Asacol vs. Asacol HD

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journey2health
Veteran Member


Date Joined Oct 2009
Total Posts : 2687
   Posted 7/18/2011 3:25 PM (GMT -6)   
My doc wants me to switch to Asacol HD because it's fewer pills, but I noticed on the Asacol website, that Asacol 400 mg. is used to treat mild flares while HD is used to treat moderate flares.

I just that that HD was a larger pill, and the same as regular Asacol.

Any explanation? Should I stick with the 400 mg. if they've been working for me or move to the HD for convenience. I feel I have mild UC with occasional flare up in the rectum.
In remission with occasional blips --pancolitis since 8/09. 8 Asacol, Rowasa/thrice weekly (nightly if inflamed), Probiotic -RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules- alternating nights, vitamins. Eat anything, but limit dairy, red meat, no alcohol. Bipolar/anxiety/depression: lamictal, Lexapro; Sleep-zinc magnesium B6 compound (ZMA)

quincy
Elite Member


Date Joined May 2003
Total Posts : 25775
   Posted 7/18/2011 3:59 PM (GMT -6)   
It seems OK for those who use it...one good thing, it's a smaller dosage than the Lialda, so increasing and decreasing is easier without an extreme dosage change.

I would still split the dosage twice a day, however.

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Airomir (asthma);Effexor XR 37.5 (depression)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4500 IU
~URSO for PBC(or PSC?) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

tryingtokeepmyheadup
Regular Member


Date Joined Nov 2010
Total Posts : 215
   Posted 7/18/2011 4:24 PM (GMT -6)   
I didn't like the HD because they were horse pills and I couldn't swallow them! A whole bottle wasted....
DX 2/10 UP. DX 07/10 UC. Pancolitis. tried: Canasa, Asacol, Bentyl, Imodium, Imuran, Prednisone, Flagyl, Cipro, Remicade, Codeine, Tramadol, Xanax, Morphine, Vicodin, Prozac, ~ nothing worked. 1st surgery 6/8/11! 2 more to go!

journey2health
Veteran Member


Date Joined Oct 2009
Total Posts : 2687
   Posted 7/18/2011 6:18 PM (GMT -6)   
I guess I can go pick up samples at my doc.

But why would HD be used for "moderate" flaring and regular be used for mild... Is there something stronger in HD

This is also on the website?

Prescribing Information

You should not substitute one Asacol HD 800 mg tablet for two Asacol 400 mg tablets unless directed by your doctor.
In remission with occasional blips --pancolitis since 8/09. 8 Asacol, Rowasa/thrice weekly (nightly if inflamed), Probiotic -RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules- alternating nights, vitamins. Eat anything, but limit dairy, red meat, no alcohol. Bipolar/anxiety/depression: lamictal, Lexapro; Sleep-zinc magnesium B6 compound (ZMA)

quincy
Elite Member


Date Joined May 2003
Total Posts : 25775
   Posted 7/18/2011 6:43 PM (GMT -6)   
Who knows....but I would think that the lowest dosage for Asacol would mean a higher lowest dosage for the HD (I think that the HD means high dosage...both are "time released"...so maybe the fact that more med is dissolved by one coating instead of more, it means more med gets dispursed.

Ha, I'm just guessing. I see no problem to continue taking what works.

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Airomir (asthma);Effexor XR 37.5 (depression)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4500 IU
~URSO for PBC(or PSC?) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

songlady
Veteran Member


Date Joined Aug 2009
Total Posts : 3252
   Posted 7/18/2011 7:55 PM (GMT -6)   
My general philosophy is, "if it ain't broke, don't fix it." If I were doing absolutely fine on regular Asacol I think I'd leave it be. My son is doing fine, and his GI has been very hesitant to change him to Lialda or Asacol HD because some of her other patients have flared with the change.

I've stayed on Asacol a long time but have flared at least twice a year anyway, so I think I may ask to try something different.
Co-Moderator, UC Forum
Age 55. Diagnosed UP 1983, UC 1986
Asacol - 16 pills/day,
Metamucil - 2 doses/day
VSL#3DS 2/3 x daily, Multivitamin, Calcium and D
homemade yogurt each day
Canasa
still healing from mini-flare...
Son, 18, dx pancolitis 2007, in remission

MotherofTeenwithNoUC
Regular Member


Date Joined Mar 2011
Total Posts : 227
   Posted 7/18/2011 8:05 PM (GMT -6)   
If you read the insert on the Asacol 800HD... it clearly states that it is NOT bioequivalent to Asacol 400mg... meaning that two regular Asacol 400mg do not equal an Asacol 800mgHD.  I learned this hard and fast.  My insurance would not cover the A800HD for my son,  they would cover the A400mg (for the first month, then they denied it).    So we ran out of samples of the A800HD and the Dr switched us to the A400mg.   My son had a severe flare within one month.   If the A800HD is working and your insurance will cover it.. take it.   We were taking the same amount of pills per day for either one (2 tabs X 3 times a day).   Like Songlady says... if it ain't broke, dont fix it".   if it is working for you, take it.  
 
