Sucralfato
Sucralfate
Aluminum sucrose sulfate, basic
También conocido como: Carafate · Antepsin · Aluminum sucrose sulfate, basic · Sucralfato · Sucralfatum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia posológica v13 auditada
Evidencia estructurada para el cálculoPrevention of stress-induced ulcers (used with acid-suppressive drugs) in foals — Right dorsal colitis | colonic ulcers
- q6-8h
NA
Contexto clínico obligatorio (3)
- b) Prevention of stress-induced ulcers (used with acid-suppressive drugs) in foals:
- ■ This medicine is best given on an empty stomach and not at the same time as other medications. If you are giving your animal any other medication, be sure to give the other medications 2 hours before you give the sucralfate.
- Store sucralfate tablets in tight containers at room temperature (15°C-30°C [59°F-86°F]). Store sucralfate suspension at controlled room temperature (20°C-25°C [68°F-77°F]); do not freeze.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El sucralfato es un gastroprotector de acción local utilizado principalmente en el tratamiento y manejo de úlceras orales, esofágicas, gástricas y duodenales. También se emplea ocasionalmente para prevenir erosiones gástricas inducidas por fármacos (p. ej., AINE o aspirina), aunque su eficacia como profiláctico se considera esporádica.
Perla clínica: En medicina veterinaria, el sucralfato se describe a menudo como una "tirita líquida" para el tracto gastrointestinal. Debido a que requiere un entorno ácido para polimerizarse adecuadamente y recubrir las úlceras, el momento de la administración en relación con la alimentación y otros antiácidos (como los antagonistas de los receptores H2 o los inhibidores de la bomba de protones) es crítico.
Aunque se ha utilizado en medicina humana como quelante de fosfato para pacientes con hiperfosfatemia secundaria a insuficiencia renal, los estudios veterinarios (como en gatos sanos) han mostrado resultados mixtos o insignificantes respecto a su capacidad para reducir los niveles séricos de fósforo.
Mecanismo de acción
Sucralfate exerts a local, non-systemic effect on the gastrointestinal mucosa.
- Polymerization: After oral administration, sucralfate reacts with hydrochloric acid (HCl) in the stomach → undergoes cross-linking → forms a highly viscous, paste-like complex.
- Barrier Formation: This complex carries a strong negative charge and binds tightly to the positively charged proteinaceous exudates (like albumin and fibrinogen) found at ulcer sites. This forms an insoluble physical barrier that protects the ulcerated tissue from further degradation by pepsin, acid, and bile salts.
- Enzyme & Bile Acid Inactivation: Sucralfate directly inactivates pepsin and binds to bile acids, reducing their mucosal toxicity.
- Cytoprotection: It exhibits cytoprotective properties, likely mediated through the local stimulation and release of prostaglandin E2 (PGE2) and prostaglandin I2 (PGI2), which enhance mucosal blood flow and mucus/bicarbonate secretion.
Note: Sucralfate does not significantly alter gastric acid output or pancreatic enzyme activity.
Seguridad y advertencias
Contraindicaciones
- No absolute contraindications
- Use with caution in patients with decreased gastrointestinal transit times (e.g., megacolon, ileus) due to the risk of constipation
- Known hypersensitivity to sucralfate
Efectos adversos
- Constipation (most common in dogs and humans)
- Vomiting (reported primarily in cats)
- Hypophosphatemia (rare, with prolonged use)
Precauciones
There are no known absolute contraindications to the use of sucralfate.
- GI Motility: Because it may cause constipation, it should be used with caution in animals where decreased intestinal transit times might be deleterious.
- Pregnancy & Nursing: FDA Category B in humans. Categorized as Class A (Probably safe) in dogs and cats. It is unknown if it is excreted in milk, but due to minimal systemic absorption, it is unlikely to be of concern in nursing animals.
- Timing of Administration: Because it requires an acidic environment to activate, it should ideally be given before acid-suppressing drugs (like H2 blockers or PPIs), typically separated by 30-60 minutes.
