[Sucralfate and bezoars: data from the system of pharmacologic vigilance and review of the literature].
A bezoar is a mass of undigested material which may form within the lumen of the gut. Some drugs have the potential to form bezoars. In the majority of patients, there is a clear predisposing factor. We present here the data of the French System of Pharmacovigilance on sucralfate and a literature review. Two distinct populations were involved: 16 adults and 5 newborn babies. All were hospitalized in intensive care units. The children were very low birth weight newborn babies, all of whom presented with abdominal distension or acute occlusion. The abdominal radiograph revealed an opaque mass filling the contour of the stomach. Adults presented an oesophageal bezoar around a nasogastric tube. Risk factors for bezoar formation were severe illness, gut hypomotility, dehydration, overdosage, nasogastric tube feeding. Sucralfate is used in the management of peptic ulcer. At pH < 4, extensive polymerization occurs and a sticky viscid gel is formed. In view of this inquiry, the French System of Pharmacovigilance decided to advise caution for adults in intensive care unit being fed by nasogastric tube and contraindication in premature babies and dysmature newborn babies receiving sucralfate.
Guy
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C
Centre Régional de Pharmacovigilance et de Renseignements sur le Médicament, Hôpital de Bellevue, Saint-Etienne, France.
Ollagnier
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M
D000328:Adult; D001630:Bezoars / Q000139:chemically induced*; D004358:Drug Therapy / Q000592:standards; D064420:Drug-Related Side Effects and Adverse Reactions; D005602:France; D005765:Gastrointestinal Agents / Q000009:adverse effects*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D010437:Peptic Ulcer / Q000188:drug therapy; D013392:Sucralfate / Q000009:adverse effects*
D005765:Gastrointestinal Agents; D013392:Sucralfate