Sucralfate with Cimetidine Interaction Details
Brand Names Associated with Sucralfate
- Carafate®
- Sucralfate
Brand Names Associated with Cimetidine
- Cimetidine
- Tagamet®
- Tagamet® HB
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 25, 2023
Interaction Effect
Decreased cimetidine absorption, decreased sucralfate effectiveness
Interaction Summary
It has been proposed that cimetidine absorption may be impaired with sucralfate, and sucralfate binding to ulcer sites may be impaired with H2 antagonists (due to increased intragastric pH). However, preliminary animal data indicate that cimetidine does not affect the binding of sucralfate to ulcer sites, and sucralfate does not appear to significantly affect the rate or extent of cimetidine absorption in humans. Furthermore, a controlled clinical study showed no difference in ulcer healing efficacy with combined cimetidine/sucralfate therapy as compared to either agent used alone .
Severity
Minor
Onset
Delayed
Evidence
Theoretical
How To Manage Interaction
Concurrent administration of cimetidine and sucralfate is not recommended. If concurrent use cannot be avoided, administer sucralfate at least two hours after the cimetidine dose.
Mechanism Of Interaction
Decreased cimetidine bioavailability/decreased sucralfate binding to ulcer sites
Literature Reports
A) Sixty-one patients receiving either cimetidine or sucralfate alone or the two drugs in combination were evaluated for ulcer healing efficacy. For the combination therapy patients, 1 g sucralfate was given one hour before meals (three times daily) and one hour before bedtime, and 300 mg cimetidine was given with meals (three times daily) and at bedtime. No antacids were allowed during the 8 week study. By the fourth and eighth weeks of the study, healing efficacy was the same for all groups .
Sucralfate Overview
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Sucralfate is used to treat and prevent the return of duodenal ulcers (ulcers located in first part of the small intestine). Treatment with other medications, such as antibiotics, may also be necessary to treat and prevent the return of ulcers caused by a certain type of bacteria (H. pylori) Sucralfate is in a class of medications called protectants. It sticks to damaged ulcer tissue and protects against acid and enzymes so healing can occur.
Cimetidine Overview
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Cimetidine is used to treat ulcers; gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and injury of the food pipe (esophagus); and conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome. Over-the-counter cimetidine is used to prevent and treat symptoms of heartburn associated with acid indigestion and sour stomach. Cimetidine is in a class of medications called H2 blockers. It decreases the amount of acid made in the stomach.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.