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Sucralfate forms a protective barrier on gastrointestinal ulcers and erosions, supporting healing while limiting systemic absorption.
Minimal systemic absorption makes it attractive for infants and children, but aluminum accumulation is possible in renal failure.
Administer at least 1 hour before or 2 hours after other medications to prevent binding.
Constipation is common; encourage hydration and fiber or use stool softeners if needed.
Multiple daily doses are required—schedule around meals and bedtime for consistent coverage.
Can be compounded as a mouthwash for oral mucositis under oncology guidance.
Sucralfate protects inflamed mucosa across GI indications.
Used for ulcers, reflux esophagitis, and mucositis adjunctive therapy.
| Condition | Age Range | First Line? | Notes |
|---|---|---|---|
| Duodenal or gastric ulcer therapy | Children and adolescents | Yes | Administer four times daily for 6–8 weeks alongside acid suppression to promote mucosal healing. Continue for 2 weeks after symptom resolution to ensure complete epithelialization. |
| Adjunctive therapy for reflux esophagitis | Children | No | Consider short courses to protect inflamed mucosa while proton pump inhibitors or H2 blockers reduce acid burden; schedule doses between meals and at bedtime. |
| Mucositis symptom relief in oncology patients | Children and adolescents | No | Use as a swish-and-swallow suspension to coat ulcerated mucosa under oncology guidance; discontinue if aspiration risk or aluminum accumulation becomes a concern. |
FDA-approved primary uses with Level A evidence
Quick selection guides and diagnostic pearls
When to consider other medications
How to explain treatment to families
Sucralfate is well tolerated; most adverse effects relate to GI motility and aluminum exposure.
Constipation is most common. Rarely, bezoar formation or hypophosphatemia can occur.
Constipation
Common • mild
Dry mouth
Uncommon • mild
Aluminum accumulation/hypophosphatemia
Rare • serious
Rash
Rare • moderate
Organized by affected organ systems
How to discuss side effects with families
Management protocols and monitoring
Common concerns and practical guidance
Administration notes for sucralfate.
Shake suspension vigorously. Give on an empty stomach one hour before meals and at bedtime. For tablets, dissolve in a small amount of water if swallowing is difficult.
Separate sucralfate from other medications by at least 2 hours to avoid binding. Maintain hydration to prevent constipation.
Emergency contact: Seek urgent care for swallowing difficulty, vomiting blood, or black stools.
Continue therapy for the full prescribed course even when symptoms improve, and follow the clinician’s reflux or ulcer management plan.
Different formulations and concentrations
Safe preparation and measuring techniques
Tailored approaches for different ages
Solutions for common challenges
Storage guidelines and safety tips
Expert pearls and evidence-based tips
Sucralfate is a basic aluminum salt of sucrose octasulfate that acts locally in the GI tract. In acidic environments (pH <4), it polymerizes and cross-links to form a viscous, adherent barrier over injured mucosa.
The sucralfate-aluminum complex adheres to ulcer bases, shielding tissue from gastric acid, pepsin, and bile salts while stimulating local prostaglandin, bicarbonate, and epidermal growth factor release. Because systemic absorption is minimal, its effect is primarily topical.
Simple explanations and helpful analogies
Receptors, enzymes, and cellular targets
Absorption, metabolism, and elimination
Age-related differences and special populations
Sucralfate is a helpful mucosal protectant when families can manage the timing and constipation risks. These pearls support safe outpatient and inpatient use.
Prioritize dose separation, bowel regimen planning, and patient education about administration technique and duration.
Provide families with a written schedule showing sucralfate at least 2 hours before or 6 hours after other oral medicine…
For suspensions, gently warm to room temperature and swirl to disperse the thick gel before drawing the dose—this improv…
Start stool softeners or polyethylene glycol for children with baseline constipation, cerebral palsy, or taking opioids—…
Limit duration and monitor serum aluminum or bone pain in patients with chronic kidney disease or on dialysis; switch to…
Core insights every provider should know
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Recent updates that change how we practice
Organized by dosing, administration, and safety
How to explain treatments to families
Real-world cases with evidence-based approaches
Key numbers, algorithms, and decision tools
Understanding your child's medication is important. We've created comprehensive guides to help you safely administer Sucralfate and monitor your child's response to treatment.
Wait at least 30 minutes after the dose before eating to let the medicine coat the lining.
It can. Increase fluids and fiber; call if constipation persists.
No. Separate by at least 2 hours to avoid binding and reduced absorption.
Follow your clinician’s plan, typically 4-8 weeks or until ulcers heal.