Sucralfate and Carafate: Same Medication with Different Names
Yes, Carafate and sucralfate are exactly the same medication - Carafate is simply the brand name for the generic drug sucralfate. 1
Medication Identity and Composition
Sucralfate is the generic name for this medication, while Carafate is a brand name under which it is marketed. According to the FDA drug label, sucralfate is chemically described as an α-D-glucopyranoside, β-D-fructofuranosyl-, octakis(hydrogen sulfate), aluminum complex 1. This medication has the following characteristics:
- It is a basic aluminum salt of sulphated sucrose 2
- It contains approximately 14-16 mEq of acid-neutralizing capacity per 1g dose 1
- The standard tablet formulation contains 1g of sucralfate along with inactive ingredients including corn starch, magnesium stearate, and microcrystalline cellulose 1
Mechanism of Action
Sucralfate works primarily through local rather than systemic action:
- Forms an ulcer-adherent complex with proteinaceous exudate at ulcer sites 1
- Creates a protective barrier against acid, pepsin, and bile salts 1, 3
- Inhibits pepsin activity in gastric juice by approximately 32% 1
- Adsorbs bile salts 1, 4
- Minimal systemic absorption (only 3-5% of an oral dose is absorbed) 3
- More than 90% is excreted unchanged in feces 3
Clinical Uses
Sucralfate/Carafate is primarily used for:
- Treatment of duodenal ulcers (FDA-approved indication) 1, 3
- Effective for NSAID-associated duodenal ulcers, particularly when the NSAID is discontinued 5
- Has been investigated for radiation proctitis management 6
- Has been used topically for various mucocutaneous conditions, though this is not FDA-approved 7
Important Clinical Considerations
- The American College of Cardiology notes that sucralfate is not effective for treatment or prevention of NSAID-related gastric ulcers 5
- PPIs are generally preferred over sucralfate for therapy and prophylaxis of NSAID and ASA-associated GI injury 5
- Research on sucralfate for prevention of radiation-induced diarrhea has shown mixed results, with some European trials showing benefit but other trials showing no improvement or even worsening of GI symptoms 6
Dosing
The standard dosage for duodenal ulcer treatment is 1g four times daily, taken one hour before meals and at bedtime 3.
Side Effects
Sucralfate is generally well-tolerated due to its minimal systemic absorption:
- Constipation is the most common side effect, occurring in approximately 2-4% of patients 2, 3
- Other reported side effects include dry mouth (xerostomia) in about 1% of patients and skin eruptions in 0.6% 3
- No significant drug-drug interactions have been reported 3
In summary, when a healthcare provider prescribes either Carafate or sucralfate, they are prescribing the exact same medication, just using either the brand name or generic name respectively.