A peptic ulcer is an open sore in the stomach or intestine lining. When the ulcer is in the first part of the small intestine, it is called a duodenal ulcer.
To fully treat duodenal ulcers, treatment with antibiotics may be needed to heal ulcers caused by a form of H. pylori, a bacterial infection linked to the growth of ulcers and potentially cancer.
Carafate acts mainly in the gastrointestinal (GI) tract as an anti-ulcer agent and works by sticking to damaged ulcer tissue so healing can occur.
Carafate contains the active ingredient sucralfate. Sucralfate is available as an orally administered medication.
Carafate is available as a liquid suspension (a liquid with small pieces of drug) and tablets to be taken by mouth.
What Is Carafate Used For?
The Food and Drug Administration (FDA) approved Carafate for:
Short-term treatment (up to eight weeks) of an active duodenal ulcer. While healing with sucralfate may occur within the first two weeks, treatment should be continued for four to eight weeks unless healing has been proven by an X-ray or endoscopic examination (a procedure that lets the healthcare provider view your gastrointestinal tract). Maintenance therapy (treatment that maintains initial progress and deterrent of a condition) of duodenal ulcers at a reduced dosage after healing of acute (severe) ulcers.
You may also use Carafate tablets as a form of maintenance therapy at a lower dosage after the ulcers heal.
How to Take Carafate
Carafate is an oral medicine. You can take it in tablet or liquid suspension form. As such, the following instructions will guide users through safe and effective treatment:
Take Carafate on an empty stomach, one hour before or two hours after a meal. If you take an antacid, do not take it within 30 minutes of your Carafate dose. If you use the suspension form of Carafate, shake the bottle well before using it. Also, ask your healthcare provider for a measuring cup to measure your dose accurately. Do not use kitchen measuring devices for medication dosing. You should only take the suspension by mouth; never inject the liquid into the body unless in the case of suspension treatment for proctitis due to radiation. If you have diabetes, check your blood sugar regularly. Notify your healthcare provider of any changes in blood sugar. Carafate may make you feel better within the first week or two. However, do not stop taking the medication even if you feel better unless your healthcare provider tells you to do so. You must complete your entire prescription to ensure that you heal completely, which can take up to eight weeks. Additionally, your healthcare provider may order an X-ray or endoscopy to monitor your ulcer’s healing.
Storage
Store Carafate at room temperature (68 to 77 degrees F), away from heat, direct light, and moisture. Do not store in a bathroom.
Keep Carafate in its original labeled container and out of the reach of children and pets. Do not allow the suspension to freeze.
Off-Label Uses
Healthcare providers may sometimes prescribe Carafate for off-label use or indications that are not yet FDA-approved.
Off-label uses for Carafate can include:
Esophagitis (an inflamed esophagus) associated with gastroesophageal reflux disease (GERD) Prevention or treatment of ulcers from drugs in the nonsteroidal anti-inflammatory drug (NSAID) category, such as aspirin Prevention of stress gastritis (inflammation of the stomach lining that can happen during a severe illness)
Carafate suspension is sometimes used off-label as a rinse to treat pain associated with canker sores or to treat mouth sores due to chemo or radiation, as well as a rectal enema to treat inflamed rectal lining from ulcerative colitis or radiation.
What Are the Side Effects of Carafate?
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
Common Side Effects
The most common side effect of Carafate is constipation.
Other potential common side effects (reported in less than 0.5% of people in clinical trials) include:
Diarrhea Nausea and vomiting Gas Indigestion Rash Dizziness Drowsiness Headache Back pain
Severe Side Effects
Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.
Serious side effects can include:
Anaphylaxis (hypersensitivity reactions): Symptoms can include rash, hives, swelling around the lips, tongue, and face, and difficulty breathing Hyperglycemia (high blood sugar): Occurs with the suspension form, not the tablet form Bezoar formation (blockages in the digestive tract)
Long-Term Side Effects
When you take Carafate, your body absorbs a small amount of aluminum.
Taking Carafate with other sources of aluminum (such as antacids that contain aluminum) may cause the body to accumulate too much (toxicity). This mainly occurs in people with kidney problems.
Your healthcare provider can assess your risk for aluminum toxicity (a side effect of kidney issues).
Dosage: How Much Carafate Should I Take?
Modifications
In some cases, your healthcare provider may modify your dose or treatment:
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (suspension): To treat duodenal ulcers: Adults—One gram (g) (10 milliliters [mL]) four times a day, taken on an empty stomach for 4 to 8 weeks. Children—Use and dose must be determined by your doctor. For oral dosage form (tablets): To treat duodenal ulcers: Adults—One gram (g) four times a day, taken on an empty stomach for 4 to 8 weeks. Children—Use and dose must be determined by your doctor. To prevent duodenal ulcers: Adults—One gram (g) two times a day, taken on an empty stomach. Children—Use and dose must be determined by your doctor.
