Lialda vs Apriso

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GidHike
Regular Member


Date Joined Jun 2011
Total Posts : 122
   Posted 11/29/2011 11:49 PM (GMT -6)   
Well I've been taking Colazal but it's now been abruptly discontinued with no explanation. I've been doing fecal transplants whenever I got a flare approaching and it's been ace. I thought of trying to quit Colazal and just doing fecal transplants if/when I get a flare but I just don't want to take the risk of getting a severe flare. To be honest I don't even know Colazal did anything for me seeing as before fecal transplants I've been getting a flare every 3-6 months anyway while on Colazal

So I need new meds ASAP. I'm uninsured and can't afford to go to the doc to discuss this so I'd like to ask here.

What would you recommend? I can't tolerate Asacol and I'm interested in these two meds because they only need to be taken once a day. I hate having to constantly remind myself and ask myself when/is it time to take Colazal yet 3x a day...

I was dx left-sided UC 3 years ago (I think it changes according to how severe your disease is, right? So I guess it doesn't really matter).

P.S please don't come here and say you've had problems with Lialda or something. Side effects differ from person to person. I'm more interested in knowing if there's more severe long-term effects with one or the other, or if one is proven to work better, etc

Post Edited (GidHike) : 11/29/2011 9:54:36 PM (GMT-7)


WingZero
Veteran Member


Date Joined Oct 2011
Total Posts : 547
   Posted 11/30/2011 7:48 AM (GMT -6)   
I'm on Lialda and haven't had any issues. However, it *is* expensive stuff. I am also uninsured and had to apply for assistance through Shire, otherwise my Rx costs me around $800/mo.

If you can't tolerate Asacol though, you probably won't be able to tolerate Lialda... they are the same thing.
26, Female

Diagnosed with Ulcerative "Pan" Colitis 1998. Was med free from 2003 onward prior to getting hit with a nasty flare August 2011. Trying to pull out of current flare and achieve remission.

Currently taking:
OFF PREDNISONE as of 11/13/11 :D
Lialda 3 tabs/day
Just started Freeda SCD Multivitamin x1/day - Much easier on the stomach!
Homemade SCD yogurt for probiotics

GidHike
Regular Member


Date Joined Jun 2011
Total Posts : 122
   Posted 11/30/2011 10:04 AM (GMT -6)   
Oh, they are? Good to know!

mkl11
Regular Member


Date Joined Jul 2007
Total Posts : 429
   Posted 11/30/2011 11:20 AM (GMT -6)   
I've been on both, and I think Apriso is working well for me, though I'm on 8 pills/day (twice the FDA dose of 4) and when I tried to go down to 4 I had returning symptoms. Apriso is nice because it has two coatings--one time released and one pH released, so the medication gets dispersed at different points in the GI tract.

I think both meds without insurance are pricey. WITH very solid insurance, my Apriso was somewhere around $60/month and I started using one of their cards so now I pay $25...so I can't imagine what it's like without insurance. My guess is Lialda would be cheaper.
23 y/o graduate student

Misdiagnosed with Crohn's June 2007, Diagnosed with left-sided UC and IBS August 2010
Currently: Apriso (3g), Canasa, VSL #3, Culturelle, Folic Acid, Vitamin D, B12 injections monthly
Previously: Prednisone (most recently Summer 2011), Cortenemas, Proctofoam, Lialda, Imuran (Allergic), Asacol, Remicade, Humira, Celexa (Post-Pred Depression)

GidHike
Regular Member


Date Joined Jun 2011
Total Posts : 122
   Posted 11/30/2011 11:38 AM (GMT -6)   
Patient assistance program makes meds free for us. I'd never spend 'retail' on meds. I think I'd rather die from colitis than give those greedy ****** the kind of money they're asking for freaking pills that barely do anything.

Prednisone does so much (good and bad) and it's like $8/month without insurance. Yet 5ASA does arguably nothing and costs a hundred times that

fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 6907
   Posted 11/30/2011 12:42 PM (GMT -6)   
I beg to differ that mesalamine (the active ingredient in Asacol, Lialda, and Apriso) "arguably does nothing." I've been in remission for 2.5 years now and have only been using mesalamine. Sure, I had to use pred to get into remission (but was pretty close only using mesalamine, until a tummy bug threw me back into the flare), but pred is not what has kept me in remission. Study after study shows the effectiveness of oral and rectal mesalamine at treating flares and maintaining remission. Sure, it does not work for all and some can't tolerate it, but there's not one single medicine that works for everyone. Even prednisone doesn't. Yes, it is expensive, but drug development is also very expensive. If the government hadn't allowed drug companies to advertise, maybe they wouldn't be quite so expensive. I also like to think my life is worth the price of Apriso.
Symptomatic remission as of May 2009
Colonoscopy in Oct. 2011 showed no inflammation
Symptoms began in Nov. 2008, about 4 weeks after birth of first child
Diagnosed with pancolitis in Jan. 2009
Apriso (Four 0.375 g pills once daily), Mesalamine enema twice weekly, multivitamin, vitamin D, probiotic
Used prednisone (starting dose 40 mg) to gain remission, tapered off easily

mkl11
Regular Member


Date Joined Jul 2007
Total Posts : 429
   Posted 11/30/2011 1:51 PM (GMT -6)   
I agree with fruitgirl, but it all comes down to the individual. That said, prednisone's bad points far, far outweigh any negatives of mesalamine (unless you have your own reaction to it) which you can stay on for years and years, as opposed to prednisone.

