Carafate (Sucralfate) - Oral

What Is Carafate?

Carafate (sucralfate) is an orally administered prescription medication used to treat and prevent the reoccurrence of duodenal ulcers, a type of peptic ulcer. Carafate is categorized as a protectant and is approved for adults and children 3 months and older.

A peptic ulcer is an open sore in the stomach or intestine lining. When the ulcer is in the first part of the small intestine, it is called a duodenal ulcer.

To fully treat duodenal ulcers, treatment with antibiotics may be needed to heal ulcers caused by a form of H. pylori, a bacterial infection linked to the growth of ulcers and potentially cancer.

Carafate acts mainly in the gastrointestinal (GI) tract as an anti-ulcer agent and works by sticking to damaged ulcer tissue so healing can occur.

Carafate contains the active ingredient sucralfate. Sucralfate is available as an orally administered medication.

Carafate is available as a liquid suspension (a liquid with small pieces of drug) and tablets to be taken by mouth.

Drug Facts

Generic Name: Sucralfate
Brand Name: Carafate
Drug Availability: Prescription
Administration Route: Oral
Therapeutic Classification: Gastrointestinal (GI) agent
Available Generically: Yes
Controlled Substance: N/A
Active Ingredient: Sucralfate
Dosage Form(s): Tablet, liquid suspension

What Is Carafate Used For? 

The Food and Drug Administration (FDA) approved Carafate for:

  • Short-term treatment (up to eight weeks) of an active duodenal ulcer. While healing with sucralfate may occur within the first two weeks, treatment should be continued for four to eight weeks unless healing has been proven by an X-ray or endoscopic examination (a procedure that lets the healthcare provider view your gastrointestinal tract).
  • Maintenance therapy (treatment that maintains initial progress and deterrent of a condition) of duodenal ulcers at a reduced dosage after healing of acute (severe) ulcers.

You may also use Carafate tablets as a form of maintenance therapy at a lower dosage after the ulcers heal.

How to Take Carafate

Carafate is an oral medicine. You can take it in tablet or liquid suspension form. As such, the following instructions will guide users through safe and effective treatment:

  • Take Carafate on an empty stomach, one hour before or two hours after a meal. If you take an antacid, do not take it within 30 minutes of your Carafate dose.
  • If you use the suspension form of Carafate, shake the bottle well before using it. Also, ask your healthcare provider for a measuring cup to measure your dose accurately.
  • Do not use kitchen measuring devices for medication dosing.
  • You should only take the suspension by mouth; never inject the liquid into the body unless in the case of suspension treatment for proctitis due to radiation.
  • If you have diabetes, check your blood sugar regularly. Notify your healthcare provider of any changes in blood sugar.
  • Carafate may make you feel better within the first week or two.
  • However, do not stop taking the medication even if you feel better unless your healthcare provider tells you to do so. You must complete your entire prescription to ensure that you heal completely, which can take up to eight weeks.
  • Additionally, your healthcare provider may order an X-ray or endoscopy to monitor your ulcer’s healing.

Storage

Store Carafate at room temperature (68 to 77 degrees F), away from heat, direct light, and moisture. Do not store in a bathroom.

Keep Carafate in its original labeled container and out of the reach of children and pets. Do not allow the suspension to freeze.

Off-Label Uses

Healthcare providers may sometimes prescribe Carafate for off-label use or indications that are not yet FDA-approved. 

Off-label uses for Carafate can include:

Carafate suspension is sometimes used off-label as a rinse to treat pain associated with canker sores or to treat mouth sores due to chemo or radiation, as well as a rectal enema to treat inflamed rectal lining from ulcerative colitis or radiation.

How Long Does Carafate Take to Work?

You may start to feel better within one or two weeks of beginning Carafate. However, it is still important to continue to take your medication until your healthcare provider tells you it is safe to stop. Taking the entire course of therapy helps to ensure complete healing.

What Are the Side Effects of Carafate?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The most common side effect of Carafate is constipation. 

Other potential common side effects (reported in less than 0.5% of people in clinical trials) include:

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. 

Serious side effects can include:

  • Anaphylaxis (hypersensitivity reactions): Symptoms can include rash, hives, swelling around the lips, tongue, and face, and difficulty breathing
  • Hyperglycemia (high blood sugar): Occurs with the suspension form, not the tablet form
  • Bezoar formation (blockages in the digestive tract)

Long-Term Side Effects

When you take Carafate, your body absorbs a small amount of aluminum.

Taking Carafate with other sources of aluminum (such as antacids that contain aluminum) may cause the body to accumulate too much (toxicity). This mainly occurs in people with kidney problems.

Your healthcare provider can assess your risk for aluminum toxicity (a side effect of kidney issues).

Report Side Effects

Carafate may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Carafate Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (suspension):
    • To treat duodenal ulcers:
      • Adults—One gram (g) (10 milliliters [mL]) four times a day, taken on an empty stomach for 4 to 8 weeks.
      • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (tablets):
    • To treat duodenal ulcers:
      • Adults—One gram (g) four times a day, taken on an empty stomach for 4 to 8 weeks.
      • Children—Use and dose must be determined by your doctor.
    • To prevent duodenal ulcers:
      • Adults—One gram (g) two times a day, taken on an empty stomach.
      • Children—Use and dose must be determined by your doctor.

Modifications

In some cases, your healthcare provider may modify your dose or treatment:

Pregnancy: There are no adequate studies of Carafate use in humans during pregnancy. In animal studies, Carafate did not appear to harm the unborn fetus.

