what part of the intestines does Pentasa work in?

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Illy
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Date Joined May 2008
Total Posts : 117
   Posted 5/26/2008 11:35 PM (GMT -7)   
So Pentasa is a capsule-released form of mesalamine, that is supposed to release only in the intestines, thereby making its action more localized and potent.
 
Is it for the terminal ileum and colon?  Or does it work in the small intestine also?  Thanks

downunda
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Date Joined May 2008
Total Posts : 19
   Posted 5/26/2008 11:44 PM (GMT -7)   
I take Pentasa that disolves really easily into small bits if I get it wet (I take tablets not a capsules of it). And I find if I am sick I can see the small bits in the vomit - and sometimes out the other end with diahorrea :) - so I wonder if it is working as it is supposed to or is my system throwing it out before it has time to work.
26F, Crohn's for 8 years, currently on 6MP and pentasa. Have previously tried remicade, iron, pred and entocort.


crohnie_boy
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Date Joined Aug 2007
Total Posts : 29
   Posted 5/27/2008 2:39 AM (GMT -7)   
Hi I have been on pentasa 4 a while, my gi doctor told me that it works for large intestine disease rather than small intestine.My disease is in large bowel + small bit of terminal ileum

 Hi I'm crohnie_boy
 33yr old boy . Diagnosed @ age 14 ileocolitis crohn's.
 Taking Pentasa 1500mg twice daily
 Try to keep smiling ,but hard sometimes


kimberlayn
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Date Joined Jul 2007
Total Posts : 239
   Posted 5/27/2008 6:17 AM (GMT -7)   
My doctor told me it was for the small intestine, my disease was at the terminal ileum. I had to stop taking it because it bothered my stomach. I know it's normal to see lits bits come out the other end. My doc said it's kind of like a dry rub for your intestines, it's not supposed to get absorbed into your system.
diagnosed w/Crohn's 11/06, solving the mystery of years of on/off abdominal pain. No more "it's just a virus". 34f with 2 boys, a lovable dog, and a wonderful husband. 150 mg Imuran, bentyl, vicodin as needed, omeprazole, fish oil, sublingual B12, metoprolol for orthostatic hypotension and heart palpitations. Bowel resection 9/07. Doc says no active disease, but flare-ups anyway. 11 year old son with IBS-C, on Bentyl.


Illy
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Date Joined May 2008
Total Posts : 117
   Posted 5/27/2008 7:39 AM (GMT -7)   
How long does it take to "work"?  I took it for two weeks, didn't do anything.  I have ileitis, not colonitis.  maybe inflam. in small intestine, don't know. 
 
I'm thinking that if it's not going help the ileitis (pain did not go down, or got referred to different areas), I would only take it if it might help in the small intestine.
 
I found the whole idea of swallowing plastic with all kinds of coloring and chemicals kind of icky, wouldn't take it with food.

Nanners
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Date Joined Apr 2005
Total Posts : 14995
   Posted 5/27/2008 9:11 AM (GMT -7)   
Before my resections I always was on Pentasa when I flared. And my Crohns was in the ileum/cecum area. It always worked fine for me, and I always saw the little pellets in my stool. Now that I have had two resections, I take Asacol, and it works well for me also. I occaisionally see them in my stool, especially when I have D. It was my understanding that Pentasa is for the upper parts of the small intestine and Asacol for the lower parts.
Been living with Crohn's Disease for 32 years.  Currently on Asacol, Prilosec 60 mg, Estrace, Prinivil, Diltiazem, Percoset prn for pain and Calcium.  Resections in 2002 and 2005.  Recently diagnosed with Fibromyalgia and doing tests to see if I have Inflammatory Arthritis or AS.


Illy
Regular Member


Date Joined May 2008
Total Posts : 117
   Posted 5/27/2008 9:19 AM (GMT -7)   
So, when it worked, it worked immediately?  because I've had no relief for a while and wondering if it's "working" without my knowing it.

