How to Apply Sucralfate?: A Complete Patient Guide

October 8, 2025 •

4 min read

Sucralfate, a mucosal protective agent, is widely used to treat and prevent duodenal and other gastrointestinal ulcers. Understanding precisely how to apply sucralfate is crucial for ensuring the medication effectively forms its protective barrier and aids in healing, as timing and technique are critical for its action.

Quick Summary

A guide detailing the correct application methods for sucralfate, including specific instructions for taking oral tablets and suspension and administering rectal enemas. Key information on timing doses around meals and other medications is also provided to maximize therapeutic benefits.

Key Points

Timing is Crucial: Take oral sucralfate on an empty stomach, at least one hour before or two hours after meals, to allow for proper coating of the ulcer.
Separate Medications: Space other oral medications at least two hours away from sucralfate to prevent interactions that reduce their absorption and effectiveness.
Shake Suspension Well: If using the liquid suspension, shake the bottle thoroughly before each dose to ensure uniform medication distribution.
Complete the Course: Finish the full prescribed course of treatment, even if symptoms improve, as healing can take several weeks.
Manage Constipation: Constipation is a common side effect; increase fiber and water intake to manage it effectively.
Rectal Enema Technique: For enemas, lie on your left side with knees bent, insert the catheter slowly, and retain the solution for at least 15 minutes.
Do Not Crush Tablets: Tablets should be swallowed whole with water and not crushed or chewed, unless specifically instructed by a doctor.

Understanding Sucralfate's Mechanism of Action

Sucralfate is unique in its function, acting locally rather than being absorbed systemically to a large degree. In the acidic environment of the stomach (with a pH below 4), sucralfate undergoes a chemical reaction that creates a sticky, viscous, paste-like material. This substance then selectively binds to the positively charged proteins found in the damaged tissue of ulcers and erosions, forming a protective barrier or coat. This barrier serves several crucial purposes:

Protects from further harm: It shields the ulcer site from the corrosive effects of stomach acid, bile salts, and pepsin.
Stimulates healing: It enhances the production of prostaglandins, which stimulate mucus and bicarbonate secretion, and increases growth factors to aid in cell regeneration.
Minimizes systemic side effects: Since very little of the medication is absorbed into the bloodstream, its potential for systemic side effects is low. Because this activation requires an acidic environment and adherence to damaged tissue, proper administration is vital to ensure the medication works as intended.

Oral Administration: Tablets and Suspension

Sucralfate is most commonly prescribed as an oral tablet or a liquid suspension. The specific instructions vary slightly depending on the form.

How to Take Sucralfate Tablets

Take on an empty stomach, usually one hour before meals and at bedtime, as directed by your doctor. Taking it on an empty stomach allows it to effectively coat the ulcer without being diluted by food.
Swallow the tablet whole with a full glass of water. Do not crush, chew, or dissolve the tablet unless your doctor specifically instructs you to do so.

How to Take Sucralfate Oral Suspension

Shake the bottle well before measuring each dose to ensure the medication is evenly mixed.
Use a marked measuring spoon, oral syringe, or medicine cup to accurately measure the prescribed dose. Do not use a household spoon, as it may not be accurate.
Take on an empty stomach, typically one hour before meals and at bedtime.

Rectal Administration: Sucralfate Enema

In some cases, sucralfate may be prepared and administered as a rectal enema to treat conditions like radiation proctitis or diversion colitis. This is an off-label use and should only be done under a doctor's supervision.

How to Prepare a Sucralfate Enema

Preparation: Wash your hands and gather the necessary equipment, which typically includes the sucralfate suspension, a syringe, and an applicator catheter. Some methods may require mixing sucralfate tablets with water. Always follow the specific instructions from your healthcare provider or pharmacist.
Mix the Solution: Draw up the prescribed amount of sucralfate suspension into the syringe. If instructed, draw up an equal amount of warm tap water and mix thoroughly.
Expel Air: Gently push the plunger to expel any excess air from the syringe before use.

