Sucralfate

What is sucralfate?

Sucralfate (brand names Carafate® and Sulcrate®) is used in the treatment of ulcers and erosions that occur in the mouth, esophagus, stomach, and small intestine, including those caused by certain medications, such as acetylsalicylic acid (ASA). Sucralfate works by creating a coating or barrier over the ulcer, protecting it from stomach acids and allowing it to heal.

The use of sucralfate in dogs, cats, ferrets, reptiles, birds, and horses is off label (extra label). Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How is sucralfate given?

• Sucralfate is available as a tablet or liquid suspension. 
• If using tablets, it is advisable to crush and dissolve them in lukewarm water. 
• If using the liquid suspension, shake well before using it and measure carefully. 
• Sucralfate should be given by mouth on an empty stomach. 
• Do not administer this medication within two hours of other medications, as sucralfate may inhibit their absorption. 
• Follow the dosing instructions provided by your veterinarian.
• It is very important to give the medication for the length of time your veterinarian has recommended. Do not stop giving the medication to your pet without first speaking with your veterinarian.

This medication should take effect within one to two hours; however, this medication can take up to a few weeks before effects are noted and, at times, improvement may not be noted outwardly.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.

Are there any potential side effects?

Sucralfate may cause the following side effects: 

• Constipation
• Vomiting (especially in cats) 

Drug sensitivities can develop over time, with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment (e.g., irregular breathing, rash, fever, puffiness and swelling around the face) and notify your veterinarian if you have any concerns.  

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This short-acting medication should stop working within 24 hours.

Are there any risk factors for this medication?

DO NOT USE sucralfate in:

• Pets that are allergic to it

USE WITH CAUTION in:

• Pets with constipation
• Pets that are pregnant or nursing (safe use has not been established)

In humans, diabetic patients using this medication had elevated sugar levels but it is unknown whether this finding is significant for animals. 

Are there any drug interactions I should be aware of?

Several medications should be used with caution when given with sucralfate, including: 

• Aluminum-containing antacids (they may interact with sucralfate, particularly in patients with kidney disease)

Sucralfate may impair the absorption of other medications, so it is important to separate the dosing of sucralfate and other drugs. Be sure to tell your veterinarian about any medications (including vitamins, supplements, and herbal therapies) that your pet is taking before starting any treatment.

Is any monitoring needed with this medication?

• Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.
• Monitor to ensure that the medication is working. If blood is visible in the stool or vomit (color can range from bright to dark red or black), contact your veterinarian. It could indicate that the ulcers are getting worse.
• At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.

How do I store sucralfate?

• Store sucralfate in a tightly sealed container, protected from light, at room temperature (59°F-86°F or 15°C-30°C). 
• Do not freeze the liquid form. It is best to keep the liquid form between 68°F and 77°F (20°C and 25°C). 
• If your veterinarian has made a special formulation, follow the storage instructions provided with the medication.
• Keep the container out of reach of children and pets.

What should I do in case of an emergency?

Overdoses of sucralfate are not usually serious. If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms.