Sucralfate with Sparfloxacin Interaction Details
Brand Names Associated with Sucralfate
- Carafate®
- Sucralfate
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 25, 2023
Interaction Effect
Decreased sparfloxacin efficacy
Interaction Summary
Aluminum and magnesium cations in sucralfate and antacids form chelation complexes when given with sparfloxacin. Coadministration of sparfloxacin and sucralfate may also result in decreased serum concentrations of sparfloxacin, leading to loss of therapeutic efficacy. Although not reported specifically for sparfloxacin, a similar interaction may be expected. A manufacturer for ciprofloxacin recommends to administer ciprofloxacin at least 2 hours before or 6 hours after sucralfate. Although this recommendation has not been specifically made for sparfloxacin, the same administrative delay may be appropriate for other quinolones .
Severity
Moderate
Onset
Rapid
Evidence
Probable
How To Manage Interaction
Concurrent administration of sparfloxacin and sucralfate is not recommended. If concurrent use cannot be avoided, sparfloxacin should be taken at least two hours before or four hours after sucralfate. Because staggered administration may not be completely reliable, monitor these patients for continued antibiotic efficacy.
Mechanism Of Interaction
Reduced sparfloxacin bioavailability
Literature Reports
A) Maximum concentration and area under the concentration-time curve of sparfloxacin were decreased by 22% and 35%, respectively, in six healthy volunteers who received concurrent aluminum hydroxide 1 gram and sparfloxacin 200 mg . The mechanism of action may be chelation of the fluoroquinolone with the cation. Sparfloxacin was less affected by aluminum hydroxide compared with other fluoroquinolones.
B) The oral bioavailability of sparfloxacin is decreased when an aluminum-magnesium suspension is administered between two hours before and two hours after the administration of sparfloxacin. However, the bioavailability is not reduced when the aluminum-magnesium suspension is given four hours after sparfloxacin administration .
C) Four male and four female healthy Japanese volunteers participated in a four-period, raondomized crossover study to determine the effect of sucralfate 1.5 g on sparfloxacin absorption. Treatment A consisted of a single dose of sparfloxacin 300 mg. Treatments B, C, and D included sucralfate 1.5 g every 12 hours for five doses. Sparfloxacin 300 mg was administered concurrently with the last dose of sucralfate in treatment B, was given two hours prior to the last dose of sucralfate in treatment C, and was given four hours prior to the last dose of sucralfate in treatment D. When administered concurrently, sucralfate decreased the mean area under the concentration-time curve (AUC) of sparfloxacin from 35.96 mccg/mL/h to 17.65 mcg/mL/h and decreased the mean maximum concentration (Cmax) 2.1-fold (from 1.3 mcg/mL to 0.62 mcg/mL). When sucralfate was given two hours after sparfloxacin, the mean AUC of sparfloxacin was decreased 1.5-fold (35.96 mcg/ml/h vs. 23.82 mcg/mL/h) and the mean Cmax was decreased from 1.3 mcg/mL to 0.91 mcg/mL. During treatment D, when the drugs were spaced four hours apart, there was no significant effect on the mean AUC or Cmax of sparfloxacin .
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.
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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.