Horse scoped and has 1 pyloric ulcer. Been on meds for 2 weeks. Vet at hospital told me to give sucralfate first then misoprostol 1 hr after 2 x day. Ive noticed no change in horses demeanour. Shouldn’t I give the misoprostol before sucralfate?? Did vet make a mistake in discharge papers?
No, that’s fine. Sucralfate needs to be fed 1 hour before/after anything else. It coats the stomach and will bind to other medication fed at the same time and keep it from being effective.
How long does the sucralfate line the stomach I’m wondering?? I’d think more than 1 hr?.,
Hilary I agree that this doesn’t sound right. The half life of sucralfate is relatively short (few hours IIRC) but definitely more than 1 hour. What I have seen is omeprazole on empty stomach, wait an hour, meal with misoprostol & any supplements, wait an hour, sucralfate. I see this is an older post … hope you’ve had good results treating your horse.
Sulcrafate always comes before the meds to coat the stomach. It can take an animal some time to realize they no longer have to be grumpy. It takes longer to change their psychological state than to change their physical state.
He has been on misoprotol and sucralfate for 5 weeks. Not any big difference in behaviour yet… eating well and looks good but still has moments of not wanting to be groomed. Not sure if still pain related or mental!
I’m pretty sure the sucralfate timing is 1/2 hour before meds/supplements or 2 hours after.
Interesting, I guess different vets are using these meds differently. I was told by multiple vets not to give sucralfate prior to feed & meds because it will impede absorption.
OP - I would think you should see some abatement of symptoms in under 5 weeks. Especially with sucralfate on board. That makes them feel better (not necessarily 100%, but better) immediately - like a band-aid for their GI tract. Are you having your horse re-scoped at any point? Misoprostol is expensive!
Dosing every 2 hours is within recommended timing, which is dosing every 2-4 hours. If things aren’t changing I’d consider increasing the dosing. Or, consider the 1 pyloric ulcer was almost incidental, and the real issues are in the hind gut. Has he been scoped again in the 5 weeks?
Sucralfate doesn’t exactly coat the stomach - it coats lesions, which is how it affects ulcer healing. According to Wedgewood Pharmacy, that lasts about 6 hours.
It doesn’t matter which of these meds you give first, just give the sucralfate about 1 hour before, or 2 hours after other meds, so that the sucralfate doesn’t bind to the medications (though H2 receptor blockers, like ranitidine, don’t appear to be affected and could be given together)
My vet had me do omeprazole on an empty stomach and sucralfate an hour later with his grain and sups.
Horse had glandular ulcers and it took a long time for them to heal. We treated for three months.
Succeed with Equishure can be a good thing as well.
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