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수크랄페이트

Sucralfate

Aluminum sucrose sulfate, basic

위장관 보호제PO개고양이페렛파충류말

다른 이름: Carafate · Antepsin · Aluminum sucrose sulfate, basic · Sucralfato · Sucralfatum

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

감사 완료 v13 용량 근거

구조화 용량 계산 근거

Prevention of stress-induced ulcers (used with acid-suppressive drugs) in foals — Right dorsal colitis | colonic ulcers

22 mg/kgPO
  • q6-8h

NA

반드시 함께 고려할 임상 맥락 (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.
formulary프로토콜 2023감사 dose-audit-plumb-v13

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

수크랄페이트는 국소적으로 작용하는 ​위장관 보호제​로, 주로 구강, 식도, 위, 십이지장 궤양의 치료 및 관리에 사용됩니다. 약물(예: NSAID 또는 아스피린)로 인한 위 미란을 예방하기 위해 간혹 사용되기도 하지만, 예방 효과는 불규칙한 것으로 간주됩니다.

​임상 팁:​ 수의학에서 수크랄페이트는 종종 위장관의 "액체 반창고"로 묘사됩니다. 궤양 부위에 제대로 중합되어 코팅되려면 산성 환경이 필요하므로, 식사 및 다른 제산제(H2 수용체 길항제 또는 양성자 펌프 억제제 등)와의 투여 간격이 매우 중요합니다.

인의학에서는 신부전에 속발하는 고인산혈증 환자의 인 결합제로 사용되어 왔으나, 수의학 연구(예: 건강한 고양이 대상)에서는 혈청 인 농도 저하 효과에 대해 혼재되거나 유의미하지 않은 결과를 보였습니다.

작용 기전

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.​

안전성·주의사항

금기사항

  • 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

부작용

  • Constipation (most common in dogs and humans)
  • Vomiting (reported primarily in cats)
  • Hypophosphatemia (rare, with prolonged use)

주의

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.

약물 상호작용

Azithromycin

Decreased oral absorption; separate dosing by at least 2 hours

Ciprofloxacin / Enrofloxacin (and other oral fluoroquinolones)

Decreased oral absorption; separate dosing by at least 2 hours

Diclofenac

Decreased oral absorption; separate dosing by at least 2 hours

DigoxinModerate

Decreased oral absorption; separate dosing by at least 2 hours

Doxycycline

Decreased oral absorption; separate dosing by at least 2 hours

Erythromycin

Decreased oral absorption; separate dosing by at least 2 hours

Ketoconazole

Decreased oral absorption; separate dosing by at least 2 hours

Levothyroxine

Decreased oral absorption; separate dosing by at least 2 hours

Penicillamine

Decreased oral absorption; separate dosing by at least 2 hours

Tetracycline

Decreased oral absorption; separate dosing by at least 2 hours

Theophylline

Decreased oral absorption; separate dosing by at least 2 hours

Vitamins (fat soluble)

Decreased oral absorption; separate dosing by at least 2 hours

Warfarin

Decreased oral absorption; separate dosing by at least 2 hours

Fluoroquinolones (e.g., Enrofloxacin, Ciprofloxacin)Major

Significantly decreased absorption of the antibiotic due to chelation

Tetracyclines (e.g., Doxycycline)Major

Significantly decreased absorption of the antibiotic due to chelation

H2-receptor antagonists / Proton Pump InhibitorsMinor

May alter the acidic environment needed for initial sucralfate activation, though clinical significance is debated

모니터링

  • 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)

약동학

흡수

Only 3-5% of an oral dose is absorbed systemically, as the drug primarily acts locally in the gastrointestinal tract.

분포

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.

대사

By reacting with hydrochloric acid in the gut, the unabsorbed remainder of the drug is converted to sucrose sulfate.

배설

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.

과다투여

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.

제품

제형

  • Tablets
  • 1 g oral tablet
  • 0.2 g/ml oral suspension

인용의약품

  • 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

규제 현황

European Union✓ 승인됨처방전의약품EMA

POM (Prescription Only Medicine)

United Kingdom✓ 승인됨처방전의약품VMD

POM (Prescription Only Medicine)

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

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'.

보호자 정보

  • ​투여 시간:​ 이 약의 효과를 극대화하려면 수의사의 다른 지시가 없는 한 ​공복​(식사 최소 1시간 전 또는 2시간 후) 및 취침 전에 투여하십시오.
  • ​규칙적인 투여:​ 투여를 거르면 위장 장애나 궤양의 임상 증상이 재발할 수 있습니다. 반드시 처방된 대로 정확히 투여하십시오.
  • ​약물 간격:​ 수크랄페이트는 다른 많은 약물의 흡수를 방해할 수 있습니다. 반려동물이 다른 약물을 복용 중인 경우, 수크랄페이트와 최소 2시간의 간격을 두고 투여하십시오.
  • ​투여 팁:​ 알약을 처방받은 경우, 수의사가 주사기로 먹이기 전에 소량의 따뜻한 물에 알약을 녹여 "슬러리(현탁액)"로 만들도록 지시할 수 있습니다. 이 액체 형태는 고체 알약보다 식도와 위를 훨씬 더 잘 코팅합니다.
  • ​부작용:​ 이 약은 일반적으로 매우 안전합니다. 가장 흔한 부작용은 가벼운 변비입니다. 반려동물이 배변 시 힘들어하거나 구토가 악화되면 수의사에게 연락하십시오.

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