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Sucralfate pp 215-224 | Cite as

Safety of Sucralfate

  • David R. Mathews
  • Nicola G. Dahl

Abstract

Sucralfate, the basic aluminum salt of a sulfated disaccharide, is an ulcer-healing drug that has been used worldwide for over 20 years. The drug is extremely well tolerated during acute and maintenance therapy, and has proven to have an excellent overall safety profile related in large part to its nonsystemic action.

Keywords

Duodenal Ulcer Dialysis Patient Aluminum Toxicity Normal Kidney Function Serum Aluminum 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Hollander D: Efficacy of sucralfate for duodenal ulcers: A multicenter, double-blind trial. J Clin Gastroenterol 3(suppl 2):153–157, 1981. References 1 through 3 are clinical trials evaluating the efficacy and safety of Carafate tablets in patients with duodenal ulcers.PubMedGoogle Scholar
  2. 2.
    McHardy GG: A multicenter, double-blind trial of sucralfate and placebo in duodenal ulcer. J Clin Gastroenterol 3(suppl 2):147–152, 1981.PubMedGoogle Scholar
  3. 3.
    Behar J, Roufail W, Thomas E, et al: Efficacy of sucralfate in the prevention of recurrence of duodenal ulcers. J Clin Gastroenterol 9(suppl 1):23–30, 1987.PubMedCrossRefGoogle Scholar
  4. 4.
    Giesing D, Lanman R, Runser D: Absorption of sucralfate in man. Gastroenterology 82(5 pt 2):1066, 1982 (Abstract). References 4 and 5 provide quantitative amounts of aluminum and sucrose octasulfate absorbed from sucralfate.Google Scholar
  5. 5.
    Haram EM, Weberg R, Berstad A: Urinary excretion of aluminum after ingestion of sucralfate and an aluminum-containing antacid in man. Scand J Gastroenterol 22:615–618, 1987.Google Scholar
  6. 6.
    Alfrey AC: Gastrointestinal absorption of aluminum. Clin Nephrol 24(1):384–387, 1985.Google Scholar
  7. 7.
    Alfrey AC: Aluminum. Adv Clin Chem 23:69–91, 1983. References 7, 9–13 provide background information on aluminum absorption, excretion, and toxicity.PubMedCrossRefGoogle Scholar
  8. 8.
    Bannwarth B, Gaucher A, Burnel D, et al: Longterm sucralfate therapy. J Rheumatol 13(6): 1187, 1986 (Letter). This article evaluates aluminum concentrations in bone obtained from sucralfate-treated patients.PubMedGoogle Scholar
  9. 9.
    Alfrey AC: Aluminum metabolism. Kidney Int 28(18):S8–S11, 1986.Google Scholar
  10. 10.
    Kaehny WD, Hegg AR Alfrey AC: Gastrointestinal absorption of aluminum from aluminum containing antacids. N Engt J Med 296(24):1389–1390, 1977.CrossRefGoogle Scholar
  11. 11.
    Wills MR, Savory J: Aluminum and chronic renal failure: Sources, absorption, transport, and toxicity. Crit Rev Clin Lab 27(1):59–107, 1989.CrossRefGoogle Scholar
  12. 12.
    McCarthy JT, Milliner DS, Kurtz SB: Interpretation of serum aluminum values in dialysis patients. Am J Clin Pathol 86:629–636, 1986.PubMedGoogle Scholar
  13. 13.
    Brahm M: Serum aluminum in nondialyzed chronic uremic patients before and during treatment with aluminum-containing phosphate-binding gels. Clin Nephrol 25:231–235, 1986.PubMedGoogle Scholar
  14. 14.
    Burgess E: Aluminum toxicity from oral sucralfate therapy. Nephron 59(3):523–524, 1991 (Letter). References 14 through 19 are case reports of aluminum toxicity in sucralfate-treated patients. All six cases involve renal failure patients.PubMedCrossRefGoogle Scholar
  15. 15.
    Campistol JM, Cases A, Botey A, et al: Acute aluminum encephalopathy in an uremic patient. Nephron 51(1):103–106, 1989.PubMedCrossRefGoogle Scholar
  16. 16.
    Cappelli G, Facchini F, Malberti F, et al: Sucralfate as a cause of aluminum overload in patients undergoing hemodialysis. G Ital Nefrol 9(2):101–103, 1992 (Letter) (English translation of Italian).Google Scholar
  17. 17.
    Lederer ED, Gillum DM: Accelerated development of hypercalcemic aluminum associated bone disease in a patient with protracted acute renal failure. Kidney Int 35(1):378, 1989 (Abstract).Google Scholar
  18. 18.
    Min DI, D’Elia JA: Sucralfate-associated aluminum toxicity in a patient with renal failure: Treatment with deferoxamine. Clin Pharm 11(7):636–639, 1992.PubMedGoogle Scholar
  19. 19.
    Withers DJ, Woolf AS, Kingswood JC, et al: Encephalopathy in patient taking aluminum-containing agents, including sucralfate. Lancet 2(8664):674, 1989.PubMedCrossRefGoogle Scholar
  20. 20.
    Hamdy RC: Aluminum toxicity and Alzheimer’s disease. Postgrad Med 88(5):239–240, 1990. This article discusses the difference between Alzheimer’s disease and aluminum toxicity.PubMedGoogle Scholar
