Pharmacology, clinical efficacy, and adverse effects of sucralfate, a nonsystemic agent for peptic ulcer.

Sucralfate, a complex salt of polyaluminum hydroxide with a sulfated disaccharide skeleton, has recently been approved by the Food and Drug Administration for the short-term treatment of duodenal ulcer. The drug is nonsystemic in action and apparently exerts its antiulcer effects by bonding with proteinaceous exudates in the ulcer crater, thereby protecting it from insult. In vitro and clinical studies have shown that the drug is not an antacid but does block the diffusion of acid. Inhibition of pepsin and bile acid activities have also been demonstrated. In double-blind clinical trials where patients used antacids as needed for pain, sucralfate 1 g 4 times a day was significantly more effective than placebo and as effective as cimetidine. No serious adverse effects have been caused by this locally-acting agent.