Lialda vs. Asacol HD vs. Delzicol

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fadoozle
Regular Member


Date Joined Apr 2011
Total Posts : 73
   Posted 4/12/2013 8:09 AM (GMT -6)   
What is the difference between Lialda and Asacol HD?

I have been on Asacol HD for three days and have experienced severe gas, intestinal gurgling, abdominal cramping and loose stool not consistent with my usual flare symptoms. I did not experience this while on regular Asacol.

Also, for people that are transitioning from regular Asacol, would you recommend sticking with the Asacol HD or trying the Delzicol? Or trying Lialda instead?

iPoop
Forum Moderator


Date Joined Aug 2012
Total Posts : 2143
   Posted 4/12/2013 8:37 AM (GMT -6)   
There really should not be a lot of difference between Asacol HD and Lialda. The differences I am aware of: Lialda contains more medication in each pill, so you take less pills per day. The delayed-release coating on Lialda is slightly different than Asacol HD, so it might release at a different PH and/or release medication at a different rate in the large intestine. I've been on both Asacol HD and Lialda. I would often see Asacol HD tablets in my poop (with a slight rupture down the side of the pill). I rarely see Lialda tablets in my poop, so I think they dissolve better in my system.

Asacol vs Asacol HD is different only in the amount of medication in each pill. I believe the coating is the same.
34 yrs old; flare since 1/1/2013 w/3 daily bms;
Rx: Daily 75mg 6MP + 5g Lialda + 4g Rowasa + 30mg Prednisone
Diet: Diet mods and supplements haven't done a thing for me.
Last Scope: 4/2/2013 moderate inflammation to 60cms
Dx: 2-2012 ulcerative proctosigmoiditis
"You, my friend, have never been in remission during the time I've known you; inflammation in every scope" - my GI

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 3766
   Posted 4/12/2013 8:40 AM (GMT -6)   
I'll be trying Delzicol when my Asacol runs out in about a month or so. It looks just like an Asacol tablet stuck inside a capsule so hopefully it works just as well. It says you're either supposed to take it at least an hour before meals or two hours after meals...I don't understand the purpose of that.
29 years old; diagnosed pancolitis March 2007

10 mg pred. Asacol, 6 tabs, 2xday; Rowasa nightly; Canasa in a.m. as needed for flares; Ortho Tri-Cyclen; Singulair; Allegra; Deva multivitamin; B-12. Vegan diet.

"I know you're tired, but come, this is the way." - Rumi

eric the red
New Member


Date Joined May 2013
Total Posts : 2
   Posted 5/14/2013 6:34 PM (GMT -6)   
Hello, I am new to this Board.

I have been on Delzicol for 1.5 weeks because of discontinuation of Asecol 400 mg tabs for treatment of what has been called mild to moderate UC. My dose is 2 tabs, 3x/day. My UC has returned with a vengeance (bloody stool, major gas episodes, and mucous-only stools). I will continue using this product for another week or two and then seek a substitute if things do not improve. I am suspicious that the new formulation (or coating) is ineffective.

I have taken the pills according to the instructions regarding meals. Also, although I found no information regarding this in the accompanying literature or online, I have been waiting 30-45 minutes before lying down post-administration of a dose of Delzicol.

I hope more of the members of this blog that have now been on the Delzicol for a period of time can post to address this issue. Are you experiencing positive results, or results similar to mine?

notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 10379
   Posted 5/14/2013 7:14 PM (GMT -6)   
I switched from Asacol 400mg to Lialda and I've been doing great :)

Eric, perhaps Lialda would work better for you.
Co-moderator: Ulcerative Colitis
Diagnosed with Pancolitis, Laryngopharyngeal Reflux & Migraines. Battling Extreme Exhaustion.
Currently: 6mp (25mg) + Lialda (2400mg) + Canasa (1g PM)

garylouisville
Veteran Member


Date Joined Aug 2012
Total Posts : 6807
   Posted 5/14/2013 7:21 PM (GMT -6)   
I've only got a couple weeks before my Asacol runs out and then it's on to HD. I have been doing fairly well compared to most so I'm really not looking forward to this transition.
Asacol 400mgs 2 pillsX3; VSL#3 112.5mgs 1 pillX2; Prescrip Assist Probiotic 1 pill X 2;Vitamin D3 5000 ius 1 pillX2;Bentyl;DAO;Folic acid

Discontinued: Robinul; Natural - peppermint oil, Inflaguard (Boswellia), Pepto Bismol, Omega 3 fish oil, Imodium, Beano, Lactaid;Zymactive, Renew Life Probiotic 80 billion, Florastor, DGL, Monolaurin, slippery elm;black cherry concentrate

eric the red
New Member


Date Joined May 2013
Total Posts : 2
   Posted 5/14/2013 8:41 PM (GMT -6)   
Thank you for your responses. I may look into the Lialda. I'm a scientists and so need to check out the studies done on it first. Good luck on the HD, Gary. I would try it but am concerned that the manufacturer claims that it is not a biological equivalent of the 400 mg tablets.

