Sucralfate

By Rania Gollakner, BS, DVM, MPH

What is sucralfate?

Sucralfate (brand names Carafate® and Sulcrate®) is used in the treatment of ulcers and erosions occurring in the mouth, esophagus, stomach, and small intestine, including those caused by certain medications (such as aspirin). The medication 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. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully.

How is sucralfate given?

Sucralfate is available as a tablet and 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.

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 when you remember, but if it is close to the time for the next dose, skip the dose you missed and give the medication at the next scheduled time and continue with the regular dosing schedule. Never give your pet two doses at once or give extra doses.

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.

Are there any potential side effects?

There are very few side effects of sucralfate. The most commonly reported side effect is constipation. Vomiting (especially in cats) has also been reported. 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. Sucralfate should be used with caution in pets that have constipation. In humans, diabetic patients using this medication had elevated sugar levels but the significance in animals is unknown. Use caution in pregnant and nursing animals, as safe use during these times has not been established.

Are there any drug interactions I should be aware of?

Aluminum-containing antacids may interact with sucralfate, particularly in patients with kidney disease. Other drugs may interact with sucralfate because it may impair the absorption of the other medications. Therefore, it is important to separate the dosing of sucralfate and other drugs. Tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking to ensure that a suitable dosing schedule can be determined.

Is there any monitoring that needs to be done with this medication?

Monitor to ensure that the medication is working. If blood is visible in the stool or vomit, it could indicate that the ulcers are getting worse. If blood is observed (color can range from bright to dark red or black), contact your veterinarian.

How do I store sucralfate?

Sucralfate should be stored in a tightly sealed container, protected from light, and at room temperature (15-30°C or 59-86°F). Do not freeze the liquid form. It is ideal to keep the liquid form between 20-25°C or 68-77°F. If your veterinarian has made a special formulation, follow the storage instructions provided with the medication.

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.

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