Has Azulfadine stopped working for others, or does type matter?

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Avimelech
New Member


Date Joined Jun 2008
Total Posts : 9
   Posted 8/23/2008 1:10 PM (GMT -6)   
(Hello, been reading here for months, so here's my belated intro.)

I was diagnosed with UC around 1990 when I went to the emergency room after nights of bloody mucously bowel movements (never any cramps or pain, although it did get so bad I had a fever). They put me on 3g of Azulfidine and an IV fast and I was released from the hospital in a few days and was amazed how something necessitating a hospital stay could be cleared up so fast. I felt like new on the drug.

I refused to stay on the drug so I researched health and came to basically the same conclusions the Maker's Diet guy did. With this I was able to get off the drug and stay in remission for many years at a time. (I came back one time and my GI guy asked why it had been so long, when I told him what I did he said diet had nothing to do with it, of course.)

Recently, I had a flare because I went off my diet (for me I realize I cannot get away with eating chocolate or other processed sugars for a week in a row or I will see the telltale mucous and the unavoidable flare follows)

But unlike before where I could take Azulfidine and quickly get in remission, and then wean myself off and get back on the right diet, I have never found it to work outside the US like it did there. Of course, I am older, and if someone tells me they used have AZ work that great and then practically not work at all, that would be helpful.

Yet, I'm wondering if I'm using the wrong type of drug since there are enteric coated ones . Up in the states I had the prescription made after my colonscopy and hospital stay and of course got what it said. But I left the US and now where I live now you can buy Azulfidine over the counter and I have been buying the Pfizer Azulfidine which dissolves in your mouth.

I do not know if maybe before I had the EN-tabs or why else it would not work the same. Are the EN-tabs much different looking?

And further, when I research this here and on the web I cannot understand what the enteric-coating really does fully. Is it just as I read, to make it not upset stomachs in children, or does it largely determine how far the drug is delivered (or both)? In my case, with it being colitis on my lower left side (bright red blood right, and others with it further up have darker blood I understand?), would I want to the enteric-coated so it reaches there? I notice this azulfidine I have quickly dissolves in your mouth if you let it linger before taking the cup of water.

Thanks for your help.

munchkindd
Regular Member


Date Joined Oct 2007
Total Posts : 348
   Posted 8/23/2008 1:47 PM (GMT -6)   
I can tell you that the azulfidine I am taking is not the enteric coated. Mine are round, gold in color and has G500 printed on it, for Greenstone (maker) and 500 for the mg. I have never been on the enteric coated ones. Which ones were you on when first prescribed azulfidine?  I don't believe the enteric coated would work for me, I was on Asacol for 2 years with no luck at all, I believe they were enteric coated and that's why they were not dissolving in my gut. 
*******Donna*******
 
South of Boston, Ma
 
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 once a week. Omega 3, Probiotics, multi vitamin, calcium supplement, Biotin 5000mcg, Fibercon.
 


Avimelech
New Member


Date Joined Jun 2008
Total Posts : 9
   Posted 8/23/2008 2:11 PM (GMT -6)   
I don't know--That's what I feebly attempted to indicate when I said I just took what the prescription gave me. I knew the name of the drug but not any other details about what type. I would probably have to special order enteric-coated type so I'd like to make sure it could make a difference from others' feedback.

jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10407
   Posted 8/23/2008 2:21 PM (GMT -6)   
It's also quite possible that the drug just isn't working for you now. Other members have had this happen - stop taking the meds and then when they flare (which almost all eventually do), that medication doesn't work for them any more. You may need to try a different drug this time. Have you seen a doctor? It's also possible this is completely different from the last time. You could have an infection, or parasites. Really, UC isn't something to treat yourself, you need to see a doctor.
Judy - Southern US 
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from Entocort.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


Avimelech
New Member


Date Joined Jun 2008
Total Posts : 9
   Posted 8/23/2008 2:34 PM (GMT -6)   
I've had UC on and off for twenty years with around a dozen flares over that time and many long remissions so I'm very familiar with what it is (no chance of a parasite, just more of what the same old familiar blight). The drug has not worked well for me for all the flares I have had living here, so that is why I am suspicious about the wrong one.

I'm still interested to hear from others on their experiences with Azulfidine entab vs. normal.

munchkindd
Regular Member


Date Joined Oct 2007
Total Posts : 348
   Posted 8/23/2008 9:11 PM (GMT -6)   
what kind are you on now? If it is enteric coated, it will probably say so on the bottle. What do your pills look like?
*******Donna*******
 
South of Boston, Ma
 
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 once a week. Omega 3, Probiotics, multi vitamin, calcium supplement, Biotin 5000mcg, Fibercon.
 


Avimelech
New Member


Date Joined Jun 2008
Total Posts : 9
   Posted 8/24/2008 1:11 AM (GMT -6)   
I bought non-en-tab. I am wondering what experiences people have with en-tabs or what people understand about exactly what enteric-coating does.

rdm
Regular Member


Date Joined Apr 2006
Total Posts : 229
   Posted 8/24/2008 5:18 PM (GMT -6)   

I doubt that the entab or the regular pill, which is what you are taking, would have much difference in its anti inflammatory effect. I believe Azulfadine or its generic version sulfasalazine is broken down in the intestine through bacteriological action where the 5 ASA component is released, thus providing its anti inflammatory action. The enteric coating is to get it past the stomach and potentially minimize some side effects.  If what you are taking is the non-generic then I really don’t have any suggestions other than to increase your dosage, generally you should not exceed 4 grams (8-500 milligram tablets a day).  The results are definitely dosage related. It also helps to space out the doses. If you are taking generic sulfasalizine you could try the original which is azulfadine.  There was a tread recently about this and you may want to search for it and read what was posted. Alternatively the drug just may not be working for you and you may have to try something else and or go to both rectal and oral doses of 5 ASA meds or rectal steroids with oral 5 ASA's which was the traditional next step up. You are at the first level of treatment which is good as you have a lot of treatment options.


Avimelech
New Member


Date Joined Jun 2008
Total Posts : 9
   Posted 8/24/2008 5:43 PM (GMT -6)   
Thanks for your confirming on the EN issue. That's what I thought.

Actually now that you mention it, when I was first on the drug and it worked great, I remember it was generic. Now I'm using what's available: Pfizer (as I mentioned above).

So it's not a generic quality control issue. It appears to be just what other's have experienced, body changes that make a drug lose its effectiveness.

Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5165
   Posted 8/25/2008 10:33 AM (GMT -6)   
I agree with Judilyn that you should consult a gastroenterologist about UC medication. Even if Azulfidine works to control one's inflammation, a patient should have periodic blood tests while on it-- because the sulfa component can impact on blood cells. I took the En-tabs for a while in the 1980s; they are designed to deliver the anti-inflammatory to the intestines while preventing stomach irritation. In my experience Colazal works much better to manage my UC; luckily, I have health insurance that pays for it + a generic is now available, too-- because it is more expensive than sulfasalazine. Take care! Don't assume that what worked in the past will always help you; UC can change your colon structurally over time even if you do not experience flare symptoms. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily for  maintenance of remission)
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