Can I Buy Antepsin Over The Counter? Quick Answer

Drug information provided by: IBM Micromedex

US brand name

carafat

Canadian brand name

Sulkrat Suspension Plus

descriptions

Sucralfate is used to treat and prevent duodenal ulcers and other conditions determined by your doctor. It works by creating a barrier, or coat, over the ulcer. This protects the ulcer from stomach acid and allows it to heal. Sucralfate contains an aluminum salt.

This medicine can only be obtained with a prescription.

This product is available in the following dosage forms:

tablet

suspension

Before use

When deciding to use a drug, the risks of taking the drug must be weighed against the benefits. This is a decision you and your doctor will make. For this medicine, the following should be considered:

allergies

Tell your doctor if you’ve ever had an unusual or allergic reaction to this medicine or any other medicines. Also, tell your doctor if you have other types of allergies, such as B. against food, dyes, preservatives or animals. For non-prescription products, carefully read the label or package ingredients.

paediatrics

No adequate studies have been conducted on the relationship between age and the effects of sucralfate in children and adolescents. Safety and effectiveness have not been established.

geriatrics

Related studies conducted to date have not identified any geriatric issues that would limit the usefulness of sucralfate in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and dose adjustment in patients receiving this drug.

breastfeeding

There are insufficient studies in women to determine the risk of infants when using this drug while breastfeeding. Weigh the potential benefits against the potential risks before using this drug while breastfeeding.

Interactions with other drugs

Although certain medicines should not be used together at all, in other cases two different medicines can be used together, even though an interaction could occur. In these cases your doctor may change the dose or other precautions may be needed. If you are taking this medicine, it is especially important for your doctor to know if you are taking any of the medicines listed below. The following interactions have been selected for their potential importance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not usually recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may change the dose or frequency of use of one or both medicines.

bictegravir

digoxin

dolutegravir

elvitegravir

ketoconazole

raltegravir

Using this medicine with any of the following medicines may increase your risk of certain side effects, but using both medicines may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or frequency of use of one or both medicines.

Ciprofloxacin

delafloxacin

fleroxacin

gemifloxacin

grepafloxacin

moxifloxacin

norfloxacin

ofloxacin

Sparfloxacin

Trovafloxacin mesylate

warfarin

Other Interactions

Certain medicines should not be used at or around the time of eating or eating certain types of food because interactions can occur. The use of alcohol or tobacco with certain drugs can also cause interactions. Discuss with your doctor the use of your medicine with food, alcohol or tobacco.

Other medical problems

The presence of other medical problems may affect the use of this medicine. Be sure to tell your doctor if you have any other medical problems, especially:

Diabetes – Use with caution. Can make this condition worse.

Kidney disease (including patients with chronic renal failure or patients on dialysis) – Use with caution. The effects may be increased due to slower removal of the drug from the body.

Stomach and Intestinal Disorders – Sucralfate can combine with other foods and medicines, which can lead to blockage of the stomach and intestines.

Correct Usage

Only take this medicine as directed by your doctor. Don’t take more of it, don’t take it more often, and don’t take it longer than your doctor tells you to.

Keep taking this medicine for the whole treatment period, even if you feel better. Do not stop taking it unless your doctor tells you to.

Take this medicine on an empty stomach.

Shake the oral liquid well before each use. Measure each dose with a marked measuring spoon, oral syringe or medicine cup.

If you are also taking an antacid, take it more than half an hour before or after taking sucralfate oral liquid.

If you are taking cimetidine, ciprofloxacin, digoxin, norfloxacin, ofloxacin, or ranitidine, take them 2 hours before sucralfate oral liquid.

dosage

The dose of this medicine is different for different patients. Follow your doctor’s or label directions. The information below only includes the average doses of this drug. If your dose is different, don’t change it unless your doctor tells you to.

The amount of medicine you take depends on the strength of the medicine. Also, the number of doses you take each day, the length of time between doses, and how long you take the medicine depend on the medical problem you are using the medicine for.

For oral dosage form (suspension): To treat duodenal ulcers: Adults – One gram (g) (10 milliliters [ml]) four times daily 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 daily 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) twice daily on an empty stomach. Children—Use and dose must be determined by your doctor.

missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Don’t double the doses.

storage

Store the medicine in a closed container at room temperature away from heat, moisture and direct light. Keep from freezing.

Keep away from children.

Do not keep any medicines that are outdated or no longer needed.

Ask your doctor how to throw away medicines you no longer use.

Precautions

It is very important that your doctor checks your progress at regular visits to make sure this medicine is working properly and to check for any unwanted effects.

This medicine can affect your blood sugar levels. Contact your doctor immediately if you experience increased thirst or urination. If you notice a change in your urine or blood sugar test results, or if you have any questions, call your doctor.

Do not take any other medicines unless they have been discussed with your doctor. This includes prescription or non-prescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

side effects

In addition to the necessary effects, a drug can have some undesirable effects. Although not all of these side effects may occur, they may require medical attention if they do occur.

Contact your doctor immediately if any of the following side effects occur:

Frequency not known

Blue lips and fingernails Blurred vision Chest pain Coughing Cough that sometimes produces pink, frothy sputum Difficult, rapid, noisy breathing Difficulty swallowing Dry mouth Bloating skin slow or irregular breathing stomach pain sweating swelling of the face, mouth, lips or throat swelling of the legs and ankles chest tightness difficulty breathing unexplained weight loss unusual tiredness or weakness vomiting

Some side effects may occur that do not usually require medical attention. These side effects may go away during treatment as your body gets used to the medicine. Also, your healthcare professional may be able to advise you on ways to prevent or reduce some of these side effects. Contact your doctor if any of the following side effects persist or bother you, or if you have any questions about them:

Less common

constipation

Rarely

back pain gas constipation diarrhea dizziness or light-headedness excess air or gas in the stomach or intestines feeling of constant movement of the body or surrounding area headache hives, itching, rash indigestion gas or gas spinning sensation drowsiness stomach cramps difficulty sleeping

Some patients may also experience other side effects not listed. If you notice other effects, contact your doctor.

Call your doctor for medical advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

Prescription and OTC Omeprazole decreases gastric acid production, which promotes healing of stomach and duodenal ulcers and other inflamed areas of gastrointestinal tissue. The risk of interactions with omeprazole is… Show more

carafat

When given with other drugs, sucralfate can bind to the drugs in the stomach and reduce absorption of the drugs. Sucralfate reduces absorption of:

dolutegravir (Tivicay),

cimetidine (Tagamet),

digoxin (Lanoxin),

ketoconazole (Nizoral),

Levothyroxine (Synthroid),

phenytoin (Dilantin),

quinidine (Chindex, Quinaglute),

ranitidine (Zantac),

tetracycline,

Theophylline (Theo-Dur, Uniphyl, others) and

all fluoroquinolone antibiotics, including ciprofloxacin (Cipro), norfloxacin (Noroxin), ofloxacin (Floxin), and lomefloxacin (Maxaquin).

All of these medications should be taken at least two hours before sucralfate.

It is possible, if not likely, that many other medications interact similarly with sucralfate. Therefore, it is probably advisable to take all medications at least 2 hours before sucralfate.

omeprazole

Omeprazole may increase blood levels of diazepam (Valium), warfarin (Coumadin), and phenytoin (Dilantin) by decreasing the clearance of these drugs by the liver.

The absorption of certain medicines can be impaired by stomach acid. Therefore, omeprazole and other PPIs decrease the absorption and concentration of ketoconazole (Nizoral) in the blood and increase the absorption and concentration of digoxin (Lanoxin) in the blood. This may decrease the effectiveness of ketoconazole or increase the toxicity of digoxin.

