Assumere solo sotto controllo medico

Il Sucralfato è un farmaco antiulcera che agisce formando una barriera protettiva sulla mucosa dello stomaco. Quando entra in contatto con l'acido gastrico, si trasforma in un gel aderente che copre l'ulcera e protegge l'area danneggiata dagli acidi e dagli enzimi digestivi. Questo permette alla mucosa di guarire più efficacemente (1). Il Sucralfato è usato per trattare ulcere gastriche e duodenali (2), gastrite erosiva (3) e può essere utilizzato anche per trattare le irritazioni della gola causate dal reflusso gastroesofageo (4). È ben tollerato dalla maggior parte dei pazienti e generalmente non viene assorbito nel flusso sanguigno, riducendo il rischio di effetti collaterali sistemici.

Processo industriale di sintesi chimica

• Sintesi di polialluminio idrossido. L’idrossido di alluminio viene reagito con acido cloridrico per formare cloruro di alluminio, che poi viene polimerizzato per ottenere polialluminio idrossido.
• Reazione di saccarosio e solfato. Il saccarosio viene reagito con acido solforico per produrre un derivato sulfato di saccarosio.
• Condensazione. Il derivato di saccarosio sulfato viene condensato con il polialluminio idrossido in presenza di un catalizzatore acido per formare il Sucralfato.
• Purificazione. Il Sucralfato grezzo viene purificato tramite tecniche come la cristallizzazione o la precipitazione per rimuovere impurità e migliorare la purezza del prodotto.
• Essiccazione. Il prodotto purificato viene essiccato per rimuovere l'umidità residua e ottenere la forma finale solida.
• Controllo di qualità. Campioni del prodotto finale vengono sottoposti a vari test di controllo qualità per assicurare che rispettino gli standard di purezza, stabilità e attività terapeutica.

Applicazioni commerciali

Recentemente, è stato adottato anche in dermatologia e cosmetica per le sue proprietà protettive e curative sulla pelle. Ecco alcuni dei principali utilizzi e benefici del Sucralfato in ambito cosmetico.

Proprietà curative. Il Sucralfato aiuta a proteggere e riparare la pelle danneggiata formando una barriera protettiva che facilita la guarigione di ferite, abrasioni e irritazioni cutanee.

Effetti protettivi. Questo composto forma un film sulla pelle che protegge da agenti irritanti esterni e inquinanti, contribuendo a prevenire ulteriori danni.

Riduzione dell'Infiammazione. Ha proprietà che aiutano a ridurre l'infiammazione cutanea, rendendolo utile per trattare condizioni come dermatiti, eczemi e altre irritazioni della pelle.

Promozione della rigenerazione della pelle. Stimola il processo di rigenerazione della pelle, accelerando la guarigione e migliorando l'aspetto delle cicatrici.

Prodotti Post-Procedure. È spesso incluso in formulazioni destinate alla cura della pelle post-procedura, come quelle usate dopo trattamenti laser o peeling chimici, per sostenere la riparazione e la protezione della pelle.

Versatilità. Il sucralfato può essere impiegato in una varietà di prodotti per la cura della pelle, inclusi creme, gel e lozioni, particolarmente quelli formulati per pelli sensibili o compromesse.

Molecular Formula    C₁₂H₅₄Al₉O₅₅S₈

Molecular Weight  1577.9 g/mol

Synonyms:

• Carafate
• Sucralfate
• Sulfate, Aluminum Sucrose
• Ulcerban
• Aluminum Sucrose Sulfate
• Antepsin
• Basic Aluminum Sucrose Sulfate
• Ulcogant
• Ulsanic

Bibliografia_____________________________________________________________________

(1) Candelli M, Carloni E, Armuzzi A, Cammarota G, Ojetti V, Pignataro G, Santoliquido A, Pola R, Pola E, Gasbarrini G, Gasbarrini A. Role of sucralfate in gastrointestinal diseases. Panminerva Med. 2000 Mar;42(1):55-9. 

Abstract. Sucralfate is a cytoprotective drug widely used in clinical practice to prevent or treat several gastrointestinal diseases such as gastro-esophageal reflux, gastritis, peptic ulcer, stress ulcer and dyspepsia. Sucralfate is a safe and well tolerated drug, as demonstrated by the quite complete lack of side effects and it is, for this reason, one of the most important therapeutic choices in the management of acid related diseases during pregnancy. Moreover, sucralfate has recently been shown to be useful in non-acid related gastrointestinal disease as well. In fact, sucralfate has also been administered topically in patients with radiation-induced mucosal procto-sigmoiditis or ulcerative colitis with surprising results. The drug is actually able to form a physical barrier between epithelium and damaging agents (-bile salts, drugs, refluxate...). Moreover, sucralfate increases the local levels of fibroblast growth factors and induces a rise in the mucosal concentration of prostaglandins which are considered important factors in mucosal healing. The aim of this paper is to describe the current and probably forthcoming uses of sucralfate in the field of gastrointestinal disorders. Moreover, we investigate the role of sucralfate as a reliable means to prevent the occurrence of reflux-like symptoms after Helicobacter pylori eradication and in the management of Helicobacter pylori negative patients affected by non-ulcer dyspepsia.

