Issue with Asacol 400mg

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at wit's end
Veteran Member


Date Joined Jun 2007
Total Posts : 569
   Posted 1/28/2008 10:02 PM (GMT -6)   
I've noticed something with the Asacol 400 mg I am taking and am curious if anyone else has experienced this. This morning I went to the bathroom and noticed that two solid Asacol 400mg were in my stool totally undissolved. This is not the first time I've observed this since being put back on Asacol in July of this past year. On at least two other occasions I noticed in my stool what appeared to be one outer layer of the Asacol with very little of the medicine inside visible, just a partial section. Does this mean my system is not absorbing this medication or not dissolving the medication? Thanks.
Diagnosed with left sided UC in sigmoid colon and rectum 1986.
Put on Azulfidine 2 X3 a day and Rowasa enemas 60mg.
Had a rectal flare with bleeding in 1991.
Have been pretty much in remission overall other than a few flares over the past 21 years.
Medicine changed to Asacol 400mg 2 pills X3 times a day.
Was taken off of all meds in 2004 after being symptom free for two years.
Diagnosed with acid reflux 2005. Put on Protonix 40mg.
Had a flare of proctitis in January 2007. Have been using Canasa 1000mg suppositories nightly since January 2007. Had a proctalgia reflux episode in June 2007. Was taking probiotics nightly.
Was put back on Asacol 400mg 2 pills 2X a day in July 2007 as a maintenance against colon cancer.
Xanax when needed.


quincy
Elite Member


Date Joined May 2003
Total Posts : 31006
   Posted 1/28/2008 10:13 PM (GMT -6)   
Hi.....are you having any other symptoms?

If your colon is more active lately or not at quite the PH level, it might not have time to completely be dispersed throughout the colon.

I've had that when I was flaring.....but only notice the casings in my bms.

Are you still on the Canasa tapered to a maintenance dosage?

q
*Heather*Status: mini flare Dec 28... tapered to every second night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....bromelain 1 - 2x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


serendipity24
Regular Member


Date Joined Jan 2008
Total Posts : 56
   Posted 1/29/2008 3:56 AM (GMT -6)   
I've had this happen for years, and it's perfectly okay and expected. It's actually in the side effects or other notes in the packaging info for Asacol. For me, it happens with and without flares, and I don't feel a difference in how my treatment is working. It's not an everyday experience, but it happens more often than one would expect. Hope this puts your mind at ease! And don't hesitate to call your doc if you're really worried about your dosage.
Rachel

23 yrs old
Diagnosed with UC: March 2004 with probable IBS component

Currently taking:
Asacol 4pills 3x/day
Prograf 5mg/day
(Prograf is my miracle drug! It doesn't seem to be well known, but it's fantastic!)

Previously Tried:
Prednisone (works, but such awful side effects!), 6-MP (gave me acute pancreatitis), Entocort, Cipro (antibiotic), Bentyl, Canasa suppositories, a couple different enemas


at wit's end
Veteran Member


Date Joined Jun 2007
Total Posts : 569
   Posted 1/29/2008 7:49 AM (GMT -6)   
Hey Quincy, I am not having any other symptoms other than bad bouts of gas. No diarrhea, no bleeding. The first two times I noticed this it was just what you stated in yours, the casings, but just a small part of it. But I've never had entire pills show up like that, well, not noticed anyway. I am still on the Canasa tapered to a maintenance dosage. My main issue with this was that if these two pills did not absorb or dissolve are any of the others? Not to mention the cost of the medicine as I have to order any medications long term mail order in a 90 day supply. I have been on Asacol in the past and didn't notice this before. But if I'm not the only one seeing this it must be normal. I just question where our meds are made that we in the States get. Wouldn't be surprised if our meds were not gotten from China by the pharmaceutical companies. Thanks you two.
quincy said...
Hi.....are you having any other symptoms?

If your colon is more active lately or not at quite the PH level, it might not have time to completely be dispersed throughout the colon.

I've had that when I was flaring.....but only notice the casings in my bms.