mspoopypants
Regular Member


Date Joined May 2013
Total Posts : 22
   Posted 5/17/2013 2:28 PM (GMT -6)   
I'm right with you, Eric The Red. They switched my Asacol 400 to Delzicol and I am in the meanest flare I have had in 25 years. Gas, severe cramping, bloody diarrhea. I have had 2 trips to the hospital for IV fluids so far & my GI doc has me on every med under the sun now including Prednisone. I am taking Asacol HD as well, but it dies not seem to be doing anything. Angry as heck right now. mad

hc64
New Member


Date Joined May 2013
Total Posts : 2
   Posted 5/18/2013 1:16 PM (GMT -6)   
Just posted this on the general discussion about the change, but wanted to post it here too. No major flare, but new distressing symptoms with the change. Read on, and good luck to all:

I spoke at great length about this change with my experienced GI Dr, who also pressed the drug rep for an explanation. Truth of this one is, sadly, the change really did come down to patent issues. The warning about the innactive ingredient is somewhat misleading - and not the real reason for the change. It was optional.

At first, fearing the change and noticing too that the tablet inside the capsule looked exactly like asacol, which I've been on for 9 years with no side effects, I removed it from the capsule and took it that way. When my doctor told me after I'd started it that the drug company also claims to have changed the formulation of the tablet "slightly", moving a substance that keeps the pill in tact until it reaches the lower GI from the tablet to the capsule, he asked me to try it in the capsule to see what happened. So, I did, and without putting two and two together - I began experiencing both extreme gastro reflux and stomach pain with it. After nearly a week, it occurred to me today that this is why. I am now going to try it again without what I think is the useless capsule and see what happens. If that doesn't work, and it "breaks up too soon" causing Crohn's symptoms to flare, I will look into Asacol HD - which is unchanged (patent not running out), or another option.

Frustrating move - re: patents and generics. Don't know if this is absolutely true, but I am told by my doctor who grilled the drug rep that some part of the deal will delay the creation of generic asacol 400 mg. - very disappointing. Good luck to all of you - and seriously, watch the reflux/stomach pain - and take with/out food (doesn't seem to help me, but may help some). My stomach issues set in at 2:00 AM the night I started taking this stuff - so almost immediate: and have continued for almost a week, constant, and bad. Glad I now think I know why. Hope this is helpful - at least to some.

Billy Bob
New Member


Date Joined May 2013
Total Posts : 1
   Posted 5/20/2013 2:02 PM (GMT -6)   
As I understand it, if you are in remission on Asocol and then go off of it and have a flare, it may no long work or work without more severe drugs, more severe side effects and a greater dosage.  In other words taking Asocol for years essentially makes you dependent on the drug -- which the drug company obviously knows about.  The new version, Delzicol, is very difficult to take requiring that one have three 3-hour fasts during the day for it to work.  It also does not seem to be effective compared to asacol which may lead to flares, and then advanced disease, more drugs, etc. 

quincy
Elite Member


Date Joined May 2003
Total Posts : 25775
   Posted 5/20/2013 4:01 PM (GMT -6)   
There ARE other options than the Delzicol, and in reality it doesn't make sense for the specification to be taken with meals.

Actually, it would be good if the med doesn't have a success...it's stoopid to put a pill with an enteric coating in a capsule unless it was like spheres, as in a time/bacterial/ph extended release.


Please, those who are flaring, PLEASE realise that rectal meds are also a common sense way of treating the rectum/sigmoid. supps and/or enemas.

Regarding the on and off and they don't work any longer...there's many reasons for that rather than the medication itself.

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 !!!

garylouisville
Veteran Member


Date Joined Aug 2012
Total Posts : 6807
   Posted 5/20/2013 4:46 PM (GMT -6)   
I'm not really completely sure why they did all this end around when I'm assuming the very same company makes Asacol HD. Seems like a lot of trouble to me when a patient can just switch from Asacol to Asacol HD.
Asacol 400mgs 2 pillsX3; VSL#3 112.5mgs 1 pillX2; Prescrip Assist Probiotic 1 pill X 2;Vitamin D3 5000 ius 1 pillX2;Bentyl;DAO;Folic acid

Discontinued: Robinul; Natural - peppermint oil, Inflaguard (Boswellia), Pepto Bismol, Omega 3 fish oil, Imodium, Beano, Lactaid;Zymactive, Renew Life Probiotic 80 billion, Florastor, DGL, Monolaurin, slippery elm;black cherry concentrate

benn
New Member


Date Joined May 2013
Total Posts : 1
   Posted 5/20/2013 10:20 PM (GMT -6)   
it's Asacol inside a empty capsule. could not believe it.