Interacciones farmacológicas
Decreased oral absorption; separate dosing by at least 2 hours
Decreased oral absorption; separate dosing by at least 2 hours
Decreased oral absorption; separate dosing by at least 2 hours
Decreased oral absorption; separate dosing by at least 2 hours
Decreased oral absorption; separate dosing by at least 2 hours
Decreased oral absorption; separate dosing by at least 2 hours
Decreased oral absorption; separate dosing by at least 2 hours
Decreased oral absorption; separate dosing by at least 2 hours
Decreased oral absorption; separate dosing by at least 2 hours
Decreased oral absorption; separate dosing by at least 2 hours
Decreased oral absorption; separate dosing by at least 2 hours
Decreased oral absorption; separate dosing by at least 2 hours
Decreased oral absorption; separate dosing by at least 2 hours
Significantly decreased absorption of the antibiotic due to chelation
Significantly decreased absorption of the antibiotic due to chelation
May alter the acidic environment needed for initial sucralfate activation, though clinical significance is debated
Monitorización
- Clinical efficacy (resolution of vomiting, melena, anorexia, or abdominal pain)
- Endoscopic examination of ulcer healing
- Fecal occult blood
- Resolution of clinical signs of GI ulceration (e.g., vomiting, melena, anorexia)
- Fecal consistency (monitor for constipation)
Farmacocinética
Absorción
Only 3-5% of an oral dose is absorbed systemically, as the drug primarily acts locally in the gastrointestinal tract.
Distribución
Acts locally at the site of ulceration. The duration of action (binding to the ulcer site) may persist for up to 6 hours after oral dosing.
Metabolismo
By reacting with hydrochloric acid in the gut, the unabsorbed remainder of the drug is converted to sucrose sulfate.
Eliminación
The small absorbed fraction (3-5%) is excreted unchanged in the urine within 48 hours. The unabsorbed sucrose sulfate is excreted in the feces within 48 hours.
Sobredosis
Overdosage is highly unlikely to cause any significant systemic problems due to minimal absorption. Laboratory animals receiving massive doses up to 12 grams/kg orally demonstrated no incidence of mortality. The primary concern with a massive overdose would be constipation.
Productos disponibles
Formulaciones
- Tablets
- 1 g oral tablet
- 0.2 g/ml oral suspension
Etiquetado para humanos
- Sucralfate Tablets: 1 gram; Carafate® (Axcan Sandipharm); generic
- Sucralfate Suspension: 1 gram/10 mL in 10 mL unit dose cups & 415 mL; Carafate® (Axcan Scandipharm); generic (Precision Dose)
- Antepsin 1 g tablet
- Antepsin 0.2 g/ml suspension
Estado regulador
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store sucralfate tablets in tight containers at room temperature. An extemporaneously prepared aqueous suspension (200 mg/mL) made by crushing tablets in distilled water (without suspending agents like acacia or tragacanth, which inactivate the drug) is stable for 14 days when refrigerated. Label 'shake well'.
Información para el cliente
- Momento de la administración: Para maximizar el beneficio de este medicamento, adminístrelo con el estómago vacío (al menos 1 hora antes de comer o 2 horas después) y a la hora de acostarse, a menos que su veterinario indique lo contrario.
- Constancia: Los signos clínicos de malestar estomacal o úlceras pueden reaparecer si se omiten dosis. Administre el medicamento exactamente como se le ha recetado.
- Separación de medicamentos: El sucralfato puede bloquear la absorción de muchos otros fármacos. Si su mascota está tomando otros medicamentos, adminístrelos con al menos 2 horas de diferencia respecto al sucralfato.
- Consejo de administración: Si le han dado comprimidos, es posible que su veterinario le indique disolver el comprimido en una pequeña cantidad de agua tibia para crear una "papilla" antes de administrarla con una jeringuilla. Esta forma líquida recubre el esófago y el estómago mucho mejor que un comprimido sólido.
- Efectos secundarios: Este medicamento es generalmente muy seguro. El efecto secundario más común es el estreñimiento leve. Póngase en contacto con su veterinario si su mascota hace esfuerzo para defecar o si los vómitos empeoran.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.