Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: KEGG:D00446 (Sucralfate)
 278 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sucralfate (Sc) suspension 6 g/day and ranitidine (Rn) tablets, 150 mg, were compared in 125 patients in a double-blind, multicenter, endoscopically controlled trial in the treatment of reflux esophagitis. Inclusion criteria were symptomatic reflux (number and severity of attacks) and endoscopic evidence of esophagitis (grades 1 to 4). Clinical assessments were performed on entry, and at 4 and at 8 weeks, and endoscopy was repeated at 8 weeks. Sc suspension and Rn placebo or Sc placebo and Rn tablets were taken on waking and immediately before retiring at night. Of the 125 patients, 27 were withdrawn because of default (Rn = 4; Sc = 14), noncompliance (Rn = 1; Sc = 2), or the development of congestive cardiac failure (Rn = 1), diarrhea (Rn = 1; Sc = 1), nausea (Sc = 1), constipation (Sc = 1), and hematemesis (Sc = 1). Analysis was performed on the remaining 98 patients, 43 of whom had been treated with Sc and 55 with Rn. Heartburn, acid regurgitation, epigastric pain, dysphagia, and chest pain were relieved in 34% vs 40%, 67% vs 72%, 71% vs 57%, and 86% vs 63% for Sc and Rn, respectively. There was no significant difference between the two groups. Endoscopic healing occurred in 47% of the Sc- and in 31% of the Rn-treated patients (chi 2 = 2.50), and healing or improvement was noted in 81% of the Sc- and 64% of the Rn-treated patients. This difference approached statistical significance (chi 2 = 3.73). There was no obvious endoscopic benefit in 8 of the 43 and 20 of the 55 patients in the groups treated with Sc and Rn, respectively. Although the findings with sucralfate and ranitidine in patients with reflux esophagitis completing the trial suggest a benefit of these agents, the absence of a placebo control group and the high default rates, particularly for those receiving sucralfate, preclude any firm conclusions as to relative or specific efficacy of these agents in this condition.
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PMID:Reflux esophagitis therapy: sucralfate versus ranitidine in a double blind multicenter trial. 188 97

Sucralfate is well established in the treatment of upper gastrointestinal inflammation and ulceration, and preliminary evidence suggests it may be of benefit in active colitis. We have therefore undertaken a clinical trial to compare enemas of sucralfate (4 g) and prednisolone metasulphobenzoate (20 mg) in the treatment of active distal ulcerative colitis. Forty-four patients were entered into a 4-week study. Two patients were withdrawn because of non-compliance, and five were unable to complete the study: two developed constipation (both allocated to sucralfate) and three were unable to retain the enemas (two prednisolone and one sucralfate). Intention-to-treat analysis showed significant within-treatment improvement in rectal bleeding, sigmoidoscopic grade, and histologic grade in the prednisolone-treated group, and in stool frequency, rectal bleeding, and sigmoidoscopic grade in the sucralfate-treated group. Between-treatment comparisons, however, showed greater resolution of rectal bleeding and more marked improvements in histologic grade in patients treated with prednisolone metasulphobenzoate enemas. Further studies using higher doses of sucralfate would be useful.
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PMID:A comparison of sucralfate and prednisolone enemas in the treatment of active distal ulcerative colitis. 268 65

This paper reviews the results of placebo and cimetidine/ranitidine controlled studies in the short-term healing and maintenance therapy of duodenal (DU) and gastric (GU) ulcer, the status of newer dosage regimens, and safety aspects of the drug. The efficacy of sucralfate 1g qid in DU and GU healing has been amply confirmed in placebo and cimetidine or ranitidine-controlled studies. Healing rates have been reported in 60 to 83% DU patients after 4 weeks treatment with sucralfate but as with other drugs the rates tend to be lower in GU patients. The DU relapse rate after sucralfate healing is perhaps lower than after cimetidine healing, and sucralfate healing rates in DU are not compromised by concomitant cimetidine therapy, or by smoking. The value of maintenance therapy with sucralfate 1 g bd in reducing the relapse rate in patients with recently healed DU is well documented. The relapse rate is reduced from the order of 60 to 20% after 6 months, and from 81% to about 30% after one year. Available data also suggests that sucralfate is at least as effective as cimetidine in maintenance therapy. Sucralfate is effective in the prevention of GU relapse in the dose of 1g in the morning and 2g nocte. Sucralfate is particularly well tolerated. Constipation occurs in 2% of patients and nausea is occasionally encountered. The more convenient dose of sucralfate 2g bd is as effective as the conventional one of 1g qid in DU healing and recent evidence suggests that a single nocturnal dose of 2g nocte offers effective maintenance therapy in DU and GU disease.
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PMID:The efficacy, safety and dosage of sucralfate in ulcer therapy. 332 83

