Do you stay on canasa for maintenance?

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

bellski
Regular Member


Date Joined Apr 2008
Total Posts : 499
   Posted 7/12/2008 11:46 AM (GMT -6)   
Just wondering, I think I would like to stay on canasa as well as asacl for maintenance, I think my doc is just wanting asacol for maintenance, any opinions on this?  Thanks, Bellski
Lori (Bellski)-age 43 from Illinois
Diagnosed February 2008 with Ulcerative Proctitis,
Currently: mild symptoms / flare ?
Medications:  Asacol 400mg X 6, Canasa X 2 
Vitamins:  Calcium 600 + D X 2, Centrum, Citrucel caplets, Probiotics
High fiber diet
"I thank God that  I found this website!"
 


libby22
New Member


Date Joined Apr 2008
Total Posts : 14
   Posted 7/12/2008 2:22 PM (GMT -6)   
Hello, I have ulcerative proctitis and am currently on Canasa once per day for maintenance. I tried oral 5ASAs but they give me a bad rash. With Canasa the rash is very mild, so I opted to stay on it instead of the oral (Lialda, Colazal). My GI says it will be fine since I can't take the normal oral stuff. I have been on it for a month & a half. The only side effects so far are the mild rash (on jawline) and some hair loss. I'm not sure it will maintain long term, but I'm keeping my fingers crossed! I'll be interested to hear what others have to say on this topic.
Thanks!

Red_34
Elite Member


Date Joined Apr 2004
Total Posts : 23551
   Posted 7/12/2008 3:56 PM (GMT -6)   
I asked my doc about this once and he has had some patients that use either Canasa or Rowasa as part of their maintenance program for years. So I think that if you are doing good with it, why rock the boat yah?
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma and Co-moderator for UC
~Left sided Uc-'92-Colazal(9 daily),6mp(50-100mgs), Hydrocortisone E's, Prilosec,Biotin,Forvia,Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa**~Allergies-Singulair, Allegra
~Secondary Reynauds Syndrome-'04-Norvasc~Spinal Stenosis~Sacroiliitis-epidural injections~bulging discs C5,C6&C7(?)~waiting for epidural injections
To help Healingwell - click here: DONATE
 
 
 
 

 
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30828
   Posted 7/12/2008 6:07 PM (GMT -6)   
You can taper to a maintenance dosage,..It'll be an increase/decrease thing anyway.
Are you still on 2 daily?  What did the doc propose for you do do....just stop them completely or to taper them?  You should taper off the morning ones firstly .... that will take at least 6 weeks anyway.
Then see how you do and start tapering the nightly ones.

6 Asacol is a good dosage for maintenance. It's my constant dosage and I increase with the enemas.

NEVER, NEVER, NEVER stop rectal meds completely....remember that's where UC starts. Stay on the Asacol because you want everything from the sigmoid up to be nice and quiet.

quincy
*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 !!!


Knitty_Cat
Regular Member


Date Joined Jun 2006
Total Posts : 105
   Posted 7/12/2008 10:25 PM (GMT -6)   

I use two a week (Rowasa) for maintenance.  Works beautifully.  I intend to keep this up for the long term as it works so well for me.  I've been doing it for over a year and have been flare-free the entire time.  I tapered down from nightly enemas after a flare in April of last year and found that things tended to not go so well as I tapered to fewer than 2 enemas a week so I just stuck with the 2 a week. 

Interestingly, there seems to be a lot of support for maintenance rectal 5ASA meds in the medical literature.  Here are some examples:

Effect of weekend 5-aminosalicylic acid (mesalazine) enemas as maintenance therapy for ulcerative colitis: results from a randomized controlled study.

http://www.ncbi.nlm.nih.gov/pubmed/17455207

Trouble maintaining remission in ulcerative colitis? give 'EM an enema!?
 
 
Long-term intermittent treatment with low-does 5-aminosalicylic enemas is efficacious for remission maintenance in ulcerative colitis
 
 
Medical Management of Ulcerative Colitis
 
 
here's the html version as I couldn't get the above link to load
 
 
Left Sided UC
Maintenance Meds: Salofalk tablets (Asacol) 2 tablets 4 times daily (4gm total) plus 2 Salofalk foam enemas per week.
Flare Meds: Salofalk enemas and/or Colifoam
Oat bran 60grams daily, Metamuscil and multivitamins


quincy
Elite Member


Date Joined May 2003
Total Posts : 30828
   Posted 7/13/2008 3:33 AM (GMT -6)   
Hi Knitty_Cat....do you use the enemas every 3rd or 4th night? or one on Saturday/one on Sunday as suggested in the first article?

I believe the foam enemas are 1g dosages, correct? You could progress to the retention enemas with more dosage during flares if you need them...at least you have a huge option base in which to increase.

quincy
*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 !!!


Knitty_Cat
Regular Member


Date Joined Jun 2006
Total Posts : 105
   Posted 7/13/2008 7:16 AM (GMT -6)   
Hi Quincy

I do my 5asa foam enemas every Thursday and Sunday night to get my twice weekly enemas. I find that two set/regular days is easier than counting out every third or fouth day. My reading of the article that suggested doing the enemas just on the weekends was that this dosing was more likely to be adhered to by patients because it was probably easier to do, rather than that consecutive days with a five day break was the optimal dosing. All the other articles just say twice weekly. Makes sense to me to spread them out over the week if possible.