(2) Lam SK. Treatment of duodenal ulcer with sucralfate. Scand J Gastroenterol Suppl. 1991;185:22-8. doi: 10.3109/00365529109093216. PMID: 1683491.

Abstract. Sucralfate attains a healing rate of about 79% for duodenal ulcer in 4 weeks, which is similar to the effects of cimetidine and ranitidine. Whereas cigarette smoking significantly affects duodenal ulcer healing by acid-reducing agents, the healing rates of smokers and non-smokers treated with sucralfate or colloidal bismuth are indistinguishable, suggesting an inherent advantage through the cytoprotective mechanisms of these agents. The 12-month relapse curves for duodenal ulcers initially healed with sucralfate and colloidal bismuth subcitrate closely overlap each other and are significantly lower than the curves for the histamine H2-receptor antagonists. These findings cannot be accounted for by clearance of Helicobacter pylori, on which sucralfate has little effect. Preliminary evidence suggests that the use of acid-reducing agents results in up-regulation of the parietal cells and may help to explain the differences in relapse rates. Sucralfate is superior to placebo and comparable to H2 antagonists in the prevention of duodenal ulcer recurrence.

(3) Rees WD. Mechanisms of gastroduodenal protection by sucralfate. Am J Med. 1991 Aug 8;91(2A):58S-63S. doi: 10.1016/0002-9343(91)90452-4. PMID: 1715673.

Abstract. Over the past 5-10 years, a number of studies have shown that topical sucralfate enhances a number of gastric and duodenal mechanisms, e.g., the "mucus-bicarbonate barrier," mucosal hydrophobicity, mucosal blood flow, cell viability, and local production of prostaglandins, as well as endogenous mediators of tissue injury and repair. It seems likely that the complex actions of sucralfate are in part related to direct interaction between the drug or its components (aluminum, sucrose, and sulfate) and gastric mucosal tissues, and in part related to effects of the drug on the various mucosal mediators of tissue injury and repair. Local actions may play a role in accelerating healing of ulcer-damaged mucosa, but this does not explain the protective actions of sucralfate on normal mucosa. Thus sucralfate appears to enhance the protective function of the "mucus-bicarbonate" barrier by actions on both components. This may depend in part on an interaction with the unstirred layer overlying gastric epithelium. Sucralfate has also been shown to increase the hydrophobicity of mucus gel. There is little doubt that sucralfate increases local production and release of protective prostaglandins (PGs), but the precise role played by these agents in mediating mucosal protection and in chronic ulcer healing remains uncertain. Currently, the mechanism of action of sucralfate on vascular integrity remains unknown and the role of PGs in this protective function is unclear. There is little evidence that epidermal growth factor plays any role in mediating mucosal protection by sucralfate, but it may be important in its ulcer-healing action. Sucralfate has been shown to be truly "cytoprotective" in that it protects isolated epithelial cells from damage by noxious agents. In animals treated with sucralfate, the surface epithelial cells were disrupted, but necrotic lesions in the deep proliferative zone were virtually absent. It seems likely that investigations of the actions of sucralfate and its components will move ever closer to defining the target cells, the intracellular events, and the mediators that bring about its protective and ulcer-healing activity.

(4) Dağlı Ü, Kalkan İH. Treatment of reflux disease during pregnancy and lactation. Turk J Gastroenterol. 2017 Dec;28(Suppl 1):S53-S56. doi: 10.5152/tjg.2017.14. PMID: 29199169.

Abstract. Gastroesophageal reflux disease (GERD) is frequently seen during pregnancy. In the medical treatment of pregnant women with GERD, alginic acid and sucralfate can be used. Calcium- and magnesium-based antacids can also be used, particularly for patients with preeclampsia. In particular, ranitidine -a histamine-2 receptor blocker- is preferred. In the case of non-responsiveness to the abovementioned treatments, proton pump inhibitors (PPIs), except omeprazole, can be given considering the benefit-harm ratio for the mother and fetus after the first trimester. In cases with GERD during the lactation period, drugs having minimum systemic absorption, such as sucralfate and alginic acid, are preferable but there is no data.