Carafate

Car·a·fate (kâr-ft)

A trademark for the drug sucralfate.

---

Carafate,

a trademark for an antiulcer drug that forms a protective layer over the ulcer site (sucralfate).

---

sucralfate

Antepsin (UK), Carafate, Nu-Sucralfate (CA), PMS-Sucralfate (CA), Sulcrate (CA)

Pharmacologic class: GI protectant

Therapeutic class: Antiulcer agent

Pregnancy risk category B

Action

Combines with gastric acid to form protective coating on ulcer surface, inhibiting gastric acid secretion, pepsin, and bile salts

Availability

Oral suspension: 500 mg/5 ml

Tablets: 1 g

⊘Indications and dosages

➣ Active duodenal ulcer

Adults: 1 g P.O. q.i.d. 1 hour before meals and at bedtime or 2 g b.i.d. for 4 to 8 weeks. For maintenance, 1 g P.O. b.i.d.

Off-label uses

• Gastroesophageal reflux
• GI symptoms caused by nonsteroidal anti-inflammatory drugs (including aspirin)
• Prevention of stress ulcers and GI bleeding in critically ill patients
• Oral and esophageal ulcers caused by radiation, chemotherapy, or sclerotherapy (oral suspension)

Contraindications

None

Precautions

Use cautiously in:
• renal failure
• pregnant or breastfeeding patients
• children.

Administration

• When giving through nasogastric tube, reconstitute drug and flush tube with water after administration.

Route	Onset	Peak	Duration
P.O.	Unknown	Unknown	6 hr

Adverse reactions

EENT: rhinitis

GI: constipation

Respiratory: respiratory difficulty

Skin: pruritus, rash

Other: facial swelling, hypersensitivity reaction

Interactions

Drug-drug. Aluminum-containing antacids: increased total body burden of aluminum

Anticoagulants: decreased hypoprothrombinemic effect

Diclofenac: decreased pharmacologic effects of diclofenac

Digoxin, quinidine: reduced blood levels and efficacy of these drugs

Histamine₂-receptor antagonists (such as cimetidine, ranitidine), fluoroquinolones, ketoconazole, tetracyclines, theophylline: decreased bioavailability of these drugs

Levothyroxine, penicillamine: decreased efficacy of these drugs

Phenytoin: decreased phenytoin absorption

Patient monitoring

• Monitor bowel pattern. Report severe, ongoing constipation.
• Assess for rash and itching.

Patient teaching

• Tell patient to take 1 hour before meals and again at bedtime.
• Caution patient not to take within 30 minutes of antacids or other drugs.
• Explain importance of completing entire course of therapy as prescribed, even after pain and other ulcer symptoms improve.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.