Sucralfate is a helpful mucosal protectant when families can manage the timing and constipation risks. These pearls support safe outpatient and inpatient use.
Provide families with a written schedule showing sucralfate at least 2 hours before or 6 hours after other oral medicines (including PPIs, H2 blockers, anticonvulsants).
For suspensions, gently warm to room temperature and swirl to disperse the thick gel before drawing the dose—this improves texture and adherence to mucosa.
Start stool softeners or polyethylene glycol for children with baseline constipation, cerebral palsy, or taking opioids—sucralfate can worsen stool retention.
Limit duration and monitor serum aluminum or bone pain in patients with chronic kidney disease or on dialysis; switch to alternative therapy if levels rise.
Plan to transition to disease-modifying therapy (acid suppression, H. pylori eradication, diet changes) once mucosal healing is underway; prolonged sucralfate monotherapy seldom addresses underlying causes.