How to Take Carafate (Sucralfate)
Carafate tablets should be swallowed whole with water, not chewed or dissolved, and taken on an empty stomach one hour before meals and at bedtime. 1
Standard Administration Method
- Swallow tablets whole with water without chewing or crushing 1
- Take 1 gram (1 tablet) four times daily: one hour before each meal and at bedtime 1, 2
- The medication must be taken on an empty stomach to ensure proper binding to ulcerated tissue 2, 3
Why This Method Matters
The intact tablet formulation is critical for sucralfate's mechanism of action:
- When exposed to gastric acid, sucralfate transforms into a viscous, adhesive substance that selectively binds to ulcer sites for up to 6 hours 2, 4
- This binding creates a protective barrier against acid, pepsin, and bile salts specifically at damaged mucosal areas 4, 3
- The drug forms electrostatic bonds between negatively charged sucralfate molecules and positively charged proteins at ulcer sites 4
- Approximately 90% of the dose remains unabsorbed and works locally in the gastrointestinal tract 2, 3
Critical Safety Considerations for Swallowing
Aspiration risk is a serious concern with sucralfate tablets 1:
- Use with extreme caution in patients with impaired swallowing, recent intubation, tracheostomy, dysphagia, or conditions affecting gag/cough reflexes 1
- Isolated reports of tablet aspiration with respiratory complications have been documented 1
- Ensure adequate water intake when swallowing to prevent choking 1
Drug Interaction Timing
- Separate sucralfate from other medications by at least 2 hours to prevent binding interactions 1
- Sucralfate can reduce absorption of multiple drugs including antibiotics, thyroid medications, anticoagulants, and cardiac medications 1
- This separation is essential because the mechanism is non-systemic binding in the GI tract 1
Why NOT to Dissolve or Chew
Altering the tablet formulation would likely compromise: