Sucralfate can be used to bind to erosions and uclers and protect them from exposure to gastric acid, bile acids, and or pepsin. 14 Sucralfate may also be cytoprotective by stimulating prostaglandin production. Since sucralfate may bind to other drugs and delay absorption, it is recommended to wait 2 hours before administering other medications. Other helpful medications H2 antagonists inhibit histamine and decrease gastric acid secretion and may be helpful with ibuprofen overdoses. The use of cimetidine with ibuprofen toxicosis appears to be controversial.
Cimetidine decreases hepatic blood flow and inhibits hepatic microsomal enzymes.
Pretreatment with cimetidine was found to increase both the rate and extent of absorption of ibuprofen in rats. 4,14,20 Mild gastrointestinal irritation may be treated symptomatically with antacids, such as magnesium or aluminum hydroxide. Bismuth subsalicylate antacid formulations are contraindicated. When renal failure is a potential, BUN, creatinine, and urine specific gravity should be monitored closely. The animal should also be monitored for acidosis and electrolyte shifts during treatment.