Through unknown mechanisms, omeprazole can increase blood levels of saquinavir and decrease blood levels of nelfinavir and atazanavir, medicines used to treat patients with human immunodeficiency virus (HIV) infection. Accordingly, the dose of saquinavir may need to be reduced to avoid toxicity, and the doses of nelfinavir and atazanavir may need to be increased to maintain efficacy.

Clopidogrel (Plavix) is converted to its active form by enzymes in the liver. Omeprazole reduces the activity of these enzymes and may reduce the activity of clopidogrel. Omeprazole should not be used with clopidogrel.

Omeprazole increases the concentration of cilostazol (Pletal). The dose of cilostazol should be reduced from 100 mg twice daily to 50 mg twice daily when co-administered with omeprazole.

Omeprazole can increase blood levels of methotrexate (Rheumatrex, Trexall) and tacrolimus (Prograf).

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You know the signs all too well. Your stomach starts gurgling, your chest starts burning, you start cramping – and you begin your frantic search for the bathroom. Digestive issues can be embarrassing and not something people want to talk about openly – not even with their doctor. But as I tell my patients, these problems are strikingly common and affect many people on a daily basis.

While digestive problems often go away on their own, over-the-counter medications can help relieve many of the symptoms that interfere with your everyday life. Here’s a guide to the OTC medications you can use to relieve stomach or digestive problems.

Remember: these medicines are for occasional, short-term use only; If your problems persist or worsen, talk to your doctor. He or she can help you create a treatment plan (including lifestyle changes) that can bring you long-lasting relief.

For heartburn

If you suffer from heartburn, you probably know all too well that burning sensation in your stomach, chest or throat that can be uncomfortable. This irritation is caused by an imbalance of acid in your stomach.

Often triggered by a large meal or certain foods, heartburn occurs when stomach contents rise up into the esophagus, causing a burning sensation in the chest, behind the breastbone, and in the mid-abdomen.

Several types of over-the-counter medicines can help relieve your symptoms and reduce the acidity in your stomach:

Antacids provide quick, short-term relief by neutralizing stomach acid. Antacids may contain ingredients such as baking soda, calcium carbonate, or magnesium compounds.

Alginic acids are often combined with antacids to provide quick relief. While antacids help neutralize stomach acid, alginic acids create a protective barrier in your gastrointestinal tract that envelops and protects inflamed areas.

H2 blockers like famotidine and cimetidine lower the amount of acid your stomach produces. While H2 blockers take up to an hour to work, the effects last longer than antacids, up to 12 hours. Proton pump inhibitors (PPIs) provide a long-lasting reduction in stomach acid production of up to 24 hours. Lansoprazole and omeprazole are both types of proton pump inhibitors.

Side effects from these three classes of drugs are usually minor and often go away on their own. These include nausea, constipation, diarrhea, and headaches. Your doctor can advise you on what type of OTC drug is best for you. Talk to your doctor before using antacids if you are pregnant, breastfeeding, taking a prescription medication, or have problems with ulcers, liver, or your kidneys.

For nausea and vomiting

Last night’s Chinese leftovers seem like a great meal idea — until your stomach obviously starts to disagree. Nausea and vomiting is one of your body’s main defenses against food poisoning, and it can also result from problems like motion sickness and overeating. While the best way to cure an upset stomach in most cases of food poisoning is to get your body rid of the bacteria causing your discomfort, over-the-counter antiemetics can be useful when dealing with nausea and vomiting caused by motion sickness and certain other conditions. There are two main types of OTC medications used to treat nausea and vomiting:

Bismuth subsalicylate, the active ingredient in OTC drugs like Kaopectate® and Pepto-Bismol™, protects your stomach lining. Bismuth subsalicylate is also used to treat ulcers, upset stomach, and diarrhea.

Other drugs include cyclizine, dimenhydrinate, diphenhydramine, and meclizine. These can be found in medications like Dramamine, Bonine or others, and they dull motion sickness by acting on your brain. They prevent messages from reaching the part of the brain that controls nausea and vomiting

Bismuth subsalicylate side effects are usually very minor and short-lived; The most common side effects are a dark tongue or stools. However, it is important not to give medicines containing bismuth subsalicylate to children or adolescents with chickenpox or flu-like symptoms, as symptoms such as behavior changes with nausea or vomiting can occur, which are early signs of Reye’s syndrome, a rare but serious illness. Talk to a doctor right away. Because some antiemetics can make you drowsy, read the label carefully and heed all warnings before mixing with alcohol, driving, or using machines. Don’t take antiemetics without reading the label first, and talk to your doctor if there are warnings about your drug of choice: There are several medications and health conditions that don’t mix well with antiemetics, including certain common pain relievers.

For constipation

What is causing your constipation? Most likely something on your dining table. A diet high in dairy and low in fiber and water can make bowel movements difficult. If you haven’t had a bowel movement for more than three days or have problems with bowel movements, you should temporarily take a laxative to solve the problem.

There are several types of laxatives available over the counter; Your doctor can help you decide which is best for you:

Bulking laxatives, which often contain ingredients like psyllium, methylcellulose, and polycarbophil, draw water into the stool to make it larger and easier to pass. Drink plenty of water while taking it.

Osmotic laxatives draw fluid from the surrounding tissues into the intestine. Osmotic laxatives often have ingredients like polyethylene glycol or magnesium. Lubricating laxatives, such as glycerin suppositories, coat the surface of the stool or anus to facilitate bowel movements. Mineral oil is a common lubricant laxative.

Stimulant laxatives should only be used for a few days as they put a heavy strain on the body. They cause the intestines to push out the stool.

Laxatives usually have no side effects, but in some cases they can cause cramping, bloating, gas, nausea, or diarrhea. Don’t use laxatives for more than a week without consulting your doctor: Long-term use of laxatives can be unhealthy and mask a problem your doctor should know about. Your doctor can help you make lifestyle and diet changes to manage constipation long-term.

Talk to your doctor before using laxatives if you have stomach pain, nausea, vomiting, fever over 40 degrees, or a sudden change in your bowel habits that lasts two or more weeks. Even if you’re currently taking prescription medication, you should consult your doctor: Laxatives make it harder for your body to absorb certain medications and nutrients.

For diarrhea

Everyone knows it from time to time – the dreaded diarrhea. Diarrhea (large amounts of loose or watery stools) occurs when your large intestine cannot absorb enough liquid from the food and liquids you eat and is most commonly caused by a gastrointestinal infection. Diarrhea does not usually require medication and resolves on its own after a few days; In most cases, lifestyle changes can help prevent future cases of diarrhea. However, medication for diarrhea can help with symptoms, especially if you have cramps. Your doctor may suggest one of two common over-the-counter antidiarrheal drugs:

Loperamide slows the movement of fluid through your gut.

Bismuth subsalicylate decreases fluid flow in your gut and also reduces inflammation and can kill the bacteria that cause diarrhea in the first place.

Loperamide can make you drowsy, so read the label carefully; The label tells you what behaviors to avoid while taking the drug. bismuth subsalicylate can make your tongue and/or stools look black; this side effect is harmless. If you think your diarrhea might be caused by an infection, talk to your doctor, as another drug may be better at treating the pathogen. You should also talk to your doctor if you have a fever or find mucus or blood in your stools, as your diarrhea may indicate a more serious problem.

find relief

The right over-the-counter medicine can provide quick relief for many short-term gastrointestinal ailments. Remember to read the labels of any medicines you plan to take, and talk to your doctor if you have any questions or concerns.

