Questions about Asacol

I don't have any answers, but just wanted to say I am sorry you GI isn't more help. why should you be the expert on this stuff? you are so new with you DX, have you talked to someone else? I think having a doc who knows his/her stuff is pretty important. does he have any patients on remicade or humira? does he have a way he usually treats patients?
you are in the right place for info and welcome! yp

Hi Ohana,

Asacol is a drug that is based on sulfasalazine which has two components -- sulfapyridine and mesalamine. With Asacol, Lialda, and Pentasa, the molecule has been split and only the mesalamine remains. Mesalamine is thought to be the therapeutic part, which is anti-inflammatory in nature. Asacol breaks down from the ileum downward into the colon, and is mostly topical. Pentasa breaks down higher in the tract; I'm not sure about Lialda. Which is used depends on where in the tract your CD is.

Mesalamine works well for some but not all. It's cheaper (not cheap) than Remicade, and considered safer I would think, so patients are usually put on it before trying Remicade. But it can have side effects.

I took it for eleven years and finally stopped when I decided some of the problems I was having could be caused by the drug. A few of the problems apparently were from the drug, but not all.

I'm supposed to have an allergy to sulfa, though I doubt it's a true allergy and more probably an intolerance. Anyway, I've been advised both ways. Some pharmacists advised me not to take it and others said it was okay since the sulfa is removed. I just don't know. I never really had any allergic reactions to Asacol, just side effects.

I would advise discussing that topic with your doctor and a knowledgeable pharmacist.

It's interesting to me that you have asthma and can't tolerate Entocort since it's the same steroid that's used in some asthma inhalers -- budesonide. My daughter has asthma and recently had to change inhalers due to a reaction, though we're not sure if it's the drug or the propellant. So anything is possible.

One person's bad doctor is another person's good doctor.  I, personally, love a doctor who gives me my options and lets me make the final decision in my treatment.  Others need a doctor who tells them what they should do, step by step.  It's all about our own perception sometimes I think. 

The traditional route is to start with the Asacol, then move to the Imuran if needed, then go for the Remicade if the others don't work.  Some doctors go straight for the big guns, like remicade.  That would scare me too.  I would certainly want to try the lesser of all evils first.

But, he's giving you the choice, so do your research and see what you think is best for you.  Then take back what you have learned and talk to him about it.