Are all 5-ASA's the same?

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fitmom00
Regular Member


Date Joined Mar 2008
Total Posts : 113
   Posted 5/18/2008 5:48 PM (GMT -6)   
They all deliver the same drug - melasamine ... but are they the same? I've been on Lialda since my diagnosis about a year ago. It worked fine for 6 months, but now I'm struggling to come fully out of this flare. I'll go one day good, the next day AWFUL, back and forth with no real reason why that I can tell. I did the Prednisone thing and will try absolutely anything before going that route again ... I'm doing Digestive Advantage, which does seem to help, but not consistently. I'm also using Canasa nightly.

So, should I ask my doctor about switching to Asacol or some other 5-ASA or do they pretty much all do the same thing?
Renee
Diagnosed w/ UC in August 2007
Current status: Flare

4 Lialda/day, Tapering off Prednisone (10mg), Rowasa at night, Wellbutrin XL


julee70
Regular Member


Date Joined Oct 2007
Total Posts : 486
   Posted 5/18/2008 6:31 PM (GMT -6)   
Hi Renee,

The 5-ASA drugs do have differences. Some deliver the drug to different places in the colon. There have been some good discussions about the differences between 5ASA drugs on this board in past months. (Sorry, I can't find a good link right now!)
But the short answer is that it is definitely, in my opinion, worth trying another 5ASA if you think that the one you are on isn't working for you.

Fortunately, you are also using the Rowasa. There are studies that show that 5ASA drugs are more effective when used in conjunction with rectal meds.
-------
UC for the last ten years
Current Meds: 6MP since 2006, Cortifoam
Past Meds: You name it; I've tried it. (Asacol, Colazol, Pentasa, DiPentum, Rowasa, Canasa, Cortenema, sulfasalazine)
5ASA drugs don't work for me. Canasa seems to make me worse.
Alternative treatments I have had success with: Acupuncture, Hypnotherapy


blankslatejoe
Regular Member


Date Joined Jun 2006
Total Posts : 71
   Posted 5/18/2008 6:45 PM (GMT -6)   
YES! they can be drastically different. Between asacol and colozal I preferred colozal --different delivery mechanism that ensures more reaches the gut. Unfortunately, generic colozal doesn't have quite the same results, and I'm violently ill against it. Asacol works well, but you'll have to chomp down TONS of them, since it's a trickle-down treatment--not as much disperses where you want it to.

goodluck!

happyliving
Regular Member


Date Joined Mar 2008
Total Posts : 166
   Posted 5/18/2008 7:47 PM (GMT -6)   
Hi Renee,

What are the symptoms of your current flare?
Where is your UC? I mean what typeof UC?
At what dosage did you started your Pred and how long did you stood at that dosage?

Thanks

munchkindd
Regular Member


Date Joined Oct 2007
Total Posts : 348
   Posted 5/18/2008 8:26 PM (GMT -6)   
They are different. I took asacol for 2 full years without any improvements at all. Sulfasalazine works very well for me, got me into remission in 2 months. It is considered an old drug, I guess, but it's what works for me.
*******Donna*******
 
diagnosed with uc 27 years ago.  Enojoyed 20 year remission with just minor blips here and there (approximately 16 of those years without any meds)
 
In a flare for 2 very long years which Asacol didn't help at all.  Finally in remission again since Jan 2008, can't believe it..............
 
currently on Sulfasalazine 2 tabs 3x day. Folic acid, mesalamine enema 2 x a week. Omega 3, Probiotics, multi vitamin, cacium supplement, Biotin....
 


fitmom00
Regular Member


Date Joined Mar 2008
Total Posts : 113
   Posted 5/19/2008 7:11 AM (GMT -6)   
Thanks for the replies! I'm definitely going to discuss w/ doc. HappyLiving, to answer your questions, my current symptoms are mostly urgency & frequency. On a "normal" day, I go to the bathroom 2-3 times in the morning - i consider this normal as this was pretty much my habit before UC. My symptoms now on a "bad" day are 8-12x in the morning w/ extreme urgency. Twice last week I almost fainted, had chills (but no fever) and nausea. Those were new symptoms. But then the next day, I might be totally fine - it's really odd!

I had to update my signature, as I am no longer on the Pred. I started in March on 40mg for 2 weeks and tapered off of it about 3 weeks ago. It was a nasty drug and I'll avoid it at all costs!!

I don't really know where my UC is, but i remember my doc saying something about 38cm??? I think it's pretty low. I prefer the Canasa b/c I can sustain it all night (i can't seem to keep the Rowasa in for more than 5 minutes!) - but do you think I should really be doing the Rowasa based on the location of the UC?
Renee
Diagnosed w/ UC in August 2007
Current status: Flare

4 Lialda/day, Rowasa or Canasa at night, Wellbutrin XL


quincy
Elite Member


Date Joined May 2003
Total Posts : 30687
   Posted 5/19/2008 10:36 AM (GMT -6)   
Hi...everyone should be using the rectal meds...but if you can't retain the Rowasa, at least try and use the Canasa two or three times a day.

How many times have you tried the Rowasa? You could try using half a bottle..which many on here have done.

q
*Heather*Status: mini flare Dec 28... tapered to every 4th 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 ....zymactive 3 - 5x 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 !!!


TraciZ
Regular Member


Date Joined Aug 2007
Total Posts : 255
   Posted 5/19/2008 11:17 AM (GMT -6)   
blankslatejoe: why are you against generic colazal? I just picked up my rx & it was generic! I had the name brand previously.
Tressa 34 (F)
Not sure of my dx- currently UC, but with skip lesions. Bloodwork is inconclusive for UC & Crohn's. Colonoscopy shows ulceration in terminal ileum and descending colon
Colazal 3X3/day
Lialda upped to 4/day,
Colazal 3X3/day
Phosphatidylcholine 4 (420 mg capsules) once/day


fitmom00
Regular Member


Date Joined Mar 2008
Total Posts : 113
   Posted 5/19/2008 11:26 AM (GMT -6)   
I didn't realize that you could use the Canasa multiple times daily. Can you OD on Melasamine?? :) I'm already taking the max amount of Lialda.
Renee
Diagnosed w/ UC in August 2007
Current status: Flare

4 Lialda/day, Rowasa or Canasa at night, Wellbutrin XL


quincy
Elite Member


Date Joined May 2003
Total Posts : 30687
   Posted 5/19/2008 12:45 PM (GMT -6)   
I use the Salofalk which is 4000mg...I'm down to every 5 nights, however..but at times, it's nightly.

The Canasa is 1000mg each.

Part of the problem could be that rectal inflammation just isn't bein dealt with. Eventually, you would probably be able to taper the Lialda to a lower dosage...but not until the rectal symptoms are consistently quiet.

q
*Heather*Status: mini flare Dec 28... tapered to every 4th 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 ....zymactive 3 - 5x 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 !!!

Post Edited (quincy) : 5/20/2008 4:01:16 AM (GMT-6)


princesa
Veteran Member


Date Joined Aug 2007
Total Posts : 2204
   Posted 5/19/2008 1:00 PM (GMT -6)   
I'm another one that didn't improve - might have gotten worse - on Asacol, but do well on the older azulfadine/sulfasalazine. Here are a couple of pro/con posts from the www.scdiet.org site:

http://www.scdiet.org/4faq/azulfidine.html

http://www.scdiet.org/4faq/asacol.html
Diagnosed with ulcerative colitis spring 1999.
 
Maintenance dose sulfasalazine.
Probiotics, l-glutamine and fish oil caps. George's aloe vera juice. Oregano oil antibiotic, antiviral, antifungal.
 
 

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