sirgumby
Regular Member


Date Joined May 2013
Total Posts : 62
   Posted 5/22/2013 4:22 PM (GMT -6)   
Hey everyone, I put up a new post about Delzicol but for those of you who have switched from Asacol 400mg , do you have any advice for which new med to start taking? I've been taking Delzicol for half a day so far and I will update when I see any changes in my symptoms. Hopefully those of you taking Delzicol have adjusted to it or switched to something else. Let me know what's been working for you. Thank you.
Diagnosed with mild patchy colitis in 2009
Started Asacol - went in remission after a week
Been in remission ever since with only Asacol
December 2012 - Ran out of Asacol and had a mini flare
Starting taking Asacol 400mg 3 pills 3xs a day again, all symptoms went away except anal soreness, started Rowasa.
95% Remission?

grandmom3379
New Member


Date Joined May 2013
Total Posts : 4
   Posted 5/27/2013 1:23 PM (GMT -6)   
There is a generic approved in Canada, Mesalamine EC 400mg.  It is an Asacol equilivent. You can order it at a reputable Canadian pharmacy with a US prescription.
 
I'm giving it a try.  Dezicol not working for me.

Melissa in Missouri
New Member


Date Joined May 2013
Total Posts : 2
   Posted 5/27/2013 9:01 PM (GMT -6)   
I also had the same symptoms with Lialda. Asacol works much better for me. More pills but bet

itrunsinthefamily
New Member


Date Joined May 2013
Total Posts : 2
   Posted 5/29/2013 6:30 AM (GMT -6)   
I just switched to Delzicol a couple of weeks back and am having some reactions...I think.  My BMs have changed slightly to be looser and I feel as if I am having constant IBS, also a factor in my illness.  Also a little intestinal pain, but this can happen for many reasons so don't know if it's from the Delzicol.  Appalled to hear that the regular Asacol tablet is inside the capsule and the reason is patent running out and generic about to come in.  So we are given yet another contaminant in our systems for our kidneys/liver to dispose of in order for the money to continue to flow to pharm.  This is very upsetting and if true, I suspect it is an illegal gesture on the part of the maker that should be stopped and maybe can be.  I am grateful for mesalamine but furious with the maker.  I'm going to look into the Canadian product mentioned but my coverage will not extend to it, I fear.  I will also consult my doctor about Asacol HD.  Any other suggestions appreciated.
   

dctravelgirl
New Member


Date Joined May 2013
Total Posts : 1
   Posted 5/29/2013 1:04 PM (GMT -6)   
I was on the regular asacol for about 20 years when I found out from my doc that it was being discontinued (due to patent expiration this summer). So I have been on Delzicol for 10 days now and I hate it--the pills are larger than asacol so harder to swallow, it tastes horrible as soon as you put it in your mouth, you have to take one hour before eating or two hours after you eat, so my schedule is all messed up, I feel like I have food in my throat which is probably those pills stuck in there (the pills have this plastic looking coating on it) and my heart rate has been acting funny since I took it. So now I am debating to go on asacol hd or lialda. I am just waiting for generic asacol to come out in the US (good because my insurance plan covers generics 100%).

quincy
Elite Member


Date Joined May 2003
Total Posts : 25775
   Posted 5/29/2013 1:07 PM (GMT -6)   
Ask your doctors for other options....there are a few. You don't have to take the Delzicol if you don't want.

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 !!!

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 3766
   Posted 5/29/2013 3:30 PM (GMT -6)   
The capsules don't have a taste at all. I just started my Delzicol last night but so far, so good. Time will tell.
29 years old; diagnosed pancolitis March 2007

Asacol, 6 tabs, 2xday; Rowasa nightly; Ortho Tri-Cyclen; Singulair; Allegra; Deva multivitamin; B-12. Vegan diet.

"I know you're tired, but come, this is the way." - Rumi

itrunsinthefamily
New Member


Date Joined May 2013
Total Posts : 2
   Posted 5/29/2013 3:51 PM (GMT -6)   
Thanks for the suggestions.  I don't have trouble swallowing the Delzicol and it seems tasteless to me but read something about it and it does have non-inert material that has to be dealt with by the body.  On this thread it is mentioned that the regular Asacol tablet is contained inside the capsule so I am going to ask my doctor if I can simply remove it from the capsule and take the tablet as usual.  I find the fasting before and after annoying and it has affected by schedule.  After more than a week of discomfort since taking the Delzicol, today I seem to be ok and hope it continues that way.  One of the problems with this disease is discomfort for which there seems to be no explanation or cause that can be pinned down, so maybe my symptoms were just part of the colitis and not necessarily caused by the switch to Delzicol.  Eventually, comments on this thread by others may clarify my own experience, hope so.  I read about Lialda, which is a little different from the Asacol I've been taking for several years.  I also take Azulfadine (sulfaslazine) because it addresses the joint pain I have so I take less Mesalamine than I used to.  I also use Canasa daily.  Can someone please distinguish Asacol HD from the regular Asacol I was taking that is now replaced by Delzicol?  The descriptions online are not very helpful.

