Dr. Andrew S. Artz, MD | Duarte, CA | Oncologist | US News Doctors

Carafate Suspension

Carafate Suspension Generic Name & Formulations General Description

Sucralfate 1g/10mL.

Pharmacological Class

Cytoprotective agent.

How Supplied

Tabs—100; Susp—14oz

Carafate Suspension Indications Indications

Short-term (up to 8 weeks) treatment of active duodenal ulcer. Maintenance of healed duodenal ulcers (tabs only).

Carafate Suspension Dosage and Administration Adult

Active: 1g 4 times daily on an empty stomach for 4–8 weeks. Maintenance: 1g 2 times daily.

Children

Not established.

Carafate Suspension Contraindications

Not Applicable

Carafate Suspension Boxed Warnings

Not Applicable

Carafate Suspension Warnings/Precautions Warnings/Precautions

Susp: administer by oral route only; do not give intravenously. Monitor for glycemia in diabetic patients. Chronic renal failure. Dialysis. Tabs: swallowing impairment (eg, recent or prolonged intubation, tracheostomy, history of aspiration, dysphagia, others). Pregnancy (Cat.B). Nursing mothers.

Carafate Suspension Pharmacokinetics Carafate Suspension Interactions Interactions

Avoid antacids within 30mins of dosing. May reduce absorption of tetracyclines, quinidine, levothyroxine, phenytoin, cimetidine, digoxin, ciprofloxacin, norfloxacin, ketoconazole, ranitidine, theophylline; dose concomitant drugs 2hrs before sucralfate. Additive aluminum load with aluminum-containing antacids. Monitor warfarin.

Carafate Suspension Adverse Reactions Adverse Reactions

Constipation.

Carafate Suspension Clinical Trials

See Literature

Carafate Suspension Note

Not Applicable

Carafate Suspension Patient Counseling

See Literature

Guide To Canker Sores

Canker sores are a commonly occurring type of mouth ulcer that is usually seen on the tongue, the inner part of the lips and cheeks, and soft palate. These are different from cold sores that can be found on the outer lip. Canker sores, in contrast, can occur only inside the mouth, although they are not contagious. They generally disappear on their own in a couple of weeks, and if you have long lasting or painful sores, it is recommended that you see your dentist.

These sores are also known as aphthous stomatitis or aphthous ulcers. They occur more often in women then men, and are more prevalent in teenagers. Canker sores have been linked to genetics.

Symptoms of Canker Sores

The earliest symptom is a burning sensation in your mouth, or a slight tingling. This usually occurs before the other symptoms begin. Small round or oval swellings appear that are red in color and painful. The center of the swelling is usually yellow or white, and it may occur either as a single spot or bump, or as a cluster. Depending on the type of canker sore, you can either have minor but not serious sores, or large, irregularly shaped lesions that can last for years, and leave scars, or clusters of tiny sores that eventually come together to form a single ulcer. Other symptoms include fever, uneasiness and swollen lymph nodes,

Types of Canker Sores

Canker sores are categorized into 3 based on their size.

Minor SoresHere, the sores are between 1mm to 10mm in diameter, lasting from a week to about 10 days. Close to 80% of all canker sores cases belong to this group.

Major SoresHere the diameter of the sore is more than 10mm, and healing time can be anywhere from 10 to 30 days. In some cases these sores can last even for months and years, and they usually leave behind large scars.

Herpetiform UlcersThese are formed by a group of several tiny sores that are each less than 3mm in size. These form 10% of all canker sores cases, and they normally heal within a week to 10 days maximum.

Causes of Canker sores

The exact causes are unclear, but doctors agree that canker sores are caused due to a combination of several causal factors. These include:

Nutritional DeficienciesLack of important nutrients like folic acids, iron and vitamin B 12 has been found linked to canker sores.

Immune DeficienciesProblems with your immune system can cause your healthy mouth cells to be attacked instead of bacteria and virus, thus causing canker sores.

Oral InjurySmall injuries to your mouth may be caused due to forceful brushing, dental treatment, sports injuries and accidental biting of the cheek.

AllergiesCertain people may have allergic reactions to bacteria in the mouth, causing sores.

BacteriaThe presence of bacteria like helicobacter pylori can cause canker sores.

DiseaseCrohn's disease, ulcerative colitis, and other inflammatory conditions of the bowel, Celiac disease, an intestinal conditions caused by allergic reaction to gluten, and Behcet's disease, a condition that inflames the entire body, and the mouth, HIV/AIDS which effects your body's immune system can all cause canker sores.