Endoscopy Open pop-up dialog Close endoscopy Endoscopy During an endoscopy, your doctor inserts a thin, flexible tube with a light and camera (endoscope) down your throat and into your esophagus. The tiny camera allows your doctor to examine your esophagus, stomach, and the beginning of your small intestine (duodenum).

To diagnose an ulcer, your doctor may first take a medical history and perform a physical exam. You may then need to undergo diagnostic tests, such as:

Laboratory tests for H. pylori. Your doctor may recommend tests to determine if the H. pylori bacterium is present in your body. He or she may check for H. pylori with a blood, stool, or breath test. The most accurate is the breath test. For the breath test, drink or eat something that contains radioactive carbon. H. pylori breaks down the substance in your stomach. Later you blow into a bag, which is then sealed. If you are infected with H. pylori, your breath sample will contain the radioactive carbon in the form of carbon dioxide. If you are taking an antacid before testing for H. pylori, be sure to tell your doctor. Depending on which test is used, you may need to stop taking the drug for a period of time because antacids can produce false-negative results.

endoscopy. Your doctor may use an endoscope to examine your upper digestive system (endoscopy). During endoscopy, your doctor inserts a hollow tube fitted with a lens (endoscope) down your throat and into your esophagus, stomach, and small intestine. Your doctor uses the endoscope to look for ulcers. If your doctor diagnoses an ulcer, a small sample of tissue (biopsy) may be taken for examination in a laboratory. A biopsy can also determine if H. pylori is in your stomach lining. Your doctor may be more likely to recommend an endoscopy if you’re older, have signs of bleeding, or have recently had weight loss or difficulty eating and swallowing. If endoscopy shows a stomach ulcer, a follow-up endoscopy should be done after treatment to show that it has healed, even if your symptoms improve.

Upper Gastrointestinal Series. Sometimes referred to as a barium swallow, this series of X-rays of your upper digestive system creates images of your esophagus, stomach, and small intestine. During the X-ray, you swallow a white liquid (which contains barium), which coats your digestive tract and makes an ulcer more visible.

Mayo Clinic Care Our caring team of Mayo Clinic professionals can help you with your health concerns related to stomach ulcers. Start here

treatment

Treatment for stomach ulcers depends on the cause. Treatment usually includes killing the H. pylori bacterium if it is present, eliminating or reducing the use of NSAIDs if possible, and healing your ulcer with medication.

Medications can include:

Antibiotic drugs to kill H. pylori. If H. pylori is found in your digestive tract, your doctor may recommend a combination of antibiotics to kill the bacterium. These may include amoxicillin (Amoxil), clarithromycin (Biaxin), metronidazole (Flagyl), tinidazole (Tindamax), tetracycline, and levofloxacin. Which antibiotics are used depends on where you live and current antibiotic resistance rates. You will likely need to take antibiotics for two weeks, as well as additional medications to reduce stomach acid, including a proton pump inhibitor and possibly bismuth subsalicylate (Pepto-Bismol).

Drugs that block acid production and promote healing. Proton pump inhibitors – also called PPIs – reduce stomach acid by blocking the action of the acid-producing parts of the cell. These drugs include the prescription and over-the-counter drugs omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), and pantoprazole (Protonix). Long-term use of proton pump inhibitors, especially at high doses, can increase your risk of hip, wrist, and spine fractures. Ask your doctor if calcium supplementation can reduce this risk.

Drugs to reduce acid production. Acid blockers — also called histamine (H-2) blockers — reduce the amount of stomach acid released into your digestive tract, which relieves ulcer pain and promotes healing. Prescription and over-the-counter antacids include the drugs famotidine (Pepcid AC), cimetidine (Tagamet HB), and nizatidine (Axid AR).

Antacids, which neutralize stomach acid. Your doctor may add an antacid to your drug regimen. Antacids neutralize existing stomach acid and can provide rapid pain relief. Side effects can include constipation or diarrhea depending on the main ingredients. Antacids can relieve symptoms but are not generally used to heal your ulcer.

Drugs that protect the lining of the stomach and small intestine. In some cases, your doctor may prescribe medications called cytostatics that help protect the tissues that line your stomach and small intestine. Options include the prescription drugs sucralfate (Carafate) and misoprostol (Cytotec).

Aftercare after initial treatment

Treatment of gastric ulcers is often successful and results in the ulcer healing. But if your symptoms are severe or persist despite treatment, your doctor may recommend an endoscopy to rule out other possible causes of your symptoms.

If an ulcer is found during endoscopy, your doctor may recommend another endoscopy after your treatment to make sure your ulcer has healed. Ask your doctor if you should have further tests after your treatment.

ulcers that don’t heal

Stomach ulcers that don’t heal with treatment are called refractory ulcers. There are many reasons an ulcer may not heal, including:

Not taking medication as directed

The fact that some types of H. pylori are resistant to antibiotics

Regular use of tobacco

Regular use of painkillers — like NSAIDs — which increase the risk of ulcers

Less commonly, refractory ulcers can result from:

Extreme overproduction of stomach acid, as occurs in Zollinger-Ellison syndrome

An infection other than H. pylori

stomach cancer

Other diseases that can cause ulcer-like sores in the stomach and small intestine, such as B. Crohn’s disease

Treatment of refractory ulcers generally involves eliminating factors that can interfere with healing and using various antibiotics.

If you have a serious ulcer complication, such as B. an acute bleeding or a perforation, you may need an operation. However, because of the many effective drugs available, surgery is required much less frequently than it used to be.

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lifestyle and home remedies

You can find relief from stomach ulcer pain if you:

Consider switching pain relievers. If you regularly take pain relievers, ask your doctor if acetaminophen (Tylenol, others) might be an option for you.

If you regularly take pain relievers, ask your doctor if acetaminophen (Tylenol, others) might be an option for you. control stress. Stress can worsen the signs and symptoms of a stomach ulcer. Look at the sources of your stress and do what you can to address the causes. Some stress is inevitable, but you can learn to manage it by exercising, spending time with friends, or by writing in a journal.

Stress can worsen the signs and symptoms of a stomach ulcer. Look at the sources of your stress and do what you can to address the causes. Some stress is inevitable, but you can learn to manage it by exercising, spending time with friends, or by writing in a journal. Do not smoke. Smoking can damage the protective lining of your stomach and make your stomach more prone to developing an ulcer. Smoking also increases stomach acid.

Smoking can damage the protective lining of your stomach and make your stomach more prone to developing an ulcer. Smoking also increases stomach acid. Limit or avoid alcohol. Excessive alcohol consumption can irritate and erode the lining of the stomach and intestines, which can lead to inflammation and bleeding.

alternative medicine

Products containing bismuth may help with stomach ulcer symptoms. There is also evidence that zinc can help heal ulcers. Mastic powder, the product of a type of evergreen shrub, may also help improve symptoms and speed up the healing of stomach ulcers.

While certain over-the-counter and alternative medications may be helpful, evidence of effectiveness is lacking. Therefore, they are not recommended as the primary treatment for peptic ulcer disease.

Prepare for your appointment

Make an appointment with your GP if you have any signs or symptoms that worry you. Your doctor may refer you to a specialist in the digestive system (gastroenterologist).

It’s a good idea to be well prepared for your appointment. Here’s some information to help you prepare and what to expect from your doctor.

