Sucralfate: What It Is and How to Use It Safely

Sucralfate is a medicine that protects the lining of your stomach and duodenum by forming a sticky barrier over ulcers. It doesn’t neutralize acid like antacids or block acid production like PPIs, but it helps injured tissue heal by shielding it from acid and enzymes. Because it acts locally and is minimally absorbed, many people tolerate it well—yet there are practical things you should know to use it safely and effectively.

How sucralfate works and when to use it

Sucralfate is mainly used for active duodenal ulcers and to help protect the gut lining in cases of stress ulcers or certain erosive conditions. Doctors sometimes prescribe it for reflux symptoms when other treatments aren’t suitable. It works by sticking to ulcer sites and creating a protective coat, which reduces irritation and helps tissue repair.

It’s not the first choice for long-term acid control. If you have chronic GERD or severe acid reflux, your provider may prefer a proton-pump inhibitor or H2 blocker instead. Sucralfate can be a good option when those drugs are contraindicated or when local protection is the goal.

Taking sucralfate: dose, timing, side effects, and interactions

Typical adult dosing is 1 gram four times a day, given one hour before meals and again at bedtime. There’s also a liquid suspension, which some people find easier to swallow and that may coat the stomach better. For kids or specific conditions, your doctor will give a tailored dose.

Key dosing tips: always take it on an empty stomach when possible, don’t crush extended-release pills (there aren’t many), and keep a two-hour gap between sucralfate and other medications you take by mouth. Sucralfate can bind drugs like fluoroquinolones, tetracyclines (doxycycline), levothyroxine, and phenytoin, making them less effective if given too close together.

Common side effects are mild: constipation is the most reported. Because sucralfate contains aluminum, people with kidney failure should use it cautiously—aluminum can build up in the body. If you notice severe constipation, confusion, muscle weakness, or unusual tiredness, contact your provider.

Buying tips: sucralfate may be prescription-only in some places. When shopping online, choose a licensed pharmacy with clear contact info, pharmacist access, and positive reviews. Avoid sites offering unusually low prices without requiring a prescription. Keep your medication stored at room temperature and follow the expiry date on the package.

If you’re pregnant, breastfeeding, elderly, or have kidney disease, talk to your clinician before starting sucralfate. It’s a straightforward drug when used correctly, but timing, interactions, and kidney function matter more than you might expect.