Are you still on the Canasa tapered to a maintenance dosage?

q



Diagnosed with left sided UC in sigmoid colon and rectum 1986.
Put on Azulfidine 2 X3 a day and Rowasa enemas 60mg.
Had a rectal flare with bleeding in 1991.
Have been pretty much in remission overall other than a few flares over the past 21 years.
Medicine changed to Asacol 400mg 2 pills X3 times a day.
Was taken off of all meds in 2004 after being symptom free for two years.
Diagnosed with acid reflux 2005. Put on Protonix 40mg.
Had a flare of proctitis in January 2007. Have been using Canasa 1000mg suppositories nightly since January 2007. Had a proctalgia reflux episode in June 2007. Was taking probiotics nightly.
Was put back on Asacol 400mg 2 pills 2X a day in July 2007 as a maintenance against colon cancer.
Xanax when needed.


tjf
Veteran Member


Date Joined Dec 2005
Total Posts : 3238
   Posted 1/29/2008 7:55 AM (GMT -6)   
Hey! Do you mind limiting your signature to 10 lines or less? Thanks!! Looks like you are getting some good help here!
Tabitha (Tab)

100mg Azathioprine, 2 Fibercon, Colazal-9 a day, Acidopholis Pearls, Nexium

http://www.healingwell.com/donate
Co-Moderator UC Forum


quincy
Elite Member


Date Joined May 2003
Total Posts : 31006
   Posted 1/29/2008 11:11 AM (GMT -6)   
AW'sE.....are you having one bm a day?

I would suggest you maybe start the canasa nightly again to see if it improves.

Are you not on any probiotics at this time? maybe consider to start them as well.

I don't think Asacol is made in China...maybe the generic when there's one..or is there one?

quincy
*Heather*Status: mini flare Dec 28... tapered to every second night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....bromelain 1 - 2x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


Birunji
Regular Member


Date Joined Sep 2007
Total Posts : 60
   Posted 1/29/2008 11:21 AM (GMT -6)   
The same thing happens to me, I think I posted about it yesterday. I notice whole pills almost daily. At first I assumed I was still absorbing it because my doctor said that the shells can come out even though the medicine is absorbed. But now I'm starting to wonder because yesterday one of the pills was cracked open a bit and I could see a bunch of white stuff inside. Also, as far as I could tell, Asacol's never done anything for me. Don't know if it's an absorption issue or what, but I may mention it to my doctor. Let me know if you find out anything useful.
Erin, 25
Dx w/ left-sided UC June 2007
(Flaring since June 2007)
Meds: Asacol 400 mg x 9; Prednisone (since 01/09/08) 20 mg 15 mg 
Supplements: Iron, Multivitamin w/ Calcium and Vit. D, Fish Oil & Probiotic Yogurt
Dx w/ Depression, GAD, and OCD in 2001
(Currently in therapy)
Meds: Paxil Lexapro Zoloft 100 mg
 


at wit's end
Veteran Member


Date Joined Jun 2007
Total Posts : 569
   Posted 1/29/2008 11:28 AM (GMT -6)   
This is weird. I already edited my signature line down one time to ten lines or less and have not added anything else to it. How on earth did it get back to more lines again? Puzzling.
tjf said...
Hey! Do you mind limiting your signature to 10 lines or less? Thanks!! Looks like you are getting some good help here!


Diagnosed with left sided UC in sigmoid colon and rectum 1986.
Put on Azulfidine 2 X3 a day and Rowasa enemas 60mg.
Had a rectal flare with bleeding in 1991.
Have been pretty much in remission overall other than a few flares over the past 21 years.
Medicine changed to Asacol 400mg 2 pills X3 times a day.
Was taken off of all meds in 2004 after being symptom free for two years.
Diagnosed with acid reflux 2005. Put on Protonix 40mg.
Had a flare of proctitis in January 2007. Have been using Canasa 1000mg suppositories nightly since January 2007. Had a proctalgia reflux episode in June 2007. Was taking probiotics nightly.
Was put back on Asacol 400mg 2 pills 2X a day in July 2007 as a maintenance against colon cancer.
Xanax when needed.