sirgumby
Regular Member


Date Joined May 2013
Total Posts : 62
   Posted 6/8/2013 2:11 PM (GMT -6)   
Hey everyone, I have been taking Delzicol for about 3 weeks now. I feel fine and it's working great. I can't speak for everyone, but it seems the same as regular 400mg Asacol, if not better. I was taking 3600mg of regular Asacol, now I am taking 2400mg of Delzicol. I really don't understand why someone posted the taste is horrible....there is no taste. It's just a coating that dissolves in water in like a minute. I found that if you have the pills in your mouth and swish some water around the pills before you swallow they are less "sticky" and the pills will go down easy.

My insurance covers Delzicol so for me it works. I just wanted to let you guys know, that so far I have had a normal positive experience with it. Let me know if you have any questions. I'm going to post this in my other thread about Delzicol in case there are some worried people out there with the recent switcharoo.

oh yea..the hour before food thing is not that bad either. I take it when I get up in the morning, wash up and by the time I have some breakfast it's close to an hour past the time I took the pills. I then take it when I get home from work around 4 which is more than the recommended 2 hours after lunch. I then eat dinner and take my last dosage before bed, about 4-5 hours after my last dinner meal. It kind of works in a normal schedule. Take it 1 hour before a meal or 2 hours after a meal. I have to admit, I have cheated and taken it with a meal and my stomach did not explode or anything crazy.

Post Edited (sirgumby) : 6/8/2013 1:23:07 PM (GMT-6)


CapJeep
New Member


Date Joined Jun 2013
Total Posts : 1
   Posted 6/12/2013 2:01 PM (GMT -6)   
Hey All, I was diagnosed in 2001 with UC, I'm 52, I had years with Colazal and I remember a few more. Most were ineffective and symptoms were bad. Tried 6MP for a time and that darn near killed me. Put on Acacol did well for a few years. Tried Lialda and thought it was truly a miracle drug achieved almost full remission. After a period of time it slipped I was back on Asacol it has worked well. Not happy about the change, went to fill my called in scrip Monday and was told by Pharmacy it was no longer available, doc just called in the Delzicol. After reading these posts I'm a little concerned hope it works but would prefer Lialda based on my own experiences. I'll try the Delzicol and let all know. I understand the coating can be removed?

MossPiglet
Regular Member


Date Joined May 2013
Total Posts : 163
   Posted 6/12/2013 2:12 PM (GMT -6)   
I was on asacol for 17 years, tried delzicol, for which the co=payment was $210/month. My insurance premium is $530/month. Yes, it does suck..I hit age 50 and apparently that makes me more costly to insure. My doctor switched me to Apriso, which is 4 large pills once a day. I do not have the heartburn, gassy cramps, etc that I had with Lialda, and I actually was- gasp! almost constipated today. It has been effective in controlling a flare for me, and even though it was not tested for *remission* I will most likely be taking it for that. What really chapped my ***, so to speak, was the cost of delzicol, and the fact that basically they took asacol and hid it in a capsule, so it was a *new* drug with a new patent and a new rip=off co-pay. Big pharma is a scam........Apriso is *only* $50/month.
UC, 17 years, dx age 33
was on Asacol just switched to Apriso
and 50 mg Imuran
Canasa now as had flare
have been on prednisone, Rowasa and hydrocortisone enemas
probiotics via homemade yougurt of: culturelle, Sacc boulardi, Primadophilus reuteri

sirgumby
Regular Member


Date Joined May 2013
Total Posts : 62
   Posted 6/12/2013 8:16 PM (GMT -6)   
hey Capjeep, I don't think you have to worry about the coating that much. If you put a pill in a glass of water and it dissolves pretty quickly and youre left with the asacol looking pill. So I don't know if it matters. If it makes you feel more comfortable taking it out of the capsule that's cool. I just leave it just in case there is a true reason for the coating on the outside.
Diagnosed with mild patchy colitis in 2009
Started Asacol - went in remission after a week
Been in remission ever since with only Asacol
December 2012 - Ran out of Asacol and had a mini flare
Starting taking Asacol 400mg 3 pills 3xs a day again, all symptoms went away except anal soreness, started Rowasa.
95% Remission?
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