5 Sucralfate (Carafate) Side Effects and How to Manage Them

Imagine wearing a glove to protect your hands from the cold, heat, or other harsh elements. This is similar to what sucralfate (Carafate) does; it’s like a protective glove for your intestine. It coats your intestinal lining and blocks acid from damaging it. Sucralfate’s protective layer allows duodenal ulcers — ulcers in the first part of the intestine — to get better.

Sucralfate is available as an oral tablet and a liquid suspension. The tablets come in a 1 g dose, while the suspension is available as a 1 g/10 mL concentration. The suspension is FDA approved to treat active duodenal ulcers in the short-term (up to 8 weeks). The tablets, though, are also approved as a maintenance treatment to prevent ulcers in the future.

When you take sucralfate, it mostly hangs out in the intestine. Your body doesn’t absorb much of it. This means most people tolerate it well. But, as with any medication, there are still possible sucralfate side effects to be aware of.

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Sucralfate side effects at a glance

Sucralfate isn’t likely to cause serious side effects. Most are mild and don’t occur often. Of the possibilities, the most common sucralfate side effect is constipation. Other less common side effects include:

• Nausea and vomiting

• Feeling gassy (flatulence)

• Dry mouth

• Skin rashes 

Here, we’ll detail five relevant sucralfate side effects and how to manage them. Make sure to talk to a healthcare professional if any of these side effects get worse or don’t go away after finishing your course of sucralfate. 

1. Constipation

Sucralfate works in the digestive tract. So it’s no wonder that constipation is a possibility while you’re taking it. In fact, it’s considered the most common side effect of sucralfate. Sucralfate is thought to cause constipation by slowing the movement of water and other fluids in the digestive tract. 

In many cases, you can prevent or relieve constipation with quick, simple lifestyle changes. Exercising regularly and eating more fiber are two starting points. You can also take an over-the-counter (OTC) medication to help if needed. This includes a stool softener, such as docusate (Colace), or a stimulant laxative, such as senna (Senokot).

2. Nausea and vomiting

Another gut-related side effect of sucralfate is nausea and vomiting. Though, this is not as common as constipation. Sucralfate has to be taken on an empty stomach, which may explain why it can cause nausea and vomiting.

EXPERT PICKS: WHAT TO READ NEXT

• Interactions alert: See which medications and foods may potentially interact with sucralfate and make it less effective.

• To eat or not to eat? Pharmacists explain why you should take sucralfate on an empty stomach.

• What’s the best sucralfate dosage? The truth is it can vary. Read more to see what experts have to say.

In some cases, taking medications with food can prevent nausea. But this is not a tactic to use with sucralfate. The medication shouldn’t be paired with food. If you do, the medication likely won’t coat and heal your ulcer properly.

Nausea will likely improve over the weeks that you continue to take sucralfate. It’s also important to stay hydrated and eat bland foods temporarily to manage nausea. But if it becomes intolerable at any point, make sure to talk to a healthcare professional about what to do next.

Keep in mind: Food can interact with sucralfate. Food can block sucralfate from properly coating and healing ulcers. Remember to separate meals and snacks by at least 1 hour before or 2 hours after taking sucralfate.

3. Feeling gassy

Sucralfate may leave you feeling gassy. When your digestive tract slows, this can lead to feeling bloated or passing gas, also called flatulence. This can feel quite uncomfortable or embarrassing, depending on the circumstance.

One way to prevent this is by paying close attention to how different food and drinks make you feel. This is especially relevant during the first few weeks that you’re taking sucralfate.

There aren’t specific foods to avoid, but it’s best to avoid foods that make you more gassy, worsen your abdominal pain, or cause heartburn. This includes spicy and high-fat foods. 

4. Dry mouth

Another possible side effect of sucralfate is dry mouth (xerostomia). In fact, dry mouth is relatively common with a lot of medications. This can happen if the medication causes your saliva production to go down. 

If you’re experiencing dry mouth from taking sucralfate, there are a few things you can try at home, such as:

• Chewing sugar-free gum to help stimulate saliva production

• Sipping cool liquids or sucking on ice chips throughout the day

• Trying a saliva substitute, such as Biotène oral rinse

If the problem continues or worsens, talk to a healthcare professional about what to do next. They may recommend a sucralfate dose adjustment or a prescription dry mouth medication, among other options.

5. Skin rashes

Sucralfate may cause a skin rash or itchy skin, but this is rare. It can appear as red or brown patches on the skin, bumps, or even peeling. This type of medication-related skin breakout is usually mild and passes quickly. You can use cold compresses or take oatmeal baths to help lessen your symptoms in the meantime.

However, if a rash comes back every time you take sucralfate or it worsens over time, it might be an allergic reaction that requires medical attention. Talk to a healthcare professional in this case. 

More serious allergic rashes are also possible. If you have severe skin symptoms at any point after taking sucralfate, it’s important to get emergency medical help right away. This may include symptoms like your rash covering a large patch of skin or developing into blisters.

Does sucralfate make you lose weight?

Possibly. Some data suggest that sucralfate may cause weight loss as a side effect. 

How does it do this? By coating the intestine, sucralfate blocks your body from absorbing fats and sugars from food. This may potentially lead to weight loss. This mimics what happens following gastric bypass surgery, which is a more long-term weight loss option.

However, sucralfate is not approved nor properly studied as a weight-loss medication. It’s not a reliable way to lose weight. It’s important to talk to a healthcare professional if you’re wondering about weight-loss treatments. They can recommend safe and approved options, if you’re eligible.

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Written by:

Hindu Rao, PharmD, APh, BCACP

Hindu Rao, PharmD, APh, BCACP is a clinical assistant professor of pharmacy practice at Chapman University School of Pharmacy and a clinical pharmacist at Providence Medical Foundation. She specializes in chronic disease management and has her board certification in ambulatory care.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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