blood leaks from blood vessels inside the body or externally, either through a natural opening such as the vagina, Mouth , nose, or anus, or through a break in the skin....
 experienced immediate relief with sucrasulfate enema
Enema

An enema is the procedure of introducing liquids into the rectum and Colon via the anus. Enemas can be carried out for medical reasons as a remedy for encopresis, as part of alternative health therapies, as punishment, and also for eroticism purposes, particularly to prepare for anal sex, and as part of BDSM activities....
 for 1 month. Grade 2 bleeding
Bleeding

Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood from the circulatory system. Bleeding can occur internally, where blood leaks from blood vessels inside the body or externally, either through a natural opening such as the vagina, Mouth , nose, or anus, or through a break in the skin....
, sucrasulfate enema
Enema

An enema is the procedure of introducing liquids into the rectum and Colon via the anus. Enemas can be carried out for medical reasons as a remedy for encopresis, as part of alternative health therapies, as punishment, and also for eroticism purposes, particularly to prepare for anal sex, and as part of BDSM activities....
 and/or coagulation
Coagulation

Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis , wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop hemorrhage and begin repair of the damaged vessel....
 were effective. Grade 3 bleeding
Bleeding

Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood from the circulatory system. Bleeding can occur internally, where blood leaks from blood vessels inside the body or externally, either through a natural opening such as the vagina, Mouth , nose, or anus, or through a break in the skin....
 lasted for 1 year despite frequent transfusions and coagulation
Coagulation

Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis , wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop hemorrhage and begin repair of the damaged vessel....
. Grade 2 and 3 rectal bleeding
Rectal bleeding

Rectal bleeding can refer to:* Lower gastrointestinal bleeding* Hematochezia* Fecal occult blood* Melena...
 occurred in 8.5% of patients. The most significant risk factor
Risk factor

A risk factor is a variable associated with an increased risk of disease or infection. Risk factors are Correlation and not necessarily Causality, because correlation does not imply causation....
 was the ICRU-CRBED. Prompt treatment with a combination of sucrasulfate enema
Enema

An enema is the procedure of introducing liquids into the rectum and Colon via the anus. Enemas can be carried out for medical reasons as a remedy for encopresis, as part of alternative health therapies, as punishment, and also for eroticism purposes, particularly to prepare for anal sex, and as part of BDSM activities....
 and coagulation
Coagulation

Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis , wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop hemorrhage and begin repair of the damaged vessel....
 is effective in controlling Grade 1 and 2 rectal bleeding
Rectal bleeding

Rectal bleeding can refer to:* Lower gastrointestinal bleeding* Hematochezia* Fecal occult blood* Melena...
 without the development of fistula
Fistula

In medicine, a fistula is an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect....
 or stricture
Stricture

Stricture may refer to:* stenosis, in medicine* a feature of the Perl programming language* tenet, in religion* Manner of articulation#Stricture, in a consonant...
.

Adverse reactions

The most common side effects
Side Effects

Side Effects is an anthology of 17 comical short stories written by Woody Allen between 1975 and 1980, all but one of which were previously published in, variously, The New Republic, The New York Times, The New Yorker, and The Kenyon Review....
 seen are constipation
Constipation

Constipation, costiveness, or irregularity, is a condition of the digestive system in which a person experiences hard feces that are difficult to expel....
 and bezoar
Bezoar

A bezoar is a mass found trapped in the gastrointestinal system , though they can occur in other locations.There are several varieties of bezoar, some of which have inorganic constituents and others organic compound....
 formation. Less commonly reported include flatulence
Flatulence

Flatulence is the production of a mixture of gases in the gastrointestinal tract of mammals or other animals that are byproducts of the digestion process....
, cephalalgia (headache
Headache

In medicine a headache or wiktionary:cephalalgia is a symptom of a number of different conditions of the head and sometimes neck. Some of the causes are benign while others are medical emergencies....
), hypophosphatemia
Hypophosphatemia

Hypophosphatemia is an electrolyte disturbance in which there is an abnormally low level of phosphate in the blood. The condition has many causes, but is most commonly seen when malnourished patients are given large amounts of carbohydrates, which creates a high phosphorus demand by cells, removing phosphate from the blood ....
, and xerostomia
Xerostomia

Xerostomia is the medical term for a dry mouth due to a lack of saliva. Xerostomia is sometimes colloquially called pasties, cottonmouth, or doughmouth....
 (dry mouth). Nursing mothers: Uncertain.

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