What you can do

Observe all restrictions before the appointment. When making the appointment, ask if there’s anything you need to do in advance, such as B. Restricting your diet. Certain medications can affect stomach ulcer tests, so your doctor may want you to stop taking them. He or she may be able to suggest alternatives to these drugs for you.

When making the appointment, ask if there’s anything you need to do in advance, such as B. Restricting your diet. Certain medications can affect stomach ulcer tests, so your doctor may want you to stop taking them. He or she may be able to suggest alternatives to these drugs for you. Write down any symptoms you have and the foods you eat. People with stomach ulcers often have more symptoms when their stomach is empty.

as well as the food you eat. People with stomach ulcers often have more symptoms when their stomach is empty. Write down important personal information, including other medical problems, major stresses, or recent life changes.

including other medical problems, major stresses, or recent life changes. Make a list of all medications, including over-the-counter medicines, vitamins, or supplements, that you are taking. It is especially important to be aware of the use of pain relievers and the usual dose you are taking.

including any over-the-counter medication, vitamins, or supplements you are taking. It is especially important to be aware of the use of pain relievers and the usual dose you are taking. Write down questions to ask your doctor.

For stomach ulcers, there are a few questions you can ask your doctor:

What is the most likely cause of my symptoms?

What kind of tests do I need and how do I prepare for them?

Is my condition likely transient or chronic?

Am I at risk of complications related to this condition?

What treatment do you recommend?

If the initial treatment doesn’t work, what would you recommend next?

Are there any dietary restrictions I need to follow?

I have other medical problems. How can I treat these along with ulcers?

In addition to the questions you’d like to ask your doctor, don’t hesitate to ask additional questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you a number of questions. When you’re ready to answer them, you can take time to go through points you want to cover. Your doctor may ask:

When did you first experience symptoms?

Were your symptoms continuous or intermittent?

How severe are your symptoms?

Are your symptoms worse when you’re hungry?

What, if anything, have you taken to relieve your symptoms?

Does anything seem to improve your symptoms?

What, if anything, seems to be making your symptoms worse?

Do you take painkillers or aspirin? If yes, how often?

Do you feel nauseous or have you vomited?

Have you ever vomited blood or black material?

Have you noticed blood in your stools or black stools?

What you can do in the meantime

While you wait to see your doctor, avoiding tobacco, alcohol, spicy foods, and stress can help relieve your symptoms.

Sucrose octasulfate sodium salt (Toronto Research Chemicals, Inc., Toronto, ON, Canada) was dissolved in distilled water for all experiments and was administered orally in a volume of 2.5 ml/kg body weight. The following drugs and reagents were also used: isoflurane inhalation solution (Pfizer, New York, NY, USA); 10% sucralfate-containing suspension (ULCERLMIN® Oral Suspension 10%; Chugai Pharmaceutical Co. Ltd., Tokyo, Japan); pepsin (1:10,000, from porcine gastric mucosa), casein, trichloroacetic acid, sodium carbonate and Folin’s reagent (all purchased from Wako Pure Chemical Industries, Ltd., Osaka, Japan); and 9-aminoacridine (9-AA; Thermo Fisher Scientific K.K., Yokohama, Japan).

Animals

All experiments used male Sprague-Dawley rats weighing 250-300 g (SLC, Inc., Shizuoka, Japan). Animals were housed in a room maintained at 23°C ± 1°C under a 12 hour light/dark cycle, with unlimited access to water and food. On the day before the experiment, the animals were fasted for 18 h and housed in raised mesh floor cages to prevent coprophagia. All animal testing was approved by the Animal Care and Use Committee of Lion Research Laboratories (Tokyo, Japan) and was conducted in accordance with Lion Corporation’s internal animal testing policies and ethical guidelines.

Esophagitis induction and drug administration

An overview of the experiment is given in Fig. 1. A model of rat reflux oesophagitis was prepared by forestomach and pylorus ligation as described in previous reports19,20. Under isoflurane anesthesia, the pylorus and the boundary bar (transitional area between forestomach and corpus) were ligated. Sucralfate or SOS (at doses of 1.8-144 μmol/kg) was then administered 10 minutes or 3.5 hours after ligation via the esophagus for delivery to the stomach to induce early and late phase therapeutic drug effects, respectively evaluate. Four hours later, gastric juice was backflowing into the esophagus, causing severe erosion. The esophagus was then removed, dissected along the long axis, and spread on filter paper. For IMS assessments, esophageal specimens were immediately frozen with dry ice powder and stored at -80°C until analysis. Control esophageal tissues were dissected from normal rats that did not undergo ligation surgery.

Figure 1 Time course of model rat generation and sucralfate or SOS treatment. First, a rat model of reflux esophagitis was prepared by forestomach and pyloric ligation. Subsequently, sucralfate or SOS was administered to assess the therapeutic effect of these drugs (Fig. 3). Using the same samples used to assess gross pathology, IMS analysis was performed to assess whether SOS adhered to the mucosal surface (Figures 6 and 7). Finally, we evaluated the localization of SOS administered after severe inflammatory lesions were induced (Fig. 8). SOS, sucrose octasulfate; IMS, imaging mass spectrometry. full size image

