What is Carafate made of? Exploring the ingredients of this ulcer medication

October 8, 2025 •

4 min read

First approved by the FDA in 1982 for tablet form, Carafate is a mucosal protective agent that works by coating ulcers rather than neutralizing stomach acid. For patients wondering what is Carafate made of, the answer lies in its key component, sucralfate, a unique complex derived from a sugar and aluminum.

Quick Summary

Carafate's primary component is sucralfate, an aluminum salt of sucrose octasulfate. This medication forms a viscous, protective paste that selectively coats ulcers and erosions in the digestive tract. It protects the stomach lining from acid, pepsin, and bile salts, promoting healing through a localized, non-systemic mechanism of action.

Key Points

Sucralfate is the active ingredient: The primary component of Carafate is sucralfate, a complex of sucrose octasulfate and aluminum hydroxide.
Forms a protective barrier: In the acidic stomach, Carafate forms a viscous, gel-like paste that selectively binds to ulcer sites, creating a physical barrier.
Heals through a local mechanism: Carafate's action is not systemic; it promotes healing by protecting the ulcer from acid and pepsin and by stimulating protective compounds like prostaglandins.
Contains varying inactive ingredients: Inactive ingredients such as colors, flavors, and preservatives differ based on the formulation, such as the tablet or oral suspension.
Minimal aluminum absorption: Only a small amount of aluminum is absorbed, but patients with chronic kidney failure must use caution to avoid aluminum toxicity.
Different from acid blockers: Unlike medications like omeprazole, Carafate does not inhibit stomach acid production; it simply protects against it.
Potential for drug interactions: Carafate can interfere with the absorption of other oral medications, so a specific dosing schedule is required.

The Core Component: Sucralfate

The most important ingredient in Carafate is sucralfate, a cytoprotective medication that acts locally on the gastrointestinal tract. Chemically, sucralfate is a complex of sucrose, a disaccharide sugar, with sulfate and aluminum hydroxide. In the acidic environment of the stomach, this complex undergoes a chemical reaction.

The Chemical Transformation in the Stomach

When Carafate is ingested and reaches the stomach, the acidic conditions trigger a series of events. The aluminum and sulfate components of the sucralfate molecule dissociate. The resulting highly polar anions then bind to positively charged proteins that are exposed at the site of mucosal injuries, such as ulcers. This binding action creates a thick, viscous, gel-like substance that forms a protective layer, or physical barrier, over the damaged tissue. This selective adherence to ulcerated areas allows the medicine to remain effective for up to six hours, shielding the vulnerable tissue from further corrosive damage caused by stomach acid, pepsin, and bile salts.

A Localized Mechanism of Action

Unlike medications that reduce or neutralize stomach acid, such as proton pump inhibitors (PPIs) or antacids, Carafate's effect is primarily localized to the ulcer site. The protective barrier it forms not only shields the ulcer but also helps create a more favorable environment for healing. Additionally, studies suggest that sucralfate may promote healing through other mechanisms, including stimulating local production of prostaglandins, which are compounds known to protect the stomach lining and increase mucus secretion. It also binds to epidermal growth factors, further contributing to mucosal repair.

The Role of Inactive Ingredients

In addition to the active ingredient, sucralfate, Carafate products contain various inactive ingredients that contribute to their form, stability, and palatability. These ingredients differ between the tablet and oral suspension formulations.

Inactive Ingredients in Carafate Tablets

D&C Red #30 Lake and FD&C Blue #1 Lake: These are coloring agents used to give the tablets their light pink appearance.
Magnesium Stearate: This compound acts as a lubricant, preventing the tablet mixture from sticking to manufacturing equipment.
Microcrystalline Cellulose and Starch: These serve as fillers and binders, holding the tablet together and aiding in its disintegration in the stomach.

Inactive Ingredients in Carafate Suspension

Colloidal Silicon Dioxide: A thickening agent that helps maintain the suspension's consistency.
FD&C Red #40: A coloring agent, giving the suspension its characteristic pink color.
Flavor (Cherry): Added to improve the taste, which is particularly important for an oral suspension.
Glycerin and Sorbitol: Sweeteners and solvents that contribute to the suspension's texture and taste.
Methylcellulose and Microcrystalline Cellulose: Suspending agents that prevent the active ingredient from settling.
Methylparaben: A preservative used to prevent the growth of mold and bacteria.
Simethicone: An anti-foaming agent.
Purified Water: The main solvent for the suspension.