The foam enema is 1g per squirt of the applicator on the can. Two squirts to deliver 2g is the common or recommended dose, and that is what I do. And you're right, any sign of a flare coming and I will just increase the frequency of the enemas. I'll also probably add in some liquid enemas if I flare as I believe they reach a little higher up than the foam does. However, I haven't had to worry about that since starting my maintenance enemas. I actually just came back from a 2 week holiday of Asia where I took my foam and continued the Thursday/Sunday routine with no issues!
Left Sided UC
Maintenance Meds: Salofalk tablets (Asacol) 2 tablets 4 times daily (4gm total) plus 2 Salofalk foam enemas per week.
Flare Meds: Salofalk enemas and/or Colifoam
Oat bran 60grams daily, Metamuscil and multivitamins


quincy
Elite Member


Date Joined May 2003
Total Posts : 30828
   Posted 7/13/2008 2:18 PM (GMT -6)   
Sounds great! If you're still taking the Salofalk tabs at 8 daily, you shouldn't have too many problems above the sigmoid. The foam should reach the sigmoid, and what you're doing is what I can't stress enough....rectal meds increased for flares and tapered to maintenance.

Thanks for the information sites...good for the rectal med "cause"..lol!
At least the weekend use for the 1gr dosage is a good option for patients who have tapered down. Patient adherance is a tough one...I know it's not for everyone to want to use them.

Be well,
quincy
*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 !!!


bellski
Regular Member


Date Joined Apr 2008
Total Posts : 499
   Posted 7/13/2008 5:22 PM (GMT -6)   
I am for sure staying on my asacol, I was just wondering about the canasa.  I got the impression from my doc that when symptoms subside, to stop the canasa.  I am mildly flaring off and on.  I am still doing 2 canasa a day (when I don't forget).  I do feel that personally I'd like to stay on at least one canasa a day even when I feel I'm in remission.  Thanks for the input, It's great as usual.  Have a good night!  Bellski

Lori (Bellski)-age 43 from Illinois
Diagnosed February 2008 with Ulcerative Proctitis,
Currently: mild symptoms / flare ?
Medications:  Asacol 400mg X 6, Canasa X 2 
Vitamins:  Calcium 600 + D X 2, Centrum, Citrucel caplets, Probiotics
High fiber diet
"I thank God that  I found this website!"
 


Knitty_Cat
Regular Member


Date Joined Jun 2006
Total Posts : 105
   Posted 7/13/2008 6:34 PM (GMT -6)   
Hi Bellski
 
Quincy and I are just talking about 5ASA rectal meds - Canasa, Rowasa, Salofalk - all mean the same thing for these purposes.  They are just different methods of delivering a topical dose of 5ASA.  So all the stuff we were talking about applies to Canasa too.
 
My personal recommendation would be to slowly taper the Canasa down as you get better until it is at 2 or 3 a week and then leave it there.  Or just leave it at a frequency that suits you.  You can certainly use them for maintenance.  When you are in remission, you (probably) shouldn't need one a day but play around as you taper down and find the right dose for you.  If your Dr doesn't think this is a good idea, refer him/her to the studies I posted and let him/her know that you'd feel better using Canasa for maintenance.  I don't think many Drs would really prevent their patients from having some extra 5ASA meds if the patient is keen.
 
I *love* rectal meds!  They have made the world of difference to me.
 
Quincy - yep, I always take the 8 Salofalk tabs a day.  My Dr and I used to try to taper that amount down, but for some reason, I don't do well on less than 4g of oral 5ASA a day.  4g doesn't cause me any troubles or side effects so we've given up and are just going to leave it at 4g daily.  He said in my recent appointment that there is now some evidence that younger people need higher (oral) 5ASA doses to maintain remission.


Left Sided UC
Maintenance Meds: Salofalk tablets (Asacol) 2 tablets 4 times daily (4gm total) plus 2 Salofalk foam enemas per week.
Flare Meds: Salofalk enemas and/or Colifoam
Oat bran 60grams daily, Metamuscil and multivitamins

Post Edited (Knitty_Cat) : 7/13/2008 7:44:49 PM (GMT-6)


bellski
Regular Member


Date Joined Apr 2008
Total Posts : 499
   Posted 7/13/2008 6:56 PM (GMT -6)   
Thanks for the resposes. Silly me, I was thinking canasa once a day was the lowest I could go even on remission. I never thought of a few times a week. I just really think it helps me and makes sense. In November I go to a new doctor (Dr. Hanauer) simply for a second opinion to make sure I know what I am doing is on the right page. He is suppose to be one of the best so he will probably be my new GI if I like him. Thanks for all of the help, Bellski
Lori (Bellski)-age 43 from Illinois
Diagnosed February 2008 with Ulcerative Proctitis,
Currently: mild symptoms / flare ?
Medications:  Asacol 400mg X 6, Canasa X 2 
Vitamins:  Calcium 600 + D X 2, Centrum, Citrucel caplets, Probiotics
High fiber diet
"I thank God that  I found this website!"
 


at wit's end
Veteran Member


Date Joined Jun 2007
Total Posts : 569
   Posted 7/15/2008 11:45 AM (GMT -6)   
I use the Canasa suppositories every other night. And I am on the Asacol for maintenance, I take two twice a day.
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. 

New Topic Post Reply Printable Version
Forum Information
Currently it is Tuesday, August 14, 2018 3:28 AM (GMT -6)
There are a total of 2,992,443 posts in 327,957 threads.
View Active Threads


Who's Online
This forum has 161192 registered members. Please welcome our newest member, dfgrdheh.
211 Guest(s), 1 Registered Member(s) are currently online.  Details
Kokopuff7