Sucralfate absorption and food interaction
Pro Research Analysisby 
Searched over 200M research papers
Sucralfate Absorption and Food Interaction: Key Insights
Sucralfate and Drug Absorption: Impact of Food
Sucralfate can interact with certain drugs, especially antibiotics like quinolones, by forming complexes with metal ions that reduce drug absorption in the gut. Studies show that when sucralfate is taken together with drugs like ofloxacin or ciprofloxacin in a fasted state, the absorption of these antibiotics is significantly reduced—by up to 70% for peak plasma concentration and over 60% for overall exposure. However, when food is present, this negative interaction is lessened, with reductions in drug absorption dropping to about 30-40%14. This means that food can help decrease the extent of sucralfate’s interference with the absorption of these antibiotics, but some interaction still remains.
Food, Sucralfate, and Other Drugs
For other drugs such as naproxen and ketoprofen, sucralfate does not significantly change the total amount of drug absorbed (bioavailability), though it can slow down the rate at which naproxen is absorbed. In contrast, food alone can greatly reduce the absorption of ketoprofen, lowering its bioavailability by more than 40%. This suggests that while sucralfate’s impact on these drugs is minimal, food itself can have a much larger effect on how quickly and how much of the drug enters the bloodstream.
Timing of Sucralfate Administration
The timing of sucralfate administration is important. For example, when sucralfate is given two hours after levofloxacin, it does not affect the drug’s absorption or overall exposure. Food can slightly delay the absorption of levofloxacin, but does not reduce the total amount absorbed. This highlights that separating the timing of sucralfate and certain drugs can help avoid unwanted interactions.
Mechanism: Metal Chelation and Drug Interactions
The main reason for these interactions is that sucralfate contains aluminum, which can bind (chelate) with drugs like fluoroquinolones, forming complexes that are not easily absorbed by the body. This chelation effect is also seen with other sources of metal ions, such as antacids or dietary supplements containing magnesium or calcium. Food can reduce the extent of this chelation, but does not eliminate it entirely145.
Sucralfate Binding to Gastric Tissue and Food Effects
Sucralfate binds strongly to ulcerated areas in the stomach and duodenum, and this binding is not affected by food. However, food can reduce sucralfate’s binding to healthy tissue, suggesting that sucralfate remains effective at ulcer sites even when food is present.
Conclusion
Sucralfate can reduce the absorption of certain drugs, especially antibiotics like quinolones, through metal chelation in the gut. Food intake lessens but does not completely prevent this interaction. For some drugs, food itself can have a larger impact on absorption than sucralfate. The timing of sucralfate administration and the presence of food are both important factors in managing potential drug interactions. Sucralfate’s ability to bind to ulcerated tissue is not affected by food, supporting its continued use in ulcer treatment regardless of meals.
Sources and full results
Most relevant research papers on this topic