However, there is not enough data on humans to establish risk. If you are pregnant or plan to become pregnant while taking Carafate, consult your healthcare provider for advice. 

Breastfeeding: It is not known whether the drug passes through breast milk. Ask your healthcare provider before using Carafate if you are nursing. 

Children: Adolescents should have their use and dose determined by their healthcare provider.

Older Adults: If you are 65 years or older, your healthcare provider may start you on a lower dose of Carafate. This accounts for any potential kidney, liver, or heart problems. In addition, your healthcare provider may monitor your kidney function during your treatment. 

Kidney Problems: Because the kidneys work to eliminate Carafate, people with kidney problems have a greater risk of negative reactions to the drug. 

Off-Label Use: Carafate’s dosing and administration may change based on its use. For example, you may use Carafate off-label as an oral rinse to relieve canker sore pain. In some cases, Carafate is also used rectally as an enema. If your healthcare provider prescribes Carafate for off-label use, they will instruct you on how to take it. 

Missed Dose

If you miss a dose of Carafate, take it as soon as you can. Skip the missed dose if it is almost time for the next dose. Do not take two doses together. 

Overdose: What Happens If I Take Too Much Carafate?

There is a low risk of overdosing on Carafate because it is minimally absorbed.

In rare reports of overdose, most people did not have any symptoms. People who had overdose symptoms experienced heartburn, nausea, and vomiting.

What Happens If I Overdose on Carafate

If you think you or someone else may have overdosed on Carafate sucralfate, call your healthcare provider or the Poison Control Center (1-800-222-1222). If someone collapses or isn’t breathing after taking Carafate, call 911.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

This medicine may affect your blood sugar levels. Check with your doctor right away if you have increased thirst or increased urination. If you notice a change in the results of your urine or blood sugar tests, or if you have any questions, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Carafate?

Carafate is not appropriate for everyone. Some people should not take Carafate.

You should not take Carafate if you are allergic to sucralfate or any of the inactive ingredients. 

If you have problems with swallowing or any conditions that affect your cough or gag reflexes, you should avoid taking sucralfate in tablet form.

There have been reports of aspiration or breathing the drug into the airways, which can cause breathing complications from sucralfate tablets.

What Other Medications Interact With Carafate? 

Taking Carafate with certain medicines can affect how your body reacts to these drugs. 

Carafate may interact with the following medications:

You can typically take the other drug two hours before taking sucralfate to help eliminate the drug interaction.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter (OTC) medicines and vitamins or supplements.

Your healthcare provider can advise you on the proper spacing of your medications to avoid interactions. 

What Medications Are Similar?

Carafate is a unique drug because it acts locally to protect ulcers. However, other medicines may also treat ulcers. 

One popular class of drugs used to treat ulcers include proton pump inhibitors (PPIs). PPIs work by reducing acid production. 

Examples of PPIs include:

Histamine H2-receptor antagonists, known as H2 blockers, are another category of drugs used to treat ulcers. They also reduce acid production. 

Examples of H2 blockers include:

This list is a list of drugs also prescribed for stomach conditions. It is not a list of drugs recommended to take with Carafate. Ask your healthcare provider if you have questions.

Frequently Asked Questions

  • What is Carafate used for?

    Carafate is available as both a tablet and suspension. Both forms can treat duodenal ulcers. The tablet form can also be used as maintenance therapy after your ulcer has healed.

  • How does Carafate work?

    The way Carafate works is not entirely understood. Carafate is thought to form a complex which covers and protects the ulcer site, allowing it to heal.

  • What drugs should not be taken with Carafate?

    Although some drugs may interact with Carafate, separating the dose from Carafate by several hours can eliminate most drug interactions. Do not take an antacid within 30 minutes of a Carafate dose.

  • How long does it take for Carafate to work?

    While you may feel much better in just seven to 14 days, finishing the entire course of therapy is essential to make sure you heal completely. This may take up to eight weeks. Your healthcare provider will advise you on the length of treatment.

  • How do I safely stop taking Carafate?

    Your healthcare provider will advise you on how long to take Carafate. You will usually take it until you finish your prescribed amount. There is no need to wean yourself off of this drug.

How Can I Stay Healthy While Taking Carafate

When taking Carafate, follow your healthcare provider’s instructions for use.

Your healthcare provider may prescribe Carafate for up to eight weeks so that your ulcer heals completely. Even if you feel better in the first few weeks, continue to take your medicine as prescribed.

Because Carafate acts locally on the ulcer, very little is absorbed.

Therefore, Carafate generally has few side effects. The most common side effect is constipation. Increasing your intake of fluid and fiber can help reduce constipation. 

If you have diabetes and take the Carafate suspension, monitor your blood sugar regularly and notify your healthcare provider of any changes.

If you have any problems with swallowing or your gag or cough reflex, Carafate tablets may not be appropriate for you. Instead, talk to your healthcare provider about using the suspension form.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. DailyMed. Label: carafate- sucralfate tablet.

  3. John Hopkins Medicine. Stomach and duodenal ulcers (peptic ulcers).

  4. MedlinePlus. Sucralfate.

  5. DailyMed. Label: sucralfate tablet.

  6. Prescribers' Digital Reference. Sucralfate - drug summary.

  7. MedlinePlus. Proton pump inhibitors.

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  9. MedlinePlus. H2 blockers.

By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.