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 5/27/2008 9:23 AM (GMT -7)   
No I would give it more than two weeks. I think these meds take a little longer, but they help to keep the inflammation down.
Been living with Crohn's Disease for 32 years.  Currently on Asacol, Prilosec 60 mg, Estrace, Prinivil, Diltiazem, Percoset prn for pain and Calcium.  Resections in 2002 and 2005.  Recently diagnosed with Fibromyalgia and doing tests to see if I have Inflammatory Arthritis or AS.


pb4
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Date Joined Feb 2004
Total Posts : 20576
   Posted 5/27/2008 10:50 AM (GMT -7)   
Pentasa is used to treat ulcerative colitis, proctitis, and proctosigmoiditis...so it's designed to reach the lower area of the GI tract not the upper (small intestines).

:)
My bum is broken....there's a big crack down the middle of it!  LOL  :)


RK
Regular Member


Date Joined Oct 2006
Total Posts : 153
   Posted 5/27/2008 11:51 AM (GMT -7)   
Pentasa has a delayed release so that it can work on the last part of the small intestines/ileum/cecum area. I've been on it for over 6 years and have never had any side effects.  As far as I know, Pentasa isn't available in capsule form in Canada. I take the tablets. It took about 3 or 4 weeks to start working and once it did, it was amazing. I felt much much better.
32-year-old female diagnosed with CD in 2001.
Currently taking Pentasa 4g x four times daily and probiotics.


pb4
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Date Joined Feb 2004
Total Posts : 20576
   Posted 5/27/2008 12:14 PM (GMT -7)   

Pentasa is mainly used for UCers because it's designed to release in the lower part of the intestinal tract, the colon and rectal area, it's not used for small intestinal inflammation...see the link...

 

http://www.drugs.com/pentasa.html

 But then I did find this info too...

Although the major part of continuous-release mesalamine is delivered to the colon, large proportions are liberated and available at high concentrations within the small intestinal lumen, thus explaining its therapeutic efficacy in small intestinal Crohn's disease.

Which is news to me because I've always been told it's used for "colitis" which is any inflammation in the colon (or lower like the rectom).

:)



My bum is broken....there's a big crack down the middle of it!  LOL  :)

Post Edited (pb4) : 5/27/2008 1:20:35 PM (GMT-6)


Illy
Regular Member


Date Joined May 2008
Total Posts : 117
   Posted 5/27/2008 12:39 PM (GMT -7)   

pb4, this is the same contradiction I've read.  I don't know what the state of my small intestines is, that's the only reason I would take it.  The ileitis is painful, but I can control it with diet and probiotics.

the ileitis is one standalone problem.  the other ones are fatigue and joint pain.  doubt that pentasa could help these at all.


gumby44
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Date Joined Nov 2007
Total Posts : 4095
   Posted 5/27/2008 1:02 PM (GMT -7)   
My understanding is that the Pentasa releases around the end of the small intestine, or the ileum. Asacol gets released lower so it is better for Crohn's in the colon.  My doc said it takes about 4 weeks to work.  I have read studies that have said that the mesalamine meds are good for colitis and decreasing the risk of colon cancer, but do not work better than placebo for Crohn's.  I seem to be doing ok on the Pentasa, although I am losing my hair which is not fun!  It seems like all of the meds have risks and are effective for some patients and not for others. Despite the "placebo study," I am still taking the Pentasa, because it seems to have the least side effects and risks, but I honestly wonder sometimes if it is really doing anything at all!

49 yr. old female, diagnosed with Crohn's in small intestine and terminal ileum Sept-Oct. 2007. Also have IBS, and had Salmonella Dec. '07
currently taking Pentasa- 8 250mg pills per day, Cipro 1 week/month, Metamucil, probiotics


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 5/27/2008 2:20 PM (GMT -7)   
The time it takes to work likely varies from person to person as well...in the link I posted above it gives all info on pentasa so it's quite informative for those who are interested.