gross pathology

Total areas (mm2) of esophageal lesions were measured under a stereomicroscope and gross pathology scored as follows: 0, no visible lesions; 1, mucosal erosion; 2, total area of ​​mucosal damage, including ulcer, was < 30 mm2; 3, total area of ​​mucosal lesions, including one ulcer, was ≥ 31 mm2; and 4, perforation. The ability of sucralfate and SOS to ameliorate the pathology of esophagitis was evaluated. Measurement of peptic activity in vivo We first hypothesized that mucosal protection by sucralfate and SOS is mediated via inhibition of digestive enzymes. To test this hypothesis, the effective peptic activity in the rat model gastric juice was evaluated by a digestion assay using casein as a substrate. Peptic activity was assessed in vivo using supernatants of rat gastric juices collected 4 hours after ligation; we used a modified procedure described in the Japanese Pharmacopoeia, 16th edition, with casein as substrate21. Briefly, the gastric juices collected were diluted 50-fold with 0.04 mol/L hydrochloric acid. A volume of 0.1 ml of the diluted juice was then added to 0.5 ml of substrate solution (0.72% lactic acid, 0.6% casein; pH 2.0) and the mixture incubated at 37°C for 10 min. The casein digestion reaction was stopped with 5% trichloroacetic acid, followed by neutralization with a 0.55 mol/L sodium carbonate solution. Tyrosine and tyrosine residues from casein were detected by the addition of Folin's reagent. Measurement of peptic activity in vitro The effect of SOS on peptic activity was further tested using artificial gastric juice. In this test, we evaluated whether SOS acts on the substrate or pepsin by preincubating the casein substrate or pepsin with SOS in the artificial gastric juice. The 50% inhibitory concentration (IC 50 ) value for pepsin was estimated. SOS was preincubated with the substrate as described below. An equal volume of 10 to 240 μmol/L SOS was added to 500 μL of a substrate solution (1.44% lactic acid, 1.2% casein; pH 2.0) and the mixture was incubated at 37°C for 30 min. Then the artificial gastric juice [0.24% hydrochloric acid, 0.2% sodium chloride, 0.85% pepsin (1:10,000); pH 1.2] was diluted 50-fold with 0.04 mol/L hydrochloric acid, and 0.1 mL of the diluted juice was added to the reaction solution. The mixture was added to 0.5 ml of the supernatant and reacted at 37°C for 10 minutes. The casein digestion reaction was stopped with 5% trichloroacetic acid, followed by neutralization with a 0.55 mol/L sodium carbonate solution. The degradation products were quantified by a colorimetric reaction using Folin's reagent. Similarly, SOS was preincubated with pepsin in artificial gastric juice. An equal volume of 10 to 240 μmol/L SOS was added to 100 μL of the artificial gastric juice [0.48% hydrochloric acid, 0.4% sodium chloride, 1.7% pepsin (1:10,000); pH 1.2] and the mixture incubated at 37°C for 30 min. Subsequently, the supernatants reacted with SOS for the artificial gastric juice were diluted 50-fold with 0.04 mol/L hydrochloric acid. A volume of 0.1 ml of the diluted supernatant was then added to 0.5 ml of a substrate solution (0.72% lactic acid, 0.6% casein; pH 2.0) and reacted at 37°C for 10 minutes. The casein digestion response was measured in the same manner as described for SOS preincubated with substrate. Imaging mass spectrometry While sucralfate can form a thick gel layer in the gastrointestinal tract, SOS lacks this gel-forming ability22. Therefore, by using IMS, we tested the hypothesis that SOS might form an alternative protective structure by attaching directly to the mucosal surface. In addition, we assessed the ability of SOS to accumulate at sites of inflammation. Thin sections (12 μm thick) of the esophageal samples were prepared at -21 °C using a cryostat (CM 1850; Leica, Wetzlar, Germany) and thawed on conductive indium tin oxide glass slides (20 Ω, SI0020N); Matsunami Glass Industry Co. Ltd.). A matrix was prepared using a solution of 10 mg 9-AA dissolved in 1 ml 80% ethanol23. The 9-AA matrix solution was manually sprayed onto the samples with an airbrush (Procon Boy PS 270 WA Platinum; Mr. Hobby) until the tissue surface was uniformly stained light yellow. Mass spectrometry (MS)/MS-based IMS was performed using a matrix-assisted laser desorption/ionization (MALDI) LTQ-XL instrument (Thermo Fisher Scientific)24. In order to perform the IMS experiment with sufficient signal selectivity, which could only detect the SOS signal from complex tissue samples, we had to determine SOS-specific ion signals on MALDI-MS/MS. To this end, we measured an authentic SOS standard sighted on an esophageal section (see Fig. 2). In the mass spectrum, a molecular ion at m/z 625 ([M-Na − 5SO 3 Na + 5 H]-) was detected with the highest intensity (Fig. 2A). We then performed MS/MS targeting the ion at m/z 625. In the product ion spectrum obtained, a strong product ion at m/z 361 was detected with the highest sensitivity (Fig. 2B). Therefore, during subsequent imaging evaluations, an m/z 625 ion was used as the parent ion with an isolation window of m/z 1.0; the mass range from m/z 360 to 363 was recorded for each data point. The collision energy was 25% of the maximum available energy for the LTQ-XL and the laser energy was set at 30 µJ. The scanning pitch of the laser irradiated area was 75 µm. Image reconstruction was performed using Image Quest software (Thermo Fisher Scientific, Waltham, MA). Figure 2 Development of a specific SOS detection method by tandem MS. Qualitative analysis of an SOS-Na reference compound spotted onto esophageal tissue was performed using a MALDI LTQ-XL instrument. (A) On the MS spectrum (m/z 500-1600), the most intense ion at m/z 625 was identified as ([M-Na - 5SO 3 Na + 5H]-); (B) Product ion spectrum (m/z 170-620) for the ion at m/z 625; (C) Structure of SOS-Na (molecular weight: 1157.628). MALDI, matrix-assisted laser desorption/ionization; MS, mass spectrometry; SOS, sucrose octasulfate. full size image Statistical analysis Data are expressed as mean ± standard error of the mean (SE). Differences in gross pathology were assessed using Steel's multiple comparison test and analyzed using JMP Pro11 software (SAS, USA). IMS data were evaluated using a region of interest (ROI) analysis; regional intensities of the SOS-selective signal (m/z 625 > 361) were calculated in mucosal and muscle regions using ImageJ software25. Group differences were assessed using Student’s t-test. For all analyses, p-values ​​< 0.05 were considered statistically significant.

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Common Sucralfate Side Effects | constipation | Serious Side Effects | How long do side effects last? | Warnings | Interactions | How to avoid side effects

Sucralfate (brand name Carafate) is a drug used to treat stomach ulcers, which are sores in the lining of the stomach or first part of the small intestine (duodenum). It also treats gastroesophageal reflux disease (GERD), a condition in which acid flows from the stomach into the esophagus. Sucralfate is available in tablet and oral suspension forms. It works by creating a protective barrier over the ulcers or inflamed tissue.

Although sucralfate is generally well tolerated, there are potential side effects associated with this drug, some of which can be quite serious. Because of this, it is important to understand these possible side effects before taking this drug.

Common sucralfate side effects

There are very few known side effects of sucralfate. The side effects of sucralfate in clinical trials were mild and rarely led to discontinuation of the drug. Constipation was the most common side effect, reported by only 2% of patients, according to the FDA. Less common (reported by less than 0.5% of patients), but possible side effects include:

Diarrhea

Dry mouth

Nausea or gastrointestinal problems

bloating/indigestion

Vomit

itching or rash

dizziness

headache

sleep disorders

back pain

constipation

The most common side effect of sucralfate is constipation. The drug works by binding to ulcers to protect them from further exposure to stomach acid, bile, pepsin, and bile salts. This gives the ulcers time to heal. Although sucralfate’s binding to ulcers is a good thing, it can also lead to constipation, which means food and waste pass through the digestive tract too slowly. This is sometimes accompanied by straining, bloating and cramps.

In clinical trials involving more than 2,700 patients treated with sucralfate, fewer than 5% of participants experienced any side effects. Constipation was the most common side effect, reported by 2% of patients.

RELATED: Home remedies for constipation

Serious side effects of sucralfate

Sucralfate has some rare but potentially serious side effects, including:

Anaphylaxis: Severe allergic reaction characterized by hives and swelling.

Severe constipation: Difficulty passing stool and, in some cases, bowel obstruction.

Bezoar formations: When undissolved particles of drug form one or more hard lumps, usually in the stomach; It can be very painful and cause nausea and vomiting.

Hyperglycemia: The oral suspension form of sucralfate can be associated with elevated blood sugar levels

How Long Do Sucralfate Side Effects Last?

Mild side effects associated with taking sucralfate, such as constipation, generally do not require medical attention and should resolve after a few days or weeks.

However, more serious side effects of this medication may require immediate medical attention. For example, if you have an allergic reaction to sucralfate or develop anaphylaxis shortly after taking the drug, call 911 right away. In the rare case of bezoar formation, the drug may need to be removed from your body during an upper endoscopy.

To avoid these possible side effects, it is important that you take the medication exactly as your doctor has told you. Do not stop taking sucralfate or change the amount you are taking without seeking medical advice from a healthcare professional.

Contraindications and Warnings for Sucralfate

There are several contraindications to taking sucralfate, including hypersensitivity to any component of the drug. In certain patients, the benefits of treatment may outweigh the risks.

Abuse, dependency and withdrawal

Sucralfate does not cause a “high” and has not been linked to any type of abuse or addiction. There are no withdrawal symptoms associated with stopping sucralfate treatment, but you should talk to your doctor before doing so to avoid side effects.

overdose

Just like with other medications, it is possible to take too much sucralfate. Side effects of overdose include abdominal pain, constipation, nausea, and vomiting.