How to Administer a Sucralfate Enema

Positioning: Lie on your left side with your knees bent towards your chest. Placing a towel underneath can help catch any leakage.
Insertion: Attach the lubricated catheter to the syringe tip. Gently and slowly insert the catheter about 10 cm into the rectum.
Injection: Press the syringe plunger with slow, steady pressure until all the liquid has been administered.
Retention: Remove the catheter and remain lying down for at least 15-30 minutes to allow the medication to be retained. Rolling over a few times can help the medication reach the affected areas.
Clean up: Wash the syringe and catheter with warm water and wash your hands thoroughly.

Important Considerations for All Forms

Interactions with Other Medications

Sucralfate can interfere with the absorption of other orally administered drugs. It is essential to space out your medication schedule appropriately. As a general rule, take other oral medications at least two hours before or after sucralfate. Specifically, for antacids, a waiting period of at least 30 minutes is recommended. Always consult your pharmacist for a personalized schedule, especially if you are taking medications like:

Warfarin (blood thinner)
Levothyroxine (thyroid hormone)
Certain antibiotics (e.g., fluoroquinolones like ciprofloxacin)
Digoxin (heart medication)

Duration of Treatment

It is crucial to complete the entire course of treatment prescribed by your doctor, even if your symptoms improve quickly. Healing of an ulcer can take 4 to 8 weeks, and stopping early may lead to a recurrence.

Managing Side Effects

Constipation is the most common side effect of sucralfate, affecting 1-10% of users. To manage this, increase your fiber and water intake, and consult your doctor about stool softeners if needed.

Comparison of Sucralfate Forms


Feature	Oral Tablet	Oral Suspension	Rectal Enema
Best For	Duodenal and stomach ulcers, maintenance therapy	Duodenal and stomach ulcers, easier swallowing	Radiation proctitis, diversion colitis
Administration	Swallow whole with water	Shake well, measure dose	Administered into the rectum with a syringe
Timing	Empty stomach, 1 hr before meals and at bedtime	Empty stomach, 1 hr before meals and at bedtime	As directed by doctor; typically twice daily
Key Benefit	Convenient, standard dosing	Good for patients with swallowing difficulty; coats throat/esophagus	Direct application to the site of inflammation
Potential Issues	May be difficult to swallow for some	Taste and texture may be disliked	Requires specific preparation and retention time

Conclusion

Regardless of the form, applying sucralfate correctly is vital for its effectiveness in protecting and healing damaged gastrointestinal tissue. By following your doctor's dosing instructions, adhering to the critical timing of administration, and being mindful of interactions with food and other medications, you can ensure optimal outcomes. Always consult a healthcare professional for personalized guidance on using sucralfate and to manage any side effects or concerns. More information on general drug administration guidelines is available from authoritative sources like the U.S. National Library of Medicine.

Frequently Asked Questions

No, you should take oral sucralfate on an empty stomach. For best results, take it one hour before meals or two hours after eating. Food can interfere with the medication's ability to coat the stomach and ulcers effectively.

You should generally take other oral medications at least two hours before or after your sucralfate dose to prevent interactions that can reduce the absorption of other drugs. For antacids, wait at least 30 minutes.

Both forms are used to treat ulcers, but the suspension is a liquid that can be easier for some patients to swallow. It may also provide a more immediate coating effect. The tablets are swallowed whole with water.

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to catch up.

The most common side effect is constipation. Other possible side effects include dry mouth, nausea, gas, and dizziness. If you experience persistent or severe side effects, contact your doctor.

You should not crush sucralfate tablets unless your doctor specifically advises you to. They are designed to be swallowed whole with a glass of water.

A sucralfate enema is an off-label treatment used rectally for conditions such as radiation proctitis and diversion colitis, which involve inflammation or bleeding in the lower bowel. Instructions for use will be provided by your doctor or pharmacist.

While sucralfate helps treat and heal ulcers by protecting the damaged lining, it addresses the symptoms and aids the healing process, but it may not address the underlying cause of the ulcer. It is important to work with your doctor to identify and treat the root cause to prevent recurrence.

Sucralfate can be used in children, but its use and dosage should be determined by a pediatrician or other qualified healthcare professional. They will consider the child's specific condition and weight.

Store sucralfate tablets and suspension at room temperature, away from moisture and heat. Keep the bottle tightly closed and out of the reach of children.