Pregnancy: There are no adequate studies of Carafate use in humans during pregnancy. In animal studies, Carafate did not appear to harm the unborn fetus.
However, there is not enough data on humans to establish risk. If you are pregnant or plan to become pregnant while taking Carafate, consult your healthcare provider for advice.
Breastfeeding: It is not known whether the drug passes through breast milk. Ask your healthcare provider before using Carafate if you are nursing.
Children: Adolescents should have their use and dose determined by their healthcare provider.
Older Adults: If you are 65 years or older, your healthcare provider may start you on a lower dose of Carafate. This accounts for any potential kidney, liver, or heart problems. In addition, your healthcare provider may monitor your kidney function during your treatment.
Kidney Problems: Because the kidneys work to eliminate Carafate, people with kidney problems have a greater risk of negative reactions to the drug.
Off-Label Use: Carafate’s dosing and administration may change based on its use. For example, you may use Carafate off-label as an oral rinse to relieve canker sore pain. In some cases, Carafate is also used rectally as an enema. If your healthcare provider prescribes Carafate for off-label use, they will instruct you on how to take it.
Missed Dose
If you miss a dose of Carafate, take it as soon as you can. Skip the missed dose if it is almost time for the next dose. Do not take two doses together.
Overdose: What Happens If I Take Too Much Carafate?
There is a low risk of overdosing on Carafate because it is minimally absorbed.
In rare reports of overdose, most people did not have any symptoms. People who had overdose symptoms experienced heartburn, nausea, and vomiting.
Precautions
What Are Reasons I Shouldn’t Take Carafate?
Carafate is not appropriate for everyone. Some people should not take Carafate.
This medicine may affect your blood sugar levels. Check with your doctor right away if you have increased thirst or increased urination. If you notice a change in the results of your urine or blood sugar tests, or if you have any questions, check with your doctor.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
You should not take Carafate if you are allergic to sucralfate or any of the inactive ingredients.
If you have problems with swallowing or any conditions that affect your cough or gag reflexes, you should avoid taking sucralfate in tablet form.
There have been reports of aspiration or breathing the drug into the airways, which can cause breathing complications from sucralfate tablets.
What Other Medications Interact With Carafate?
Taking Carafate with certain medicines can affect how your body reacts to these drugs.
Carafate may interact with the following medications:
Lanoxin (Digoxin) Fluoroquinolone antibiotics, such as Cipro (ciprofloxacin) Ketoconazole Synthroid (levothyroxine) Tetracycline Theo-24 (theophylline) Jantovin (warfarin)
You can typically take the other drug two hours before taking sucralfate to help eliminate the drug interaction.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter (OTC) medicines and vitamins or supplements.
Your healthcare provider can advise you on the proper spacing of your medications to avoid interactions.
What Medications Are Similar?
Carafate is a unique drug because it acts locally to protect ulcers. However, other medicines may also treat ulcers.
One popular class of drugs used to treat ulcers include proton pump inhibitors (PPIs). PPIs work by reducing acid production.
Examples of PPIs include:
Aciphex (rabeprazole) Dexilant (dexlansoprazole) Nexium (esomeprazole) Prevacid (lansoprazole) Prilosec (omeprazole)
Histamine H2-receptor antagonists, known as H2 blockers, are another category of drugs used to treat ulcers. They also reduce acid production.
Examples of H2 blockers include:
Pepcid AC (famotidine) Tagamet (cimetidine)
This list is a list of drugs also prescribed for stomach conditions. It is not a list of drugs recommended to take with Carafate. Ask your healthcare provider if you have questions.
How Can I Stay Healthy While Taking Carafate
When taking Carafate, follow your healthcare provider’s instructions for use.
Your healthcare provider may prescribe Carafate for up to eight weeks so that your ulcer heals completely. Even if you feel better in the first few weeks, continue to take your medicine as prescribed.
Because Carafate acts locally on the ulcer, very little is absorbed.
Therefore, Carafate generally has few side effects. The most common side effect is constipation. Increasing your intake of fluid and fiber can help reduce constipation.
If you have diabetes and take the Carafate suspension, monitor your blood sugar regularly and notify your healthcare provider of any changes.
If you have any problems with swallowing or your gag or cough reflex, Carafate tablets may not be appropriate for you. Instead, talk to your healthcare provider about using the suspension form.
