The recommended adult oral dosage of APO-SUCRALFATE (sucralfate) for duodenal and gastric ulcer is one tablet of 1 gram four times a day, one hour before meals and at bedtime, on an empty stomach. For duodenal ulcer, APO-SUCRALFATE may also be administered as two 1 g tablets twice daily, on waking and at bedtime on an empty stomach.
In duodenal ulcers, while healing with sucralfate often occurs within two to four weeks, treatment should be continued for a maximum of 8 to 12 weeks unless healing has been demonstrated by X-ray and/or endoscopic examination.
In the case of gastric ulcers, an alternative treatment should be considered if no objective improvement is observed following 6 weeks of APO-SUCRALFATE therapy. However, patients with a large gastric ulcer that has demonstrated a progressive healing tendency may require an additional 6 weeks of treatment.
For the prophylaxis of duodenal ulcer recurrence, the recommended dosage is one tablet of 1 g twice daily, on an empty stomach. Treatment may be continued for up to one year.
For relief of pain, antacids may be added to the treatment. However, antacids should not be taken within 1/2 hour before or after APO-SUCRALFATE intake.
Duration of continuous treatment in patients with chronic renal failure receiving dialysis should be elevated by periodic monitoring of serum aluminium levels, due to the possiblity of aluminium accumulation in these patients (see PRECAUTIONS). According to information widely available in the literature, patients with serum aluminium concentrations that approach to 100 ug/L should be carefully monitored for symptoms of aluminium toxicity and treatment should be discontinued if such symptoms appear.
There is no evidence to indicate that patients with chronic renal failure, who do not require dialysis, are at risk of developing aluminium toxicity while receiving the recommended doses of sucralfate. Physician discretion should be exercised when considering the duration of treatment (see PRECAUTIONS).