Prescription ·Strong evidence ·Reviewed May 2026
Sucralfate is a locally acting aluminum salt of sulfated sucrose used primarily for duodenal ulcer treatment and maintenance. In acidic environments it forms a viscous protective complex that adheres to ulcerated mucosa and can reduce absorption of many oral drugs and some nutrients, so timing separation is central to safe use.
The bottom line
Evidence rating strong. Most-documented uses: short-term treatment of active duodenal ulcer, maintenance therapy after duodenal ulcer healing, mucosal protection when acid injury contributes to symptoms. 3 sources indexed (1986–2026), with 4 interaction records on file.
Core mechanism
In gastric acid, sucralfate polymerizes and cross-links to form a sticky, negatively charged paste that binds positively charged proteins at ulcer bases. This barrier limits acid, pepsin, and bile salt injury while promoting local prostaglandin, mucus, and bicarbonate defenses. Minimal systemic absorption occurs, but small amounts of aluminum can be absorbed and accumulate in advanced kidney disease.1,3
Take on an empty stomach, typically 1 hour before meals and at bedtime. Separate other oral medications and mineral supplements because sucralfate can bind them and reduce absorption.
Nutrients this medication can lower over time, and what to replace.
Aluminum in sucralfate can bind intestinal phosphate and reduce absorption, especially with prolonged use or low dietary intake.
Sucralfate can bind iron in the gut and may reduce iron absorption or the absorption of other oral medications taken with iron.
Recommendation: Separate iron from sucralfate by at least 2 hours, and longer if response is inadequate.
Calcium supplements can compete for binding and add to the burden of poorly absorbed minerals when taken with sucralfate.
Recommendation: Take calcium at a different time of day, typically at least 2 hours away from sucralfate.
Magnesium products may interfere with sucralfate binding behavior and can reduce the predictability of other oral drug absorption.
Recommendation: Separate magnesium from sucralfate by at least 2 hours; avoid magnesium-containing antacids close to sucralfate unless directed.
Sucralfate can physically bind oral minerals; zinc taken at the same time may have less predictable absorption.
Recommendation: Separate zinc and sucralfate by at least 2 hours and reassess if zinc is being used for a documented deficiency.
Numbered references. Citations throughout the page link here.
Review describes clinically relevant adsorption and timing strategies for coadministered oral medications.
Aluminum exposure is most hazardous in advanced kidney disease and can contribute to bone and neurologic toxicity.
Labeling describes 1 g four times daily dosing, drug binding interactions, and renal aluminum accumulation warnings.
This page is educational. Do not start, stop, or change a supplement or medication based on it without checking with a qualified healthcare professional.
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