In the United States, the drugs most commonly used to treat peptic ulcer disease are antacids and the H2-receptor antagonists cimetidine and ranitidine. Other available agents include anticholinergics and the coating agent sucralfate. Investigational drugs such as colloidal bismuth, carbenoxolone, prostaglandins, the tricyclic compound pirenzepine, and substituted benzimidazoles are not available for use in the United States. Most of the commercially available and investigational compounds have similar efficacy; therefore the optimal drug may be the one associated with the fewest adverse effects and the most convenient dosing regimen. Cimetidine causes a small number of adverse effects, including neuropsychiatric disorders, gynecomastia, impotence, loss of libido, elevation of serum creatinine and serum transaminases concentrations, and drug interactions. Some of these reactions have been of clinical significance. Presently, there are rare reports of gynecomastia, bradycardia, inhibition of acetylcholinesterase, headache, lethargy, diarrhea, and rash in patients receiving ranitidine. Antacids can produce either diarrhea or constipation and have been associated with low serum phosphorus concentrations, and metabolic alkalosis. Anticholinergics, especially in elderly or debilitated patients, can cause central nervous system disorders, intestinal atony, or urinary retention. Sucralfate may cause constipation, diarrhea, nausea, and headache. The investigational agents have their own side effect profiles. The adverse effects of anticholinergics make them unattractive therapeutic choices, and antacids and sucralfate have inconvenient dosing requirements compared with some equally efficacious alternatives. In addition, clinical experience with sucralfate in the United States is limited. The safety record of cimetidine is admirable. As clinical experience with ranitidine increases, currently unrecognized adverse effects may be reported. However, based on current data, ranitidine is as effective as cimetidine and is associated with a lower incidence of side effects.
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PMID:Problems associated with medical treatment of peptic ulcer disease. 609 62

Sucralfate is a basic aluminium salt of sulphated sucrose which is advocated for use in peptic ulcer disease. It is minimally absorbed after oral administration and is believed to act primarily at the ulcer site by protecting the ulcer from the effects of pepsin, acid and possibly bile salts. Controlled therapeutic trials have demonstrated that sucralfate 1g 4 times daily is effective in increasing the rate of healing of duodenal and gastric ulcer over a period of 4 to 8 weeks. Trials comparing sucralfate and cimetidine have not found any significant difference in efficacy between the drugs in small numbers of patients. A dosage of 2g daily given prophylactically decreases the rate of recurrence of duodenal ulcers, but the efficacy of sucralfate in preventing relapse of gastric ulcers has yet to be clearly demonstrated. Sucralfate is particularly well tolerated. Constipation, the most common side effect, occurs in 2% of patients. Thus, sucralfate offers an effective and well tolerated alternative for the management of peptic ulcer disease.
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PMID:Sucralfate. A review of its pharmacodynamic properties and therapeutic use in peptic ulcer disease. 636 84

The pharmacology, pharmacokinetics, clinical studies, adverse reactions, and dosage of sucralfate (Carafate, Marion Laboratories), a unique drug for peptic-ulcer disease, are reviewed. Sucralfate exerts its antiulcer effect by binding with proteinacious material, neutralizing local acidity without affecting gastric pH, and forming a protective barrier at the ulcer site. It also inhibits the diffusion of hydrogen ion, inhibits the action of pepsin, and adsorbs bile salts. Approximately 3-5% of an orally administered dose of sucralfate is absorbed; more than 90% of the dose is excreted unchanged in the feces. Sucralfate remains at the site of gastric ulcers for up to six hours. In the treatment of duodenal ulcers, sucralfate is more effective than placebo and comparable with cimetidine and intensive antacid therapy. Healing rates for gastric ulcers are less impressive but are comparable with those produced by cimetidine and antacids. Additive or synergistic effects of sucralfate with cimetidine or intensive antacid therapy have not been studied. Sucralfate has few side effects because it is not absorbed; most frequently reported are constipation (3-4%), xerostomia (1%), and skin eruptions (0.6%). No drug-drug interactions have been reported. The recommended dose of sucralfate is 1 g four times a day one hour before meals and at bedtime. Sucralfate is a unique antiulcer drug that compares favorably with cimetidine and antacid therapy in terms of safety and efficacy. Sucralfate is FDA-approved for short-term (up to eight weeks) treatment of duodenal ulcers.
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PMID:Sucralfate--alternative therapy for peptic-ulcer disease. 676 89

The safety of sucralfate, an aluminum salt of sucrose octasulfate that is used to treat peptic ulcer disease, is based on data from clinical trials in over 2,000 patients. In vitro, animal, and clinical studies have shown that sucralfate does not have anticoagulant effects, in contrast to other sulfated polysaccharides. Sucralfate was well tolerated by healthy volunteers in a multiple-dose study, in which the drug was administered in doses two and three times higher than the normal treatment dose, for 14 and 28 days, respectively. In open-label trials conducted in Japan, France, and Latin America in 1,600 subjects, side effects were reported in only 44 subjects, with the most common complaint being constipation (in 23 subjects). In the United States, safety evaluations of sucralfate were similar to those obtained in other countries, with only 12.9% of subjects treated with sucralfate (232) reporting side effects. The incidence of side effects in the placebo-treated group was about 12.1%. Furthermore, sucralfate has been shown to heal ulcers comparable to antacids and cimetidine. Its therapeutic efficacy, combined with the fact that it is well tolerated and free of serious systemic effects, enhances sucralfate's therapeutic clinical usefulness in the treatment of peptic ulcer disease.
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PMID:Sucralfate: a review of drug tolerance and safety. 703 54

Sucralfate is a well-established drug in the therapy of gastric and duodenal ulcers. Its adverse reactions are rare, where constipation is the most common side effect. Liver injury due to sucralfate has not been previously reported. We describe an elderly patient with significant liver injury accompanied with pruritus during treatment with sucralfate.
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PMID:Hepatotoxicity related to sucralfate. 1134 60