Product Description

Indications: Ulrif is indicated in adults and adolescents above 14 years of age for the treatment of duodenal ulcer, gastric ulcer, chronic gastritis, and for the prophylaxis of gastrointestinal hemorrhage caused by stress ulceration in seriously ill patients.

Pharmacology: Sucralfate is a minimally absorbed, non-systemic agent that acts locally in the gastrointestinal tract. It promotes healing of gastric and duodenal ulcers by forming a protective chemical complex that adheres to ulcer sites, creating a barrier against acid, pepsin, and bile. Sucralfate also inhibits the action of pepsin and bile acids. The small amount absorbed is mainly excreted in the urine.

Dosage & Administration: For duodenal ulcer, gastric ulcer, and chronic gastritis, the usual adult dose is 2 g twice daily taken in the morning and at bedtime, or 1 g four times daily taken one hour before meals and at bedtime. The maximum recommended daily dose is 8 g, although treatment may continue for up to 12 weeks in resistant cases. For prophylaxis of gastrointestinal hemorrhage from stress ulceration, the usual adult dose is 1 g orally or through a nasogastric tube 4 to 6 times daily. The duration of therapy should be individualized and continued as long as risk factors remain present, usually not exceeding 14 days. Sucralfate should be taken on an empty stomach and antacids should not be used within 30 minutes of administration. Safety and efficacy in children under 14 years have not been established.

Interaction: Ulrif may reduce the absorption and bioavailability of several drugs including ciprofloxacin, norfloxacin, tetracycline, ketoconazole, sulpiride, digoxin, warfarin, phenytoin, theophylline, levothyroxine, quinidine, and H2 receptor antagonists. To minimize interaction, these medications should be taken at least two hours apart from Ulrif. Co-administration with citrate preparations should be avoided as it may increase aluminium absorption. Enteral feeds given through nasogastric tubes should be separated from Ulrif administration by at least one hour to prevent bezoar formation.

Contraindications: Ulrif is contraindicated in patients with hypersensitivity to sucralfate or any component of the formulation.

Side Effects: Common side effects include headache, nausea, abdominal pain, constipation, diarrhea, and urticaria. Rare cases of bezoar formation have been reported, especially in severely ill patients or those receiving enteral feeding. Episodes of hyperglycemia have also been observed in diabetic patients.

Pregnancy & Lactation: The safety of sucralfate during pregnancy has not been established and it should be used only if clearly needed. It is not known whether sucralfate is excreted into human breast milk; therefore, caution is advised during breastfeeding.

Precautions & Warnings: Ulrif should be used cautiously in patients with renal impairment due to the risk of aluminium accumulation and toxicity. Long-term use in patients with chronic renal disease may lead to aluminium osteodystrophy, osteomalacia, encephalopathy, or anemia. Monitoring of aluminium, phosphate, calcium, and alkaline phosphatase levels may be required in patients with impaired renal function. Concurrent use of other aluminium-containing medications is not recommended. Bezoar formation has been reported mainly in critically ill patients or those receiving enteral tube feeding. Patients experiencing dizziness or drowsiness should avoid driving or operating machinery.

Use in Special Populations: Ulrif is not recommended for children under 14 years due to insufficient safety and efficacy data. No dose adjustment is generally required in elderly patients. Caution is advised in patients with renal insufficiency.

Overdose Effects: Most overdose cases are asymptomatic, although abdominal pain, nausea, and vomiting have been reported occasionally. Due to minimal systemic absorption, the risk associated with overdose is generally low.

Therapeutic Class: Chelating complex.

Storage Conditions: Store in a cool and dry place protected from light.