DietCertain highly acidic foods like pineapples have been found to increase the possibility of canker sores. A diet that's rich in eggs, nuts, coffee, cheese, chocolate and strawberries can put a person at risk for sores.

ToothpasteToothpaste that contains sodium lauryl sulfate can also cause canker sores.

MedicationBeta blockers like atenolol and anti inflammatory medications like ibuprofen, have been found linked to canker sores.

Emotional causesStress anxiety or depression can also this condition.

LifestylePeople who smoke or chew tobacco are likely to suffer from these sores.

Hormonal CausesHormonal changes that occur during menstruation or pregnancy can cause sores.

Risk Factors for Canker Sores

Certain people are more prone to canker sores.

Women are more prone to these sores than men.

People between the ages of 10 to 40 are likely to have their first experience with canker sores, and the likelihood of sores decreases with age.

Heredity and genes also play a role with at least half the population who suffer from canker sores also having a closely related member of the family with the same condition.

How to Diagnose Canker Sores

No special tests are needed, and your dentist can easily identify these sores visually. In case of severe or extremely painful sores, your dentist may refer you to a physician for a health check up.

Treatment of Canker sores

Minor canker sores normally go away on their own without treatment. In the case of major sores however, intervention is necessary. Some of the commonly used forms of treatment are

Mouth Rinse Treatmentsyour dentist may recommend a dexamethasone-containing mouth rinse to decrease the inflammation. He may also recommend the anti biotic tetracycline.

Topical applicationsPrescription pastes that contain a corticosteroid called triamcinolone acetonide, amlexanox, and fluocinonide can help reduce the inflammation, and speed up the healing process when applied directly to sores.  A solution of debacterol when applied topically to the lesion, can chemically cauterize the sores.

AnestheticsYour dentist may prescribe a numbing anesthetic like lidocaine to reduce the pain. This has to be applied just before you eat, alleviating the pain that you feel while eating.

Vitamin SupplementsIf your canker sores are caused due to nutritional deficiencies, a course of folic acid, vitamin B12 or iron supplements may help. These supplements may have to be taken for several months to be effective.

Oral MedicationsSometimes, medications recommended for other conditions can work for canker sores. An example of this is the drug cimetidine which is used for the treatment of gout. This medication can also be used to treat canker sores. Carafate, a medication that is prescribed for the treatment of peptic ulcers has also been found beneficial for canker sores treatment. Oral steroid medications are prescribed when the person doesn't respond to other forms of treatment. However, the risk of side effects is so high that these medications are used only as a last resort.

Alternative medicationsZinc lozenges, lysine supplements and probiotics like acidophilus may also be used. A paste of deglycyrrhizinated licorice, elm powder or alum can also help.

Hormonal TreatmentIn women who find that canker sores flare up during certain periods of their menstrual cycle, an oral contraceptive prescribed for a 6-monh period can help.

Home TreatmentThere are certain things you can use at home to reduce the symptoms of canker sores.

Milk of Magnesia when applied in small quantities on the sore can help.

Over the counter products including Orajel, can be used. Apply a paste of baking soda on the sores.

An oral rinse consisting of salt water, diluted hydrogen peroxide or baking soda may also help.

Ice when applied to the sores, can relieve the inflammation.

Use a soft bristled tooth brush to avoid injuries to your mouth.

Complications

The antibiotics that are used to treat canker sores can also lead to other oral infections, like oral thrush. Sometimes Ludwig's angina and other bacterial infections can occur. Canker sores are not an indication of cancer, but if these lesions do not disappear even after 2 weeks, get them checked to rule out cancer.

Prevention of Canker Sores

You can decrease the frequency of canker sores by monitoring your diet and following proper oral hygiene practices.

Avoid chips, spicy or salty foods, nuts, pineapple, oranges and other acidic fruits that can irritate the sensitive lining of the mouth. Eat plenty of whole grains, fresh fruits and vegetables and yoghurt containing good bacteria.

Brush regularly and floss at least once a day. Use a soft bristled tooth brush.

Protect your mouth from injuries if you wear braces by using orthodontic waxes.

Makes minor changes to your habits - for instance avoid talking while eating, because this can damage the lining of the mouth.

In conclusion, canker sores are not usually a serious condition, with outbreaks lasting only for a few days. Minor sores improve on their own while the more severe lesions can last longer. The possibility of canker sores decreases as you get older.

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