硫糖鋁
Sucralfate
Aluminum sucrose sulfate, basic
別名: Carafate · Antepsin · Aluminum sucrose sulfate, basic · Sucralfato · Sucralfatum
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
經審核的 v13 劑量證據
結構化劑量計算證據Prevention of stress-induced ulcers (used with acid-suppressive drugs) in foals — Right dorsal colitis | colonic ulcers
- q6-8h
NA
必須一併考量的臨床脈絡 (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.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
硫糖鋁（Sucralfate）是一種局部作用的胃腸黏膜保護劑，主要用於治療和管理口腔、食道、胃及十二指腸潰瘍。它偶爾也用於預防藥物（如非類固醇消炎藥或阿斯匹靈）引起的胃部糜爛，但其預防效果並不穩定。
臨床重點： 在獸醫學中，硫糖鋁常被形容為胃腸道的「液體OK繃」。因為它需要酸性環境才能正確聚合並覆蓋在潰瘍面上，所以給藥時間與進食及其他制酸劑（如H2受體拮抗劑或質子幫浦抑制劑）的間隔至關重要。
雖然在人類醫學中，它曾被用作腎衰竭繼發高血磷症患者的磷結合劑，但獸醫研究（如在健康貓咪中）顯示其降低血清磷濃度的效果好壞參半或不顯著。
作用機轉
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.
安全性與警告
禁忌症
- 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
不良反應
- Constipation (most common in dogs and humans)
- Vomiting (reported primarily in cats)
- Hypophosphatemia (rare, with prolonged use)
注意事項
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.
藥物交互作用
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
監測
- 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)
藥物動力學
吸收
Only 3-5% of an oral dose is absorbed systemically, as the drug primarily acts locally in the gastrointestinal tract.
分佈
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.
代謝
By reacting with hydrochloric acid in the gut, the unabsorbed remainder of the drug is converted to sucrose sulfate.
排除
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.
過量
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.
可用產品
劑型
- Tablets
- 1 g oral tablet
- 0.2 g/ml oral suspension
人用標示
- 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
各地核准狀態
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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'.
飼主須知
- 給藥時間： 為了達到最佳效果，除非獸醫師另有指示，請在空腹時（飯前至少1小時或飯後2小時）及睡前給予此藥物。
- 按時服藥： 如果漏掉劑量，胃部不適或潰瘍的臨床症狀可能會復發。請務必完全按照處方給藥。
- 藥物間隔： 硫糖鋁會阻礙許多其他藥物的吸收。如果您的寵物正在服用其他藥物，請與硫糖鋁間隔至少2小時給予。
- 給藥技巧： 如果您拿到的是錠劑，獸醫師可能會指示您在給藥前將錠劑溶解在少量溫水中製成「懸浮液」，再用針筒餵食。這種液體形式比固體錠劑更能有效地覆蓋食道和胃部。
- 副作用： 此藥物通常非常安全。最常見的副作用是輕微便秘。如果您的寵物排便困難或嘔吐加劇，請聯繫您的獸醫師。
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