Just my opinion cool
 
MotherofTeenwithUC
14 yr old male, Diagnosed February 2011. Recent Flare currently under control
Started Remicade 6/15/11- next infusion 6/30/11, 3rd infusion scheduled 7/28
Asacol 800HD- 2 tabs 4x day - while the samples last
Prednisone 35 mg day
Poly-Iron 2 xday
Pepcid 20 mg, 2 x day
Canasa suppositories 1X day

hateuc
Veteran Member


Date Joined Jun 2010
Total Posts : 1802
   Posted 7/18/2011 9:32 PM (GMT -6)   
Hi Ellen,
 
Just FYI, my friend has always taken reg Asacol and did very well with it.  (She does however go unmedicated between flares)  For her last flare up her Dr. gave her Asacol HD and it did not help her at all.  She went to reg. Asacol...back out of the flare.  So...I think there must be a difference.  I would say also...if it ain't broke don't fix it!  Good luck,
B

journey2health
Veteran Member


Date Joined Oct 2009
Total Posts : 2687
   Posted 7/19/2011 11:14 AM (GMT -6)   
OK, I'm sticking to regular Asacol for pancolitis. It would be nice if it helped the rectum though. It doesn't.
In remission with occasional blips --pancolitis since 8/09. 8 Asacol, Rowasa/thrice weekly (nightly if inflamed), Probiotic -RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules, vitamins, fish oil, calcium, l-acetyl carnitine. Eat anything, but limit dairy, red meat, no alcohol. Bipolar/anxiety/depression: lamictal, Lexapro; Sleep-zinc magnesium B6 compound (ZMA)

Noah_Bodie
Regular Member


Date Joined Nov 2010
Total Posts : 164
   Posted 7/19/2011 1:28 PM (GMT -6)   
With the patent on Asacol running out in 2013, I'd say that Warner Chilcott is offering a higher kickback to doctors for prescribing Asacol HD. Get the addicts moved to the new crack and maintain the profit stream.

A similar thing happened with Astra Zeneca when the patent ran out on Prilosec. They introduced Nexium, and that became magic.

Me, my older sister, and younger brother, all three have UC. Each of us has experience and learned the maxim: if it ain't broke, don't fix it.
Ken
Age 44
1200 mg generic Asacol twice a day
20 mg Omeprazole (generic Prilosec) once a day

AZYooper
Veteran Member


Date Joined Mar 2010
Total Posts : 1155
   Posted 7/19/2011 2:09 PM (GMT -6)   
It is in the best financial interest of the company to convince the FDA that asacol is not the bioequivalent of asacol HD. The coating are not exactly the same but the PH required to dissolve them is almost. If it was found to be bioequivalent, they would not get a fresh patent for Asacol HD. Proctor and gamble sold asacol and asacol hd because of doubts about patent and/or profitability once asacol goes generic. Most countries did not give them a new patent or allow them to charge more for HD

Also Asacol HD is not approved as a maintenance medication.It is approved for high dose induction of remission for mild-moderate flares. Your insurance company might refuse to cover it long term.

I would only switch to save money and then it still might be a chancy thing.

journey2health
Veteran Member


Date Joined Oct 2009
Total Posts : 2687
   Posted 7/19/2011 2:22 PM (GMT -6)   
AZYooper and Noah_Bodie, your information makes a lot of sense. My doc says it's bioequivalent. Already ordered Asacol garden variety.

Thanks all!
In remission with occasional blips --pancolitis since 8/09. 8 Asacol, Rowasa/thrice weekly (nightly if inflamed), Probiotic -RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules, vitamins, fish oil, calcium, l-acetyl carnitine. Eat anything, but limit dairy, red meat, no alcohol. Bipolar/anxiety/depression: lamictal, Lexapro; Sleep-zinc magnesium B6 compound (ZMA)

Noah_Bodie
Regular Member


Date Joined Nov 2010
Total Posts : 164
   Posted 7/20/2011 2:28 AM (GMT -6)   
journey2health said...
My doc says it's bioequivalent.

Point your doc to this.

www.asacol.com/pdf/asacolhd-info.pdf

One Asacol HD 800 mg tablet has not been shown to be bioequivalent to two AsacolĀ® (mesalamine) delayed-release 400 mg tablets (2)
Ken
Age 44
1200 mg generic Asacol twice a day
20 mg Omeprazole (generic Prilosec) once a day

sfc425
Regular Member


Date Joined Jul 2010
Total Posts : 382
   Posted 7/20/2011 11:52 AM (GMT -6)   
When I ran out of Asacol HD (I take 2 pills 3X a day) I went to Asacol 400 mg and just doubled the dosage. Had the same effect, as far as I could tell.

That's all I can tell you as far as the efficacy. And the pills are larger, but I'd hardly call them "horse pills." They are not difficult to swallow.
26 Year Old Male. Diagnosed with UC in early 2006. Remission soon after diagnosis with treatment of Asacol. Eventually symptoms went away until mid 2010. Minor flareup mostly in remission with use of Asacol HD and then Apriso. Also living with Hiatal Hernia and GERD.

Taking: 0.375g Apriso (4X in AM, Acidophilus probiotic (1X daily). Librax (2X daily) and Omeprazole (1X daily) for GERD.

quincy
Elite Member


Date Joined May 2003
Total Posts : 25775
   Posted 7/20/2011 1:29 PM (GMT -6)   
Noah....it doesn't explain why, however. Can you expand on why it's not equivalant...is it better or worse?

The treatment dosage seems to be the same...top dosage of 4800 mg daily. Same as Asacol. Which doesn't seem to be necessary for many patients regardless.

Any other info you can share?

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Airomir (asthma);Effexor XR 37.5 (depression)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4500 IU
~URSO for PBC(or PSC?) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

Noah_Bodie
Regular Member


Date Joined Nov 2010
Total Posts : 164
   Posted 7/20/2011 2:40 PM (GMT -6)   
Let me nose around and see what I find.
Ken
Age 44
1200 mg generic Asacol twice a day
20 mg Omeprazole (generic Prilosec) once a day

quincy
Elite Member


Date Joined May 2003
Total Posts : 25775
   Posted 7/20/2011 4:47 PM (GMT -6)   
thanks
q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Airomir (asthma);Effexor XR 37.5 (depression)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4500 IU
~URSO for PBC(or PSC?) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!
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