Nexium and Sucralfate

I read the entire nexium thread and was thinking of trying it. My question is, my horse is currently getting sucralfate 2x per day, in his AM and PM feed.

Due to my boarding situation, there is no way to feed the nexium before the AM feed. Will I be able to add the nexium to the AM feed, along with the sucralfate, or will the sucralfate block absorbtion of the nexium?

Thoughts/suggestions appreciated.

Yes, sucralfate will block the absorption of Nexium. Gotta separate by at least two hours. It’s a pain in the rear

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Would it be worth it to feed nexium in the am feed and sucralfate 1x in the pm feed?

I would try to do the Nexium in a “lunch” meal if possible.


Unfortunately, the only options available to me are AM or PM feed.

I did this regimen and I think it was successful.

Have you thought about asking your vet about injectable omeprazole? Then you don’t have to worry about interaction with the sulcrafate at all. Otherwise, do the best you can - feeding them at the same time should be fine, seeing as sulcrafate coats the stomach, and absorption happens in the intestines (right? I’m not an enterologist…). If you’re seeing good results with sulcrafate, I would keep that at twice a day, and add in an extra tab or two of the nexium.

Thanks @2bayboys! So, you did nexium am and sucrulfate pm and had success with that regimen?


Thanks for the suggestion! I had forgotten about that option. I had discussed that with my vet, but in her experience with the injectable omeprazole, she has had horses come up pretty sore in the neck, so we were trying to brainstorm other options first. I may need to revisit that option if other means of administration are off the table.

Yep! I also would add a sucralfate dose mid day if I could, but that was only random.

I had a horse that had a terrible swollen neck from injectable omeprazole as well, just fyi.

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Is there no way you can tweak the feeding process to have the nexium fed even 30 min before evening meals?

The nexium mini-pills are so easily eaten, that what I arranged was that a small labeled tupperware sat outside my horse’s stall. When AM shift person go there the first thing they did was feed the tupperware (it just had the nexium pills and a small handful of grain - he usually just fed it by hand like a treat).

Then he would go do the rest of the horses and dump grain for my girl last. This usually bought us about 30min between feedings. Sometimes he would start doing turn out prep before dumping my girl’s grain.

Same for PM - first fed the tupperware. Then did all the other horses, then went back and gave mine dinner.

It worked effectively for her and was minimally disruptive to our barn staff – but its dependant on what order of operations are at your place whether a modifed process like that could work.

Coming back to update for anyone who might be searching this thread at a later date.

The Nexium AM and Sucralfate PM was a resounding success. My horse is happy, soft and willing. All behaviors resolved 100%. He’s actually going the best that he’s ever been.

In the interest of full transparency, I did add two other things to our routine, in addition to the nexium and sucralfate.

  1. I now always feed alfalfa cubes immediately prior to our ride. He does not get ridden on an empty stomach EVER.

  2. I added gastro elm plus 1x per day. The cost is minimal so I added it on the “can’t hurt, might help” theory.

Hope anyone reading this is having success with their ulcer management!


That’s great to hear!! Can you add how much nexium you gave in the AM and when (e.g., with breakfast versus 30 min before), and same for sucralfate in PM?

So nice to see a success story on here for a change!!

4 Nexium clear mini capsules dropped in the feed in the AM, along with 1 scoop of the GastroElm Plus.
1.5 scoops (per vet) of Sucralfate powder added to the PM feed.

Best of luck to everyone out there also on the ulcer journey~!

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My mare has got to have the most sensitive digestive tract on the planet. Ive had her since weanling age and she will be 12 in June. She has allllways had loose poop but not fecal water symdrome. She was scoped and treated with GG and sucralfate. She did well for a while but then went back to being grouchy. Loose poop never resolved. Did the nexium and sucralfate but no real change.

And theeeeeen, after trying everything else on the market I gave Jeremiah’s Ulcer Repulser a try and SHAZAAM!!! After 30 days i noticed great improvement. 6 months later this is still her daily prevention and her poop has never looked better! She is chipper and lovey!! JUR takes care of fore and hindgut and is all natural. I will never be without it!

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