Why is a combination of Ranitidine and Sucralfate better avoided in patient with peptic ulcer disease?
High-Yield Explanation
Sucralfate polymerizes at pH < 4 by cross linking of molecules, assumes a sticky gel like consistency, and then preferentially and strongly adheres to ulcer base. Ranitidine would increase the gastric pH (lower acidity) and prevent action of sucralfate by preventing its polymenzation which occurs at pH values < 4. Ref: KD Tripathi, 5th Edition, Page 596 ; Katzung, 9th Edition, Page 1043