Ralfate Oral 20 mg/100 ml Suspension

Ulcer-coating agent (forms a protective barrier) for:

• Duodenal and gastric ulcers (treatment and prevention of relapse)
• Chronic gastritis
• Prevention of stress ulcers in critically ill patients
• Mouth ulcers and oesophagitis (suspension, some uses)

Adults: 1 g four times daily (1 hour before each meal and at bedtime) or 2 g twice daily, for 4–8 weeks (up to 12 weeks); maximum 8 g daily.

Prevention of duodenal ulcer relapse: 1 g twice daily.

Stress ulcer prevention: 1 g every 4–6 hours (via tube).

• Take on an empty stomach. Tablets may be dispersed in water.
• Not recommended for children under 15 (except specialist use).

• Allergy to sucralfate
• Severe kidney failure on dialysis (aluminium accumulation — caution/avoid)

Common: constipation.

Less common: dry mouth, nausea, indigestion, wind, rash, dizziness.

Rare: bezoar formation (in tube-fed patients or poor stomach emptying), aluminium accumulation in kidney failure, raised blood sugar (suspension in diabetes).

• Kidney impairment: avoid long-term use.
• Tube feeding: risk of bezoars.
• Diabetes: suspension may raise sugar.

Considered safe in pregnancy and breastfeeding (minimal absorption).

Reduces absorption of many drugs — take them 2 hours before sucralfate:

• Quinolones (ciprofloxacin), tetracyclines, digoxin, warfarin, phenytoin, levothyroxine, ketoconazole, theophylline, H2 blockers
• Antacids: take 30 minutes before or after
• Enteral feeds (bezoars)

Unlikely to be harmful. Supportive care.

Store below 30°C.