How To Dose Omeprazole And Sucralfate Together

Answer

As a general rule of thumb, sucralfate (brand name Carafate) should be separated from other drugs, including omeprazole, by at least 2 hours to avoid interactions. 

This is simply due to how sucralfate works.

When we take a dose of sucralfate, it reacts with the hydrochloric acid in our stomach to form a viscous (i.e. thick) substance, which acts as an acid buffer. It also adheres to surfaces in the stomach/GI tract (e.g. an ulcer). These actions have been shown to decrease the absorption of other drugs when taken at the same time.

The prescribing information for sucralfate specifically mentions that studies have shown it can decrease absorption of:

• Cimetidine
• Digoxin
• Fluoroquinolone antibiotics
• Ketoconazole
• Levothyroxine
• Phenytoin
• Quinidine
• Ranitidine
• Tetracycline
• Theophylline

The prescribing information goes on to say:

"Due to CARAFATE's [sucralfate's] potential to alter the absorption of some drugs, CARAFATE [sucralfate] should be administered separately from other drugs when alterations in bioavailability are felt to be critical."

In your case, wanting to know how to separate omeprazole from sucralfate, your best bet would be to separate it by about 2 hours. However, if you take omeprazole first, you can feel relatively safe taking it 30 minutes before sucralfate.

It takes about 30 minutes for omeprazole to start inhibiting acid pumps, which is why it is recommended to be taken 30 minutes before food (you want those pumps inhibited before food stimulates acid release!).

So, overall:

• Take omeprazole 30 minutes before or 2 hours after sucralfate to best avoid an interaction.

Final Words

Thanks and be sure to reach out if you have additional questions!