at wit's end
Veteran Member


Date Joined Jun 2007
Total Posts : 569
   Posted 1/29/2008 11:39 AM (GMT -6)   
Birunji, spoke with the nurse at my doctor's office this morning. She said it is somewhat normal to have this occur occasionally as it is time released but also said if it starts occuring over and over they will need to switch my medicine as the medicine itself is not dissolving, therefore, it is not getting to the colon to do it's job. You may want to notify your doctor of this.
Diagnosed with left sided UC in sigmoid colon and rectum 1986.
Put on Azulfidine 2 X3 a day and Rowasa enemas 60mg.
Had a rectal flare with bleeding in 1991.
Have been pretty much in remission overall other than a few flares over the past 21 years.
Medicine changed to Asacol 400mg 2 pills X3 times a day.
Was taken off of all meds in 2004 after being symptom free for two years.
Diagnosed with acid reflux 2005. Put on Protonix 40mg.
Had a flare of proctitis in January 2007. Have been using Canasa 1000mg suppositories nightly since January 2007. Was put back on Asacol 400mg 2 pills 2X a day in July 2007 as a maintenance against colon cancer. Xanax when needed.


Birunji
Regular Member


Date Joined Sep 2007
Total Posts : 60
   Posted 1/29/2008 12:04 PM (GMT -6)   
Thanks for the heads up. It definitely happens to me near daily, so perhaps I need to try something else.
Erin, 25
Dx w/ left-sided UC June 2007
(Flaring since June 2007)
Meds: Asacol 400 mg x 9; Prednisone (since 01/09/08) 20 mg 15 mg 
Supplements: Iron, Multivitamin w/ Calcium and Vit. D, Fish Oil & Probiotic Yogurt
Dx w/ Depression, GAD, and OCD in 2001
(Currently in therapy)
Meds: Paxil Lexapro Zoloft 100 mg
 


at wit's end
Veteran Member


Date Joined Jun 2007
Total Posts : 569
   Posted 1/29/2008 12:25 PM (GMT -6)   
You're welcome.

Diagnosed with left sided UC in sigmoid colon and rectum 1986.
Put on Azulfidine 2 X 3 a day and Rowasa enemas 60mg.
Had a rectal flare with bleeding in 1991.
Have been pretty much in remission overall other than a few flares over the past 21 years.
Medicine changed to Asacol 400mg 2 pills X3 times a day.
Was taken off of all meds in 2004 after being symptom free for two years.
Diagnosed with acid reflux 2005. Put on Protonix 40mg.
Have been using Canasa 1000mg suppositories nightly since January 2007. Was put back on Asacol 400mg 2 pills 2X a day in July 2007 as a maintenance against colon cancer. 


Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4538
   Posted 1/29/2008 12:51 PM (GMT -6)   
serendipity24 said...
I've had this happen for years, and it's perfectly okay and expected. It's actually in the side effects or other notes in the packaging info for Asacol. For me, it happens with and without flares, and I don't feel a difference in how my treatment is working. It's not an everyday experience, but it happens more often than one would expect. Hope this puts your mind at ease! And don't hesitate to call your doc if you're really worried about your dosage.
Actually, in the package insert it says to tell your doctor if this happens repeatedly.
 
I've noticed mine coming out whole lately, too. It seemed to happen more often when I started flaring worse a few weeks ago. Almost every day I notice the red casing, but I have been seeing the white medicine inside pretty often lately.
24 years old
Diagnosed with UC March 2007; yet to go into remission
Asacol 4 tablets 3x/day
Rowasa (generic) - daily
Nature's Way Primadophilus Reuteri 1/day; Chewable multivitamin; Metamucil; Viactiv (Calcium and Vit. D); fish oil


Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4538
   Posted 1/29/2008 12:55 PM (GMT -6)   
What did you nurse mean by it's time-released? I thought it started to dissolve based on the pH of the terminal ileum.

BTW, Asacol is made in Germany.