:)
My bum is broken....there's a big crack down the middle of it!  LOL  :)


rootsmith
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Date Joined Jan 2004
Total Posts : 598
   Posted 5/27/2008 4:02 PM (GMT -7)   
It is my understanding that Asacol is intended primarily for disease in the colon and pentasa for disease higher up in the small intestine, although it is released throughout the gut, its just not the best thing for disease in the lower end.

My personal experience was this. After a normal colonoscopy and a normal biopsy which did not include biopsies of the terminal ileum, don't ask me why, my doctor suggested Asacol to see how I responded. So, I started taking it and found very shortly that my pain (my primary symptom) was relieved about 50%. My gi said that some Asacol gets into the very end of the small intestine.

Next I started on pentasa and I remember my gi saying "with the small intestine its better to use more frequent dosing rather than one or two larger doses", so he suggested 1,000mg three times per day. However, if I kept forgetting to take the middle dose, I could take 1500mg twice a day.

I am assuming my disease is in my small intestine but all I know for sure is that it is not in the 3 places he biopsied. I am pleased with pentasa but I just found out what "normal" really feels like, with prednisone.
10 years, many tests, 3 gi doctors, Pentasa 1000mg 3x day
diovan, simvastatin, sertraline, lyrica  


Illy
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Date Joined May 2008
Total Posts : 117
   Posted 5/27/2008 6:00 PM (GMT -7)   
have you tried the prednisone without the pentasa? 
thanks for your input.

pb4
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Date Joined Feb 2004
Total Posts : 20576
   Posted 5/27/2008 6:31 PM (GMT -7)   
rootsmith said...
It is my understanding that Asacol is intended primarily for disease in the colon and pentasa for disease higher up in the small intestine, although it is released throughout the gut, its just not the best thing for disease in the lower end.

I think that's way off, if you go to the UC board, tons of them use pentasa because it does reach the colon and even the rectom which is the end of the GI tract basically and even in the link I posted above it states that it's used for ulcerative colitis/proc***...if it didn't target those areas then it wouldn't be commonly used for colitis/proctitis.
 
:)
My bum is broken....there's a big crack down the middle of it!  LOL  :)


teaspoon
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Date Joined May 2008
Total Posts : 16
   Posted 5/28/2008 1:22 AM (GMT -7)   
Pentasa as pills

is absorbed in the small intestines

Pentasa as supp. pills

is absorbed in the rectum

rootsmith
Veteran Member


Date Joined Jan 2004
Total Posts : 598
   Posted 5/28/2008 5:05 AM (GMT -7)   
No, I haven't tried prednisone without pentasa. My gi is giving me pentasa but it was the rheumatologist I just saw that did the prednisone trial. This was to justify starting me on something like methotrexate or immuran. I sure hope they coordinate my care or maybe it will be up to me to tell each what the other is doing. Its because of my foot complaint I got the prednisone, the gi office thinks I'm fine the way I was. "we only treat the gut". You have to go to a rheumatologist for the foot problem. So I did

PB4, I don't know for sure about the effects of pentasa on the lower colon. I've never researched it much but I must have picked it up somewhere that pentasa wasn't the drug of choice for the lower end, but like I said, don't know for sure. But I wonder why pentasa would be prescribed for the colon if Asacol is the same drug (mesalamine) and designed to release in the colon. Perhaps if there is disease throughout the gut, or there could be, as in my case.
10 years, many tests, 3 gi doctors, Pentasa 1000mg 3x day
diovan, simvastatin, sertraline, lyrica  


Crohn's 4 ever
Regular Member


Date Joined May 2008
Total Posts : 207
   Posted 5/28/2008 5:18 AM (GMT -7)   
Teaspoon is right, the pill Pentasa is 5 asa's and must be taken whole, disigned to release in the small intestine.  I have been on and off it for 15 years, didnt do a thing for me, or the Entocort, but we are all different.
 
