Sucralfate—Safety and Side Effects

Abstract

Marks IN. Sucralfate—safety and side effects. Scand J Gastroenterol 1991, 26(suppl 185), 36–42

The safety of sucralfate in terms of aluminium absorption, excretion, tissue accumulation, and toxicity is discussed, with special reference to the small amount of aluminium absorbed, its ready excretion by the normal kidney, and the hazard of toxicity in patients with advanced renal failure. The various manifestations of aluminium toxicity are described, and the notion that Alzheimer's disease should be included in this category is refuted. The clinical relevance of possible intraluminal binding and drug-drug interactions in patients receiving sucralfate therapy is also considered. Evidence is presentcd to show that sucralfate reduces the hyperphosphataemia in chronic uraemia, albeit at the risk of raised blood aluminium levels, but has no measurable effect on normal phosphate levels in patients with good renal function. The hioavailability of phenytoin, fluoroquinolone antibiotics. and H₂-receptor blockers may be impaired by concomitant dosing with sucralfate, but normal kinetics are restored by administerins the drug 2 h before sucralfate.

Key Words:

• Aluminium absorption
• aluminium bioavailability
• aluminium toxicity
• drug-drug interactions
• intraluminal binding
• phosphate binding
• sucralfate safety