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Sucralfate is only minimally absorbed from the gastrointestinal tractThe small amounts of the sulfated disaccharide that are absorbed are excreted primarily in the urineAlthough the mechanism of sucralfate’s ability to accelerate healing of duodenal ulcers remains to be fully definedit is known that it exerts its effect through a localrather than systemicactionThe following observations also appear pertinent:

When sucralfate is administered orallysmall amounts of aluminum are absorbed from the gastrointestinal tractConcomitant use of sucralfate with other products that contain aluminumsuch as aluminum-containing antacidsmay increase the total body burden of aluminumPatients with normal renal function receiving the recommended doses of sucralfate and aluminum-containing products adequately excrete aluminum in the urinePatients with chronic renal failure or those receiving dialysis have impaired excretion of absorbed aluminumIn additionaluminum does not cross dialysis membranes because it is bound to albumin and transferrin plasma proteinsAluminum accumulation and toxicityaluminum osteodystrophyosteomalaciaencephalopathyhave been described in patients with renal impairmentSucralfate should be used with caution in patients with chronic renal failure.

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