Plasma and urine aluminium concentrations in healthy subjects after administration of sucralfate [see comments]

Abstract

1. Sucralfate (basic sucrose aluminium sulphate), a topical intestinal agent, was administered in suspension or granule form to 25 healthy subjects at a total dose of 4 g day‐1 for 21 days. Aluminium in plasma and 24 h urine samples was assayed before, during and after administration of sucralfate by inductively coupled plasma optical emission spectrometry. 2. Sucralfate produced significant increases in plasma and urine aluminium concentrations. On average, plasma aluminium increased from about 2 micrograms 1‐1 to more than 5 micrograms 1‐1 and 24 h urine aluminium increased from less than 5 micrograms to more than 30 micrograms. Both plasma and urine aluminium concentrations decreased rapidly after sucralfate was stopped. However, urinary aluminium concentrations remained higher than normal 5 and 10 days after discontinuation of sucralfate administration. Moreover subjects receiving sucralfate granules had significantly higher average urinary excretion of aluminium than subjects receiving the suspension. 3. The small but significant increase in plasma and urine aluminium following sucralfate administration in therapeutic doses may reflect intestinal absorption of aluminium. Although such absorption would appear to be moderate in healthy subjects, it is suggested that aluminium‐based treatments should be used only intermittently, especially in patients with renal disorders.

Effects of an EDTA infusion on the urinary elimination of several elements in healthy subjects.

“…The 24 h excretion of Al that we observed is in agreement with literature values (Allain et al, 1990). The 24 h urinary excretion of Pb (9.8 ,ug 24 h-1) was similar to the value of Behringer etal.…”

Absence of Gastrointestinal Absorption or Urinary Excretion of Aluminium from an Allantoinate Complex Contained in Two Antacid Formulations in Patients with Normal Renal Function

“…These results contrast with findings for other compounds such as Al hydroxide (3), sucralfate in healthy subjects (23,24), or in patients with peptic ulcer disease with normal renal function (21). Kaehny et al (3) clearly demonstrated high plasma Al levels in normal adults who ingested Al hydroxide, as compared with those receiving Al phosphate and controls.…”

Aluminum absorption following sucralfate therapy [letter; comment]

“…The article by Allain et al (1990) describing aluminium absorption from sucralfate in subjects with normal renal function complements a report of a similar study in patients with renal insufficiency (Burgess & Muruve, 1991a). Both studies used a 3 week therapeutic course of sucralfate (4 g day-1) and showed increases in serum aluminium concentrations after 1 day with a plateau after 7 days of therapy.…”