Surlka™

[Sucralfate]

Surlka

Description / Properties

Surlka™ (Sucralfate) is a unique oral drug. Chemically, it is a complex of octasulfate of sucrose to which aluminum hydroxide has been added. in an acidic environment (PH<4), it undergoes excessive cross linking and polymerization, to produce a viscous sticky gel that adheres strongly to epithelial cells and even more strongly to ulcer craters for as long as 6 to 8 hours after a single dose.

In addition inhibition of hydrolysis of mucosal proteins by pepsin Surlka has additional cytoprotective effects including stimulation of local production of mucosal prostaglandins and epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF). Surlka (sucralfate) binds to the surface of ulcers (attaching to exposed proteins) and coats the ulcer, thus protecting the ulcer surface to some extent from further injury by acid and pepsin.

Surlka (sucralfate) directly inhibits pepsin (an enzyme that breaks apart proteins) in the presence of stomach acid. It also binds bile salts coming from the liver via the bile thus protecting the stomach lining from injury caused by the bile acids.

Sucralfate is a member of the heparin binding growth factor family and the structure of sucralfate and heparin are similar, sucralfate can combine with endogenous bFGF. Thus sucralfate stabilizes bFGF and delivers it to ulcer site. Sucralfate also stabilizes bFGF at ulcer base and then further accelerates healing.

Indications

Surlka™ is indicated for the treatment of:

  • Gastric ulcers
  • Duodenal ulcers
  • Stress ulcers
  • NSAID induced ulcers
  • Gastritis
  • Duodenitis
  • Bile reflux Gastritis
  • GERD

    Drug Interactions

    Sucralfate (surlka) reduces the absorption of some of the drugs when taken at the same time as the other drugs. These drugs include: cimetidine, digoxin, ketoconazole, phenytoin, quinidine, ranitidine, tetracycline, theophylline, and all of the fluoroquinolone antibiotics, including ciprofloxacin, norfloxacin, ofloxacin, and lomefloxacin . All of these medications should be taken at least two hours prior to the sucralfate. It is possible, if not likely, that many other drugs will interact similarly with sucralfate. Therefore, it probably is prudent to take all medications at least 2 hours prior to sucralfate.

    Contraindication

    Surlka™ is contraindicated in patients with known hypersensitivity to sucralfate.

    Warning and Precautions

    Chronic renal failure and dialysis patients
    When the drug is orally administered only small amount of it is absorbed by the GIT. However concomitant use of Surlka with other products that contain aluminum, such as aluminum containing antacids may increase the total body burden of aluminum. Patients with normal renal functions receiving the recommended doses of surlka and aluminum containing compounds excrete aluminum in their urine. Patients with chronic renal failure or on dialysis have impaired excretion of absorbed aluminum. In addition aluminum does not cross dialysis membrane because it is bound to aluminum and transferring plasma proteins. Aluminum toxicity and accumulation have been described in patients with renal impairment. Surlka should be used with precaution in patients with chronic renal failure.

    Pregnancy
    Sucralfate itself is not teratogenic in animals, even in doses considerably higher than those used in humans. Although some animal data demonstrate concern for the effects of aluminum during pregnancy, all human data show no ill-effect on the fetus. Sucralfate is considered safe during pregnancy.

    Nursing Mothers
    Minimal if any sucralfate penetrates into breast milk because so little is absorbed from the gastrointestinal tract. Although there is no data, sucralfate is considered safe in nursing mothers.

    Side Effects
    Sucralfate is well tolerated. Constipation is the most frequent side effect and occurs in 1 of every 50 patients who take sucralfate.

    Dosage

    Ulcer patients: Surlka 1g suspension 4 times a day or 2g twice a day, one hour before each meal.
    Non Ulcer Patients: Surlka 1g suspension two times a day, one hour before meal.

    Surlka should be taken empty stomach or as directed by the physician.

    Presentations Available

  • Surlka 1g suspension. Each 5 ml (1 teaspoonful) contains Sucralfate (USP)

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