Comparison: Carafate vs. Acid-Reducing Medications

To better understand Carafate's unique composition and action, it's helpful to compare it with other common treatments for gastrointestinal issues.


Feature	Carafate (Sucralfate)	Omeprazole (Prilosec)	Antacids (e.g., Tums, Maalox)
Drug Class	Mucosal Protective Agent	Proton Pump Inhibitor (PPI)	Acid Neutralizer
Active Ingredient	Sucralfate (sucrose-aluminum complex)	Omeprazole	Calcium carbonate, aluminum hydroxide, etc.
Mechanism	Forms a physical barrier over ulcers to protect from acid, pepsin, and bile salts.	Reduces stomach acid production by blocking the enzyme that produces it.	Neutralizes existing stomach acid.
On-Label Use	Short-term treatment of duodenal ulcers; maintenance therapy.	Treatment of GERD, erosive esophagitis, and other conditions involving excess acid.	Symptomatic relief of heartburn and indigestion.
Common Side Effects	Constipation, nausea, dry mouth.	Headache, stomach pain, nausea.	Diarrhea or constipation.
Drug Interactions	Binds to and reduces absorption of many drugs; must be separated by at least 2 hours.	Fewer interactions, but can affect some drugs like clopidogrel.	Can interfere with absorption of other drugs if taken close together.

Safety and Precautions Regarding Aluminum

Because sucralfate is a sucrose-aluminum complex, a small amount of aluminum is absorbed by the body. For individuals with normal kidney function, this minimal amount is easily excreted. However, for patients with chronic renal failure or those on dialysis, excretion is impaired, and there is a risk of aluminum accumulation and toxicity. Therefore, Carafate should be used with caution in these specific patient populations. Additionally, the risk of aluminum toxicity is increased if Carafate is taken alongside other aluminum-containing products, like some antacids.

Conclusion

Carafate's composition, centered on the unique sucrose-aluminum complex known as sucralfate, defines its function as a targeted, local-acting ulcer treatment. By forming a protective barrier and stimulating healing factors, it addresses gastrointestinal injuries without relying on the systemic suppression of stomach acid. While generally safe and effective, its aluminum content necessitates caution, particularly for patients with compromised kidney function. Understanding what is Carafate made of highlights the distinction between a protective medication and an acid-reducing one, underscoring its specific role in managing gastrointestinal disorders.

For more detailed information on Carafate's specific inactive ingredients and usage guidelines, refer to the official FDA product labeling.

Frequently Asked Questions

Sucralfate is the active ingredient in the brand-name drug Carafate. It is a complex compound consisting of sucrose (sugar), sulfate, and aluminum hydroxide.

Yes, the active ingredient sucralfate is chemically derived from sucrose, a type of sugar. However, its structure is complexed with sulfate and aluminum and it does not act like a typical sugar.

When it comes into contact with stomach acid, sucralfate forms a thick, paste-like substance. This paste then binds to the positively charged proteins at the ulcer site, creating a protective barrier that shields the ulcer from acid, pepsin, and bile salts.

While the active ingredient, sucralfate, is the same, the inactive ingredients differ. For example, the oral suspension contains ingredients like flavor, glycerin, and preservatives not found in the tablets.

No, Carafate is not an antacid. It functions by forming a protective barrier over an ulcer rather than neutralizing stomach acid. In fact, antacids should be taken at least 30 minutes after Carafate to avoid interfering with its action.

The aluminum in sucralfate is complexed with the sucrose octasulfate. In the presence of stomach acid, the aluminum allows the sucralfate to form its protective, adhesive barrier over the ulcer site.

Aluminum absorption from Carafate is minimal in individuals with normal kidney function. However, patients with chronic renal failure or those on dialysis are at a higher risk of aluminum toxicity because they cannot excrete the absorbed aluminum efficiently.