24 years old
Diagnosed with UC March 2007; yet to go into remission
Asacol 4 tablets 3x/day
Rowasa (generic) - daily
Nature's Way Primadophilus Reuteri 1/day; Chewable multivitamin; Metamucil; Viactiv (Calcium and Vit. D); fish oil


at wit's end
Veteran Member


Date Joined Jun 2007
Total Posts : 569
   Posted 1/29/2008 1:59 PM (GMT -6)   
I don't know about any ph anything but I looked up what I took on the web this morning through the FDA site as I am taking Asacol NE 400mg and it even states it is time released.


Diagnosed with left sided UC in sigmoid colon and rectum 1986.
Put on Azulfidine 2 X 3 a day and Rowasa enemas 60mg.
Had a rectal flare with bleeding in 1991.
Have been pretty much in remission overall other than a few flares over the past 21 years.
Medicine changed to Asacol 400mg 2 pills X3 times a day.
Was taken off of all meds in 2004 after being symptom free for two years.
Diagnosed with acid reflux 2005. Put on Protonix 40mg.
Have been using Canasa 1000mg suppositories nightly since January 2007. Was put back on Asacol 400mg 2 pills 2X a day in July 2007 maintenance. 


Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4538
   Posted 1/29/2008 3:19 PM (GMT -6)   
I guess it probably means it's timed to release when it gets to that certain pH in the terminal ileum...sorry that was a sort of dumb question on my part. I've just never heard it called "time released" before.


24 years old
Diagnosed with UC March 2007; yet to go into remission
Asacol 4 tablets 3x/day
Rowasa (generic) - daily
Nature's Way Primadophilus Reuteri 1/day; Chewable multivitamin; Metamucil; Viactiv (Calcium and Vit. D); fish oil

Post Edited (Sara14) : 1/29/2008 1:23:31 PM (GMT-7)


at wit's end
Veteran Member


Date Joined Jun 2007
Total Posts : 569
   Posted 1/29/2008 5:40 PM (GMT -6)   
Here is what timed release means: consisting of or containing a drug that is released in small amounts over time (as by dissolution of a coating) usually in the gastrointestinal tract.


Diagnosed with left sided UC in sigmoid colon and rectum 1986.
Put on Azulfidine 2 X 3 a day and Rowasa enemas 60mg.
Have been pretty much in remission overall other than a few flares over the past 21 years.
Medicine changed to Asacol 400mg 2 pills X3 times a day. Taken off all meds in 2004.
Diagnosed with acid reflux 2005. Put on Protonix 40mg.
Have been using Canasa 1000mg suppositories nightly since January 2007.
Was put back on Asacol 400mg 2 pills 2X a day in July 2007 maintenance. 


Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4538
   Posted 1/29/2008 5:43 PM (GMT -6)   
Makes sense. Thanks.
24 years old
Diagnosed with UC March 2007; yet to go into remission
Asacol 4 tablets 3x/day
Rowasa (generic) - daily
Nature's Way Primadophilus Reuteri 1/day; Chewable multivitamin; Metamucil; Viactiv (Calcium and Vit. D); fish oil


teddybearweiser
Veteran Member


Date Joined Oct 2004
Total Posts : 3042
   Posted 1/30/2008 5:20 AM (GMT -6)   
Hi I am also on Asacol it is the shell of the Asacol that you saw. I asked my gastro doctor which he told me this.
Hi, I am teddybearweiser, I am a male.
I was diagnosed with crohns disease when i was admitted to the hospital
in 1992, in Jan of 1993 I was back in the hospital for surgery for my crohns. I had part of my right colon resectioned with ilecolonstomy.
 My GI doctor has me on Asacol, Dicyclomine,Imuran,Celebrex and Remicade. B-12 injection once a month.
My Internest doctor has me on Lisnopril-HTCZ and Folic Acid. Diagnosed
with Osteoarthritis July 2007
 


at wit's end
Veteran Member


Date Joined Jun 2007
Total Posts : 569
   Posted 1/30/2008 7:36 AM (GMT -6)   
What I saw Monday morning was way more than a shell. They were the entire pills, intact. But the other time it was part of the shell.
Diagnosed with left sided UC in sigmoid colon and rectum 1986.
Put on Azulfidine 2 X 3 a day and Rowasa enemas 60mg.
Have been pretty much in remission overall other than a few flares over the past 21 years.
Medicine changed to Asacol 400mg 2 pills X3 times a day. Taken off all meds in 2004.
Diagnosed with acid reflux 2005. Put on Protonix 40mg.
Have been using Canasa 1000mg suppositories nightly since January 2007.
Was put back on Asacol 400mg 2 pills 2X a day in July 2007 maintenance. 