If you suspect an overdose, call a poison control center or go to an emergency room right away.

pregnancy and breast feeding period

Sucralfate is safe to take during pregnancy. It is not known to cause birth defects and should only be used during pregnancy if the benefit outweighs the risk. Human studies show minimal systemic absorption of the drug.

Sucralfate is also safe to use while breastfeeding. Although no human data are available, the drug poses a small risk to the infant if used during this time. Mothers may need extra fluids while taking sucralfate to prevent constipation that can occur with use. It is not expected to affect maternal milk production.

children

Sucralfate is safe for short-term (up to eight weeks) treatment of duodenal ulcers in children over 12 months of age. Its safety and effectiveness have not been studied in children under 12 months.

senior citizens

Clinical trials didn’t include enough participants over the age of 65, so it’s not clear if older adults experience different side effects or a different response to the drug. Dose adjustments may be required in patients 65 years and older. It is recommended to start at the lower end of the dosage range and slowly increase as needed.

dysphagia

Sucralfate is contraindicated in patients with dysphagia of no known cause, a condition in which patients have difficulty swallowing. This is because sucralfate can form a large, bezoar-like mass in the esophagus if it is not completely dissolved before it reaches that area of ​​the body. On the other hand, dysphagia caused by acid reflux is a condition commonly treated with sucralfate.

GI obstruction

Patients with known GI obstruction, a blockage in the intestines, should not take sucralfate. This drug can bind to food and other medications, which can lead to constipation if the material is unable to pass through the intestines.

renal dysfunction

Kidney disease can affect the way sucralfate is metabolized in the body, meaning a dose reduction may be necessary. This drug should be used with caution in patients with known kidney disease, kidney failure, or who are on dialysis.

Type 2 diabetes

Sucralfate can affect blood sugar levels in patients with type 2 diabetes. The drug has been reported to induce hyperglycemia in some diabetics. If the benefits of taking this drug outweigh the risk, patients should be carefully monitored. The amount of antidiabetic medicines you take may need to be adjusted.

RELATED: What Are Normal Blood Sugar Levels?

aspiration hazard

Sucralfate may increase the risk of pneumonia and other pulmonary complications in patients at increased risk of aspiration. Some medical conditions can affect the way a patient swallows or even prevent them from swallowing. Sucralfate should not be taken in these cases. Use caution in patients with a tracheostomy, recent intubation, history of aspiration, or difficulty swallowing.

Impaired gag reflex

Conditions that can alter the gag reflex include certain types of anesthesia, Parkinson’s disease, a history of stroke, or esophageal surgery. Taking sucralfate may make some of these conditions worse because patients with an impaired gag reflex have an increased risk of developing a bezoar if this drug is not fully dissolved before it enters the stomach.

Interactions with sucralfate

Some prescription and over-the-counter medications, dietary supplements, and herbal products can interact with how sucralfate works. The most common drug interactions include:

Baloxavir Marboxil: Can lower the level of baloxavir in the blood.

Deferasirox: May decrease blood levels of Deferasirox.

Sucralfate also has the ability to bind to other medications you are taking and decrease their absorption. Sucralfate can reduce the absorption of other medicines, e.g.

naproxen

potassium phosphate

sodium phosphate

tetracycline

digoxin

cimetidine

ketoconazole

levothyroxine

This is not a complete list of drug interactions. Always discuss with your doctor what medications you are taking before starting treatment.

How To Avoid Sucralfate Side Effects

Sucralfate can cause a variety of side effects in some patients. Fortunately, there are ways to avoid these potential problems:

1. Take sucralfate as directed

The way you take sucralfate will depend on the form you are prescribed and the condition being treated. If you have a prescription, always take the medication as directed by your doctor. Be sure to read the drug information provided to you at the pharmacy.

For oral suspension: shake the liquid well before each use. You should always use the dosing syringe or cup that came with the medication. Measure each dose with the syringe or cup and do not use a household spoon as this will not give you an accurate reading. Take this medication exactly as your doctor has told you. The oral suspension is for oral use only. Never share or otherwise take this medication.

For oral tablets: Swallow the medication whole with enough water to ensure it is swallowed completely. Do not crush, chew or break the pill before swallowing unless otherwise directed by our doctor.

2. Take sucralfate on an empty stomach

Sucralfate works best when taken on an empty stomach. It should be taken at least two hours before or after a meal.

3. Tell your doctor about all medical conditions and medications

Be sure to tell your doctor about any medical conditions you may have. Sucralfate is contraindicated in patients with a history of certain medical conditions such as:

dysphagia

GI obstruction

renal dysfunction

Type 2 diabetes

aspiration hazard

Impaired gag reflex

Tell your doctor and pharmacist about all prescription and nonprescription drugs you take, including over-the-counter and herbal supplements. Some medications interfere with how sucralfate works in the body.

4. Store at room temperature

You should always store sucralfate at room temperature away from sources of heat and moisture. Always keep the bottle tightly closed and out of the reach of children when not in use.

5. Avoid taking other medications within two hours before or after taking sucralfate

Sucralfate may decrease absorption of certain medications and supplements. As such, you should not take it within one to two hours of other prescriptions, over-the-counter medications, or herbal products.

6. Avoid taking antacids within 30 minutes after taking sucralfate

Sucralfate may decrease absorption of some antacids when taken together. Therefore, you should never take antacids within 30 minutes of taking sucralfate. Ask your doctor what antacids are best to take while on this medication.

7. Take the missed dose as soon as possible

If you miss a dose, take the missed dose as soon as possible. It is important never to take multiple doses at the same time. If you cannot take the missed dose before your next dose, skip it and go back to your regular dosing schedule.

8. Complete the entire treatment cycle

Don’t stop taking sucralfate just because your symptoms improve. Do not skip doses or stop treatment early, even if you feel better after the first few weeks. Always complete the treatment, even if it means taking the medication longer than prescribed.

Sucralfate is generally prescribed for short-term treatment, between six and eight weeks. It is important to complete the entire course of treatment to ensure any ulcers have healed and to prevent them from coming back.

9. Report side effects immediately

Although sucralfate is generally a safe medication and the list of possible side effects is not as long as some other medications, you should always report any symptoms that may be related to sucralfate.

Medically reviewed by Carmen Fookes, BPharm. Last updated on July 28, 2021.

1. How it works

Sucralfate can be used to treat stomach disorders such as duodenal ulcers.

The exact way sucralfate works is not known; However, research shows that it forms a film with albumin (a protein) secreted by the ulcer site. This film acts as a barrier to stomach acid, pepsin (one of the most important digestive enzymes) and bile salts.

Sucralfate belongs to the class of drugs known as disaccharide sulfates. It is also known as a protective agent against ulcers.

2. Benefits

Used for short-term (four to eight weeks) treatment of duodenal ulcers.

Can be given long-term in a smaller dose to prevent re-erosion of the duodenal ulcer.

Only minimally absorbed from the stomach and duodenum; Therefore, sucralfate is generally well tolerated and has few side effects.

3. Disadvantages

If you’re between the ages of 18 and 60, don’t take any other medications, or don’t have any other medical conditions, you’re more likely to experience the following side effects:

Constipation is the most commonly reported side effect (in 2% of patients); Other side effects include diarrhea, nausea, itching, rash, and dry mouth. In general, side effects are relatively rare (only 4.7% of people taking sucralfate). Allergic reactions and bezoars (a buildup of indigestible material in the gastrointestinal tract) have been reported rarely. Hypersensitivity reactions that have occurred with sucralfate include shortness of breath, lip swelling, itching, rash, and hives.