  21. 21.
    Algozzine GJ, Hill G, Scoggins WG, et al: Sucralfate bezoar. N Engl J Med 309(22):1387, 1983 (Letter). References 21 through 26 are case reports of bezoars in sucralfate-treated patients.PubMedGoogle Scholar
  22. 22.
    Anderson W: Esophageal medication bezoar in patient receiving enterai feedings and sucralfate. Am J Gastroenterol 84(2):205–206, 1989 (Letter).PubMedGoogle Scholar
  23. 23.
    Carrougher JG, Barrilleaux CN: Esophageal bezoars: The sucralith. Crit Care Med 19(6):837–839, 1991.PubMedCrossRefGoogle Scholar
  24. 24.
    Hart RS, Levin B, Gholson CF: Esophageal obstruction caused by sucralfate impaction. Gastrointest Endosc 35(5):474–475, 1989 (Letter).PubMedCrossRefGoogle Scholar
  25. 25.
    Rowbottom SJ, Wilson J, Samuel L, et al: Total oesophageal obstruction in association with combined enterai feed and sucralfate therapy. Anaesth Intensive Care 21(3):372–374, 1993.PubMedGoogle Scholar
  26. 26.
    Shueke M, Minas AA: Esophageal bezoar due to sucralfate. Endoscopy 23(5):305–306, 1991 (Letter).PubMedCrossRefGoogle Scholar
  27. 27.
    Roxe DM, Mistovich M, Barch DH: Phosphate-binding effects of sucralfate in patients with chronic renal failure. Am J Kidney Dis 13(3):194–199, 1989. References 27 and 28 are clinical studies evaluating the effect of sucralfate on serum phosphate in dialysis patients.PubMedGoogle Scholar
  28. 28.
    Kozak E, Hudnik V, Drinovec J, et al: The influence of aluminum hydroxide and sucralfate on serum aluminum levels in chronic dialysis patients, in Trace Element Analytical Chemistry in Medicine and Biology. Berlin, Walter de Gruyter &0026; Co, 1987, pp 473–480.Google Scholar
  29. 29.
    Chines A, Pacifici R: Antacid and sucralfate-induced hypophosphatemic osteomalacia: A case report and review of the literature. Calcif Tissue Int 47(5):291–295, 1990. This article is a case report of hypophosphatemia in a patient receiving sucralfate and antacids.PubMedCrossRefGoogle Scholar
  30. 30.
    Giesing DH, Bighley LD, Iles RL: Effect of food and antacid on binding of sucralfate to normal and ulcerated gastric and duodenal mucosa in rats. J Clin Gastroenterol 3(suppl 2):111–116, 1981. This reference is an animal study evaluating potential interactions between sucralfate and food or antacids.PubMedGoogle Scholar
  31. 31.
    Cannon LA, Heiselman D, Gardner W, et al: Prophylaxis of upper gastrointestinal tract bleeding in mechanically ventilated patients—A randomized study comparing the efficacy of sucralfate, cimetidine, and antacids. Arch Intern Med 147:2101–2106, 1987. References 31 and 32 are stress ulcer prophylaxis studies that describe the administration of sucralfate through a nasogastric tube.Google Scholar
  32. 32.
    Driks MR, Craven DE, Celli BR, et al: Nosocomial pneumonia in intubated patients given sucralfate as compared with antacids or histamine type 2 blockers. N Engl J Med 317:1376–1382, 1987.PubMedCrossRefGoogle Scholar
  33. 33.
    Lamy PP, Kitler ME: Gastric erosions in the elderly: Increased need for cytoprotection. Gastroenterol Clin Biol 9(12):102–105, 1985. References 33 through 35 discuss geriatric considerations in the medical management of PUD.PubMedGoogle Scholar
  34. 34.
    Miller DK, Burton FR, Burton MS, et al: Acute upper gastrointestinal bleeding in elderly persons. JAGS 4:409–422, 1991 (Review).Google Scholar
  35. 35.
    Wade WE: Medical management of peptic ulcer disease in the elderly. J Geriatr Drug Ther 3(2): 23–41, 1988.Google Scholar
  36. 36.
    Lewis JH, Weingold AB: The use of gastrointestinal drugs during pregnancy and lactation. Am J Gastroenterol 80(11):912–923, 1985. This review provides the recommendations from the American College of Gastroenterology subcomittee on FDA-related activity concerning the use of gastrointestinal drugs in pregnant or lactating women.PubMedGoogle Scholar
  37. 37.
    Ranchet G, Gangemi O, Petrone M: Sucralfate in the treatment of gravidic pyrosis (Italian). G Ital Ostet Ginecol XXII(1):1–16, 1990 (English translation). This reference is an open-label study evaluating the use of sucralfate to treat heartburn in pregnant women.Google Scholar

Copyright information

© Plenum Press 1995

Authors and Affiliations

  • David R. Mathews
    • 1
  • Nicola G. Dahl
    • 1
  1. 1.Marion Merrell Dow Inc.Kansas City

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