Anyway, Apriso is technically only indicated for maintenance, not inducing remission, so that's something to consider. I'm on 2x the amount because I was using it to get out of a flare (so some doctors believe it can induce remission though it's not approved for that), on top of other mesalamines and steroids.
23 y/o graduate student

Misdiagnosed with Crohn's June 2007, Diagnosed with left-sided UC and IBS August 2010
Currently: Apriso (3g), Canasa, VSL #3, Culturelle, Folic Acid, Vitamin D, B12 injections monthly
Previously: Prednisone (most recently Summer 2011), Cortenemas, Proctofoam, Lialda, Imuran (Allergic), Asacol, Remicade, Humira, Celexa (Post-Pred Depression)

GidHike
Regular Member


Date Joined Jun 2011
Total Posts : 122
   Posted 12/1/2011 12:01 AM (GMT -6)   
Hey WingZero, I'm doing some research on Apriso and in several places people said that Apriso is just like Asacol. You mention that Lialda is just like Asacol as well.

I took Asacol as my first med when I was diagnosed with UC and it made my symptoms noticeably worse. And Rowasa enemas gave me horrible stomach pains for a week after my first enema. So I think whatever is in Asacol and Rowasa I am allergic to it. So just wondering, is it true that Apriso has the same things in it as Asacol?

Also makes me worry - Apriso is made by Salix, the same people who made and discontinued Colazal. Maybe they found out Colazal does something very bad? Like cancer or kidney failure? Since there's no news anywhere on why Colazal was disconnected it is just speculation but it is very shady

Post Edited (GidHike) : 11/30/2011 10:05:10 PM (GMT-7)


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 6907
   Posted 12/1/2011 7:55 AM (GMT -6)   
I told you that Apriso, Asacol, and Lialda all have mesalamine as the active ingredient, but I guess you don't believe me. They aren't exactly "just alike" as the mechanism in which they break down is different, but they do all contain mesalamine. You seem to be allergic to mesalamine.

I imagine the reason for Colazal being discontinued was lack of profit as generic versions are on the market.
Symptomatic remission as of May 2009
Colonoscopy in Oct. 2011 showed no inflammation
Symptoms began in Nov. 2008, about 4 weeks after birth of first child
Diagnosed with pancolitis in Jan. 2009
Apriso (Four 0.375 g pills once daily), Mesalamine enema twice weekly, multivitamin, vitamin D, probiotic
Used prednisone (starting dose 40 mg) to gain remission, tapered off easily

GidHike
Regular Member


Date Joined Jun 2011
Total Posts : 122
   Posted 12/1/2011 11:15 AM (GMT -6)   
According to http://ibdcrohns.about.com/library/meds/blcolazalfaq.htm

"Colazal interacts with bacteria in the large intestine to release mesalamine. The mesalamine works topically to decrease the inflammation caused by ulcerative colitis."

So is Colazal ALSO the "same"? I'm confused

fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 6907
   Posted 12/1/2011 11:20 AM (GMT -6)   
I thought you were asking if Lialda and Asacol were the same, not Colazal.

Colazal is very similar, but since it doesn't "turn into" mesalamine until it's in the colon, some people who can't tolerate "true" mesalamine can tolerate it.

Apriso is a *much* lower dose of mesalamine than Asacol or Lialda, so there's a chance you could tolerate it.
Symptomatic remission as of May 2009
Colonoscopy in Oct. 2011 showed no inflammation
Symptoms began in Nov. 2008, about 4 weeks after birth of first child
Diagnosed with pancolitis in Jan. 2009
Apriso (Four 0.375 g pills once daily), Mesalamine enema twice weekly, multivitamin, vitamin D, probiotic
Used prednisone (starting dose 40 mg) to gain remission, tapered off easily

mkl11
Regular Member


Date Joined Jul 2007
Total Posts : 429
   Posted 12/1/2011 4:08 PM (GMT -6)   
I could not tolerate Asacol but I tolerated Apriso just fine, even taking it at such a high dose.
23 y/o graduate student

Misdiagnosed with Crohn's June 2007, Diagnosed with left-sided UC and IBS August 2010
Currently: Apriso (3g), Canasa, VSL #3, Culturelle, Folic Acid, Vitamin D, B12 injections monthly
Previously: Prednisone (most recently Summer 2011), Cortenemas, Proctofoam, Lialda, Imuran (Allergic), Asacol, Remicade, Humira, Celexa (Post-Pred Depression)

tensai
New Member


Date Joined Sep 2011
Total Posts : 19
   Posted 12/1/2011 6:22 PM (GMT -6)   
Just a note about asacol/lialda. I was on Asacol HD for two weeks and had severe reactions to it. I've now been on lialda for three weeks with no reaction at all (not positive or negative). I know you mentioned that everyone was different in the OP, so take it for what its worth, but just because you can't tolerate Asacol, does not mean you won't respond differently to Lialda.

hateuc
Veteran Member


Date Joined Jun 2010
Total Posts : 1801
   Posted 12/1/2011 6:50 PM (GMT -6)   
I also read that just b/c you have a bad reaction to one ASA doesn't mean you won't be able to tolerate a different one. I think the article said that it was not "cross reactive"
B
Proctosigmoiditis
2 Lialda/day  Rowasa nightly
VSL#3
Metamucil wafers
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