Duodenal ulcer tends to be a recurring disease. Once discontinued, sucralfate will not affect the frequency or severity of future ulcerations.

May not be suitable for individuals with medical conditions affecting swallowing or altering the gag or cough reflex, or with a history of aspiration. Aspiration of sucralfate tablets has rarely occurred.

Sucralfate contains aluminum. After oral administration, small amounts of aluminum are absorbed. This can lead to aluminum accumulation in people with impaired kidney function or people taking other products containing aluminum (e.g. antacids).

Individuals with renal impairment may be more likely to experience side effects or aluminum accumulation with sucralfate. The dose of sucralfate may need to be reduced in elderly patients or patients with known renal impairment.

It is not known if sucralfate is safe in children.

May decrease absorption of some drugs including digoxin, fluoroquinolone antibiotics, phenytoin and thyroxine. These medications should be taken at least two hours before taking sucralfate.

Usually taken four times a day to treat ulcers and twice a day for ulcer care.

Use during pregnancy only if the potential benefits outweigh the risks. Animal studies have found no evidence of fetal harm in studies in pregnant women. It is not known whether sucralfate is excreted in human milk.

Note: In general, the elderly or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures), or people taking other medications are at higher risk of developing a wider range of side effects. Check out the full list of side effects

4. Conclusion

Sucralfate is used to treat duodenal ulcers. It appears to act directly on the ulcer, covering it with a protective film, and side effects are minimal.

5. Tips

The usual dosage for treating ulcers is four times a day on an empty stomach (at least one hour before meals and at bedtime). Take it as directed by your doctor. Continue for the recommended duration or until x-ray or endoscopic examination confirms ulcer healing.

You can also take antacids while using sucralfate; However, do not take an antacid within half an hour of a sucralfate dose.

Tell your doctor if you’re breastfeeding, pregnant, or accidentally become pregnant while taking sucralfate.

6. Response and Effectiveness

Sucralfate acts locally (meaning it acts directly on the lining of the stomach/duodenum – it does not need to be absorbed to have an effect).

Shortly after dissolution of the tablet, sucralfate forms an ulcer-adhesive complex with albumin exudate from the ulcer. The sucralfate-albumin film forms a barrier to the diffusion of hydrogen ions. In humans, at doses recommended for the treatment of ulcers, sucralfate inhibits gastric pepsin activity by 32%.

A dose lasts approximately 6 hours.

It can take up to eight weeks for an ulcer to fully heal.

Each 1 g dose of sucralfate neutralizes approximately 14 to 16 mEq of gastric acid.

7. Interactions

Sucralfate can reduce the absorption of some other medicines if taken at the same time of the day as these. In most cases, dosing the other drug two hours before sucralfate eliminates the interaction. Talk to your doctor about how drug interactions should be managed.

Common drugs whose absorption may be affected by sucralfate are:

Antibiotics such as ciprofloxacin, gemifloxacin, ketoconazole, levofloxacin, moxifloxacin, norfloxacin, ofloxacin, or tetracycline

aspirin

cimetidine

digoxin

L-thyroxine (levothyroxine)

nonsteroidal anti-inflammatory drugs such as diclofenac, ibuprofen, indomethacin, naproxen

phenytoin

phosphate supplements

quinidine

ranitidine

theophylline.

There have been some reports of sucralfate reducing the effects of warfarin; However, this has not been confirmed by clinical studies.

Sucralfate is best given separately (two hours apart) from other drugs.

references

sucralfate. Revised 10/2020. Actavis Pharma, Inc. https://www.drugs.com/ppa/sucralfate.html

Further information

Remember to keep this and all other medicines out of the reach of children, never share your medicines with others, and use sucralfate only for the prescribed indication.

Always check with your doctor to ensure that the information presented on this page is appropriate for your personal circumstances.

Copyright 1996-2022 Drugs.com. Revision Date: July 28, 2021.

Medical Disclaimer

Sucralfate is indicated for the short-term treatment (up to 8 weeks) of active duodenal ulcer. While healing with sucralfate may occur in the first 1 to 2 weeks, treatment should be continued for 4 to 8 weeks unless healing is demonstrated by x-ray or endoscopic examination.

Sucralfate is also indicated for maintenance therapy in patients with duodenal ulcers at a reduced dose after the acute ulcer has healed.

Sucralfate is available under the following different brand names: Carafate.

The dosage depends on your medical condition and your response to therapy.

Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time every day. Continue taking this medication even if you don’t feel any ulcer pain. Do not stop taking this medication without consulting your doctor. It may take 4 to 8 weeks for your ulcer to fully heal.

Some medications may not work as well if you take them at the same time as sucralfate. They may need to be taken at a different time of the day than when you take sucralfate. Ask your doctor or pharmacist for help in creating a dosing schedule that works for all of your medications.

Antacids can be used with this medicine, but they should be taken at least 30 minutes before or after sucralfate.

Tell your doctor if your condition persists or worsens after taking sucralfate for 4 weeks.

Endoscopy Open pop-up dialog Close endoscopy Endoscopy During an endoscopy, your doctor inserts a thin, flexible tube with a light and camera (endoscope) down your throat and into your esophagus. The tiny camera allows your doctor to examine your esophagus, stomach, and the beginning of your small intestine (duodenum).

To diagnose an ulcer, your doctor may first take a medical history and perform a physical exam. You may then need to undergo diagnostic tests, such as:

Laboratory tests for H. pylori. Your doctor may recommend tests to determine if the H. pylori bacterium is present in your body. He or she may check for H. pylori with a blood, stool, or breath test. The most accurate is the breath test. For the breath test, drink or eat something that contains radioactive carbon. H. pylori breaks down the substance in your stomach. Later you blow into a bag, which is then sealed. If you are infected with H. pylori, your breath sample will contain the radioactive carbon in the form of carbon dioxide. If you are taking an antacid before testing for H. pylori, be sure to tell your doctor. Depending on which test is used, you may need to stop taking the drug for a period of time because antacids can produce false-negative results.

endoscopy. Your doctor may use an endoscope to examine your upper digestive system (endoscopy). During endoscopy, your doctor inserts a hollow tube fitted with a lens (endoscope) down your throat and into your esophagus, stomach, and small intestine. Your doctor uses the endoscope to look for ulcers. If your doctor diagnoses an ulcer, a small sample of tissue (biopsy) may be taken for examination in a laboratory. A biopsy can also determine if H. pylori is in your stomach lining. Your doctor may be more likely to recommend an endoscopy if you’re older, have signs of bleeding, or have recently had weight loss or difficulty eating and swallowing. If endoscopy shows a stomach ulcer, a follow-up endoscopy should be done after treatment to show that it has healed, even if your symptoms improve.

Upper Gastrointestinal Series. Sometimes referred to as a barium swallow, this series of X-rays of your upper digestive system creates images of your esophagus, stomach, and small intestine. During the X-ray, you swallow a white liquid (which contains barium), which coats your digestive tract and makes an ulcer more visible.

Mayo Clinic Care Our caring team of Mayo Clinic professionals can help you with your health concerns related to stomach ulcers. Start here

treatment

Treatment for stomach ulcers depends on the cause. Treatment usually includes killing the H. pylori bacterium if it is present, eliminating or reducing the use of NSAIDs if possible, and healing your ulcer with medication.

Medications can include:

Antibiotic drugs to kill H. pylori. If H. pylori is found in your digestive tract, your doctor may recommend a combination of antibiotics to kill the bacterium. These may include amoxicillin (Amoxil), clarithromycin (Biaxin), metronidazole (Flagyl), tinidazole (Tindamax), tetracycline, and levofloxacin. Which antibiotics are used depends on where you live and current antibiotic resistance rates. You will likely need to take antibiotics for two weeks, as well as additional medications to reduce stomach acid, including a proton pump inhibitor and possibly bismuth subsalicylate (Pepto-Bismol).