Birunji
Regular Member


Date Joined Sep 2007
Total Posts : 60
   Posted 1/30/2008 11:32 AM (GMT -6)   
I also just talked to my doctor about this. He said that the drug companies say that seeing the pill doesn't mean you didn't absorb it, but that he doesn't necessarily believe it. He recommended taking it with food in case increased motility was the issue, and that if I kept seeing the whole pills (I currently see about 1-3 every day) to let him know and he'd switch me to Pentasa (which apparently has a different release mechanism).
Erin, 25
Dx w/ left-sided UC June 2007
(Flaring since June 2007)
Meds: Asacol 400 mg x 9; Prednisone (since 01/09/08) 20 mg 15 mg 
Supplements: Iron, Multivitamin w/ Calcium and Vit. D, Fish Oil & Probiotic Yogurt
Dx w/ Depression, GAD, and OCD in 2001
(Currently in therapy)
Meds: Paxil Lexapro Zoloft 100 mg
 


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 1/30/2008 11:37 AM (GMT -6)   
From my understanding asacol and imuran type meds are designed to reach the colon to treat the inflammation there specifically, so they'd be timed released in order to reach the colon where it needs to be affective and this could very well be why the casing for asacol comes out whole.

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


Birunji
Regular Member


Date Joined Sep 2007
Total Posts : 60
   Posted 1/30/2008 11:46 AM (GMT -6)   
That makes some sense, though I'm pretty sure more than just the casing is coming out, since I've seen one partially cracked open and full of white stuff. :/
Erin, 25
Dx w/ left-sided UC June 2007
(Flaring since June 2007)
Meds: Asacol 400 mg x 9; Prednisone (since 01/09/08) 20 mg 15 mg 
Supplements: Iron, Multivitamin w/ Calcium and Vit. D, Fish Oil & Probiotic Yogurt
Dx w/ Depression, GAD, and OCD in 2001
(Currently in therapy)
Meds: Paxil Lexapro Zoloft 100 mg
 


Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4538
   Posted 1/30/2008 12:32 PM (GMT -6)   
Yeah...it's not just the casing we're talking about. I've seen the whole pill, with medicine inside.
24 years old
Diagnosed with UC March 2007; yet to go into remission
Asacol 4 tablets 3x/day
Rowasa (generic) - daily
Nature's Way Primadophilus Reuteri 1/day; Chewable multivitamin; Metamucil; Viactiv (Calcium and Vit. D); fish oil


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5191
   Posted 1/30/2008 12:55 PM (GMT -6)   
Birunji-- if your UC is left-sided, you should likely switch to Colazal, not Pentasa, which is more a right-sided & terminal ileum-dissolving med. Besides, Colazal has a new generic that might save you big bucks! / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily for maintenance of remission)

Birunji
Regular Member


Date Joined Sep 2007
Total Posts : 60
   Posted 1/30/2008 1:01 PM (GMT -6)   
Old Hat:

Thanks for the tip! I'll be sure to mention it to my doctor. While my UC is left-sided, it does extend across my mid-transverse colon. Would Colazal be helpful there as well?
Erin, 25
Dx w/ left-sided UC June 2007
(Flaring since June 2007)
Meds: Asacol 400 mg x 9; Prednisone (since 01/09/08) 20 mg 15 mg 
Supplements: Iron, Multivitamin w/ Calcium and Vit. D, Fish Oil & Probiotic Yogurt
Dx w/ Depression, GAD, and OCD in 2001
(Currently in therapy)
Meds: Paxil Lexapro Zoloft 100 mg
 

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