 

yori
Regular Member


Date Joined Jan 2006
Total Posts : 56
   Posted 5/28/2008 9:01 AM (GMT -7)   
I was prescribed pentasa for crohns in the small intestine. I took it for a year and felt no difference. It just made my hair very thin.

Illy
Regular Member


Date Joined May 2008
Total Posts : 117
   Posted 5/28/2008 10:51 AM (GMT -7)   

Thanks, everyone!

So, still alittle unclear:  Pentasa pills work in the small intestine, and the plastic coated capsules don't dissolve until the end of the small intestine/ileum?  But both cause hair loss, gas, etc?

I think but not sure since I only have Pentasa that it's in these thick large capsules that allow it to go all the way to the end of the digestive tract and be released there.  Have not seen asacol so can't say if it does the same thing.

rootsmith:  I know what you mean about the specialization:  I went to my GP today, told him about the diagnosis, asked him to monitor my liver & kidney bloods on the Pentasa, as GI did not suggest it and would be a bit rigid if I asked him to do it.  GP declined, but gave me a recommendation for a GI who is on the board of the ileitis foundation, whatever that is.  He also said he's a bit senior, might not be accepting new patients, and I'm thinking oh, great, he's stuck in the mindset of Crohns c. 1995, probably.  I said I have more arthritic symptoms than D etc. maybe I don't really need another GI and he gave me the name of a rheumatologist, said I'd already been to one who missed Crohn's completely and he was like, oh, no they know all about Crohn's now.  we'll see.

It's like, if I knew what medicine to take, I'd go to the doctor that prescribes that medicine.  that's the only way to pick a doctor these days!

 


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 5/28/2008 11:12 AM (GMT -7)   
Well it must release in the colon and rectom otherwise people at the UC board wouldn't be having success with it, since their small intestines are not affected by disease what so ever...not to mention, googling pentasa as I did, brings up links that state it's used for colitis and protitis.
 
It's so weird the contradictions related to this drug.

:)


My bum is broken....there's a big crack down the middle of it!  LOL  :)


gumby44
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Date Joined Nov 2007
Total Posts : 4095
   Posted 5/28/2008 2:43 PM (GMT -7)   
For whatever it's worth, my GI doc said some patients respond better to Asacol over Pentasa and vice versa despite where the disease is located, however Pentasa is designed to begin releasing in the small intestine and Asacol in the colon
49 yr. old female, diagnosed with Crohn's in small intestine and terminal ileum Sept-Oct. 2007. Also have IBS, and had Salmonella Dec. '07
currently taking Pentasa- 8 250mg pills per day, Cipro 1 week/month, Metamucil, probiotics


Ann Ireland
Veteran Member


Date Joined Apr 2006
Total Posts : 511
   Posted 5/28/2008 3:01 PM (GMT -7)   
Researched pentasa about year and a half ago and read they have found it not effective for crohns b ut good for Uc. Asked my gastro if I could come off, he said yes, no difference whatsoever.
I am now having trouble controlling diarrea but been ery sick over past 3 plus years with other things.
Also Pentasa is known to give a positive ANA reading. In otherwords a false positive. Makes things a bit dificoutl/
My crohns is well behaved in the main.
xx
Ann
Ann Ireland

Congenital Rubella Syndrome (CRS) Severely Deaf, Pes Cavus, scoliolis, Hiatus hernia, diverticular disease, neuromuscular disorder, movement disorder, recently dxed as drug induced 2008 Crohns Disease 1996,Hypothyroidism 1998, Raynauds 2006, Sjogrens 2008, Lupus 2008, Chronic Muscle Myopaythy 2008, spine in very, very bad way dx 2008
Irish, not an illness!

100mcg tyroxine, 10mg Cipramil, 3mg Entocort, 30mg Tamazipam, mystatin, sudocream, neurontin 600mg, acidopolis, Vitamin B complex, Coenzyme Q10, Vitamin B12 injection, Nexium 40mg, Fortijuice.

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