Drugs that block acid production and promote healing. Proton pump inhibitors – also called PPIs – reduce stomach acid by blocking the action of the acid-producing parts of the cell. These drugs include the prescription and over-the-counter drugs omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), and pantoprazole (Protonix). Long-term use of proton pump inhibitors, especially at high doses, can increase your risk of hip, wrist, and spine fractures. Ask your doctor if calcium supplementation can reduce this risk.

Drugs to reduce acid production. Acid blockers — also called histamine (H-2) blockers — reduce the amount of stomach acid released into your digestive tract, which relieves ulcer pain and promotes healing. Prescription and over-the-counter antacids include the drugs famotidine (Pepcid AC), cimetidine (Tagamet HB), and nizatidine (Axid AR).

Antacids, which neutralize stomach acid. Your doctor may add an antacid to your drug regimen. Antacids neutralize existing stomach acid and can provide rapid pain relief. Side effects can include constipation or diarrhea depending on the main ingredients. Antacids can relieve symptoms but are not generally used to heal your ulcer.

Drugs that protect the lining of the stomach and small intestine. In some cases, your doctor may prescribe medications called cytostatics that help protect the tissues that line your stomach and small intestine. Options include the prescription drugs sucralfate (Carafate) and misoprostol (Cytotec).

Aftercare after initial treatment

Treatment of gastric ulcers is often successful and results in the ulcer healing. But if your symptoms are severe or persist despite treatment, your doctor may recommend an endoscopy to rule out other possible causes of your symptoms.

If an ulcer is found during endoscopy, your doctor may recommend another endoscopy after your treatment to make sure your ulcer has healed. Ask your doctor if you should have further tests after your treatment.

ulcers that don’t heal

Stomach ulcers that don’t heal with treatment are called refractory ulcers. There are many reasons an ulcer may not heal, including:

Not taking medication as directed

The fact that some types of H. pylori are resistant to antibiotics

Regular use of tobacco

Regular use of painkillers — like NSAIDs — which increase the risk of ulcers

Less commonly, refractory ulcers can result from:

Extreme overproduction of stomach acid, as occurs in Zollinger-Ellison syndrome

An infection other than H. pylori

stomach cancer

Other diseases that can cause ulcer-like sores in the stomach and small intestine, such as B. Crohn’s disease

Treatment of refractory ulcers generally involves eliminating factors that can interfere with healing and using various antibiotics.

If you have a serious ulcer complication, such as B. an acute bleeding or a perforation, you may need an operation. However, because of the many effective drugs available, surgery is required much less frequently than it used to be.

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lifestyle and home remedies

You can find relief from stomach ulcer pain if you:

Consider switching pain relievers. If you regularly take pain relievers, ask your doctor if acetaminophen (Tylenol, others) might be an option for you.

If you regularly take pain relievers, ask your doctor if acetaminophen (Tylenol, others) might be an option for you. control stress. Stress can worsen the signs and symptoms of a stomach ulcer. Look at the sources of your stress and do what you can to address the causes. Some stress is inevitable, but you can learn to manage it by exercising, spending time with friends, or by writing in a journal.

Stress can worsen the signs and symptoms of a stomach ulcer. Look at the sources of your stress and do what you can to address the causes. Some stress is inevitable, but you can learn to manage it by exercising, spending time with friends, or by writing in a journal. Do not smoke. Smoking can damage the protective lining of your stomach and make your stomach more prone to developing an ulcer. Smoking also increases stomach acid.

Smoking can damage the protective lining of your stomach and make your stomach more prone to developing an ulcer. Smoking also increases stomach acid. Limit or avoid alcohol. Excessive alcohol consumption can irritate and erode the lining of the stomach and intestines, which can lead to inflammation and bleeding.

alternative medicine

Products containing bismuth may help with stomach ulcer symptoms. There is also evidence that zinc can help heal ulcers. Mastic powder, the product of a type of evergreen shrub, may also help improve symptoms and speed up the healing of stomach ulcers.

While certain over-the-counter and alternative medications may be helpful, evidence of effectiveness is lacking. Therefore, they are not recommended as the primary treatment for peptic ulcer disease.

Prepare for your appointment

Make an appointment with your GP if you have any signs or symptoms that worry you. Your doctor may refer you to a specialist in the digestive system (gastroenterologist).

It’s a good idea to be well prepared for your appointment. Here’s some information to help you prepare and what to expect from your doctor.

What you can do

Observe all restrictions before the appointment. When making the appointment, ask if there’s anything you need to do in advance, such as B. Restricting your diet. Certain medications can affect stomach ulcer tests, so your doctor may want you to stop taking them. He or she may be able to suggest alternatives to these drugs for you.

When making the appointment, ask if there’s anything you need to do in advance, such as B. Restricting your diet. Certain medications can affect stomach ulcer tests, so your doctor may want you to stop taking them. He or she may be able to suggest alternatives to these drugs for you. Write down any symptoms you have and the foods you eat. People with stomach ulcers often have more symptoms when their stomach is empty.

as well as the food you eat. People with stomach ulcers often have more symptoms when their stomach is empty. Write down important personal information, including other medical problems, major stresses, or recent life changes.

including other medical problems, major stresses, or recent life changes. Make a list of all medications, including over-the-counter medicines, vitamins, or supplements, that you are taking. It is especially important to be aware of the use of pain relievers and the usual dose you are taking.

including any over-the-counter medication, vitamins, or supplements you are taking. It is especially important to be aware of the use of pain relievers and the usual dose you are taking. Write down questions to ask your doctor.

For stomach ulcers, there are a few questions you can ask your doctor:

What is the most likely cause of my symptoms?

What kind of tests do I need and how do I prepare for them?

Is my condition likely transient or chronic?

Am I at risk of complications related to this condition?

What treatment do you recommend?

If the initial treatment doesn’t work, what would you recommend next?

Are there any dietary restrictions I need to follow?

I have other medical problems. How can I treat these along with ulcers?

In addition to the questions you’d like to ask your doctor, don’t hesitate to ask additional questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you a number of questions. When you’re ready to answer them, you can take time to go through points you want to cover. Your doctor may ask:

When did you first experience symptoms?

Were your symptoms continuous or intermittent?

How severe are your symptoms?

Are your symptoms worse when you’re hungry?

What, if anything, have you taken to relieve your symptoms?

Does anything seem to improve your symptoms?

What, if anything, seems to be making your symptoms worse?

Do you take painkillers or aspirin? If yes, how often?

Do you feel nauseous or have you vomited?

Have you ever vomited blood or black material?

Have you noticed blood in your stools or black stools?

What you can do in the meantime

While you wait to see your doctor, avoiding tobacco, alcohol, spicy foods, and stress can help relieve your symptoms.

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Carafat is an anti-ulcer drug that forms a complex that coats the ulcer site and protects it from acid so it can heal.

For more information on Carafat go to:

https://www.drugs.com/carafate.html

There are other over the counter products that can be used to reduce stomach acid for heartburn, gastritis etc including H2 antagonists,

proton pump inhibitors and antacids.

For more information on these see:

https://www.drugs.com/drug-class/proton-pump-inhibitors.html

https://www.drugs.com/drug-class/h2-antagonists.html

https://www.drugs.com/drug-class/antacids.html