Flaring after stupidly going lower than I should have on Asacol

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Regular Member

Date Joined Jun 2008
Total Posts : 45
   Posted 2/5/2009 12:02 PM (GMT -6)   
I had been on Asacol 12 pills/day since June. In November, my doctor told me since I was feeling great, no symptoms, to take it down by 2 pills a month until I was at 8 pills a day. I did that, and felt great. Then I foolishly decided to see how I felt on 7 pills--great. Then 6 pills--flare.
It isn't as bad as my precipitating flare last summer, but I went back up to 10 Asacol and started 60 mg of prednisone. The prednisone improved things immediately, but I still have 2 explosive bms in the morning, with alot of blood, then nothing for the rest of the day. No pain. Do I have to rebuild from scratch (ie, give the Asacol time to "kick in" again) or should I consider that it's working, start tapering the prednisone in 4 days, or hang fire and see if any more improvement is coming?
I will never do this again. What a way to learn a lesson. Thanks in advance for any advice. I am so thankful that this forum exists--my doctor was delighted that I had found it.

Old Hat
Veteran Member

Date Joined Feb 2007
Total Posts : 5191
   Posted 2/5/2009 12:46 PM (GMT -6)   
From what my gastro says, 60 mg Prednisone daily is the maximum permissible dose, so you'll want to taper ASAP. Mesalamine does take longer than a steroid to subdue a flare, but hopefully it will still work for you. Maybe you could use the retention enemas in combo with Asacol to speed healing in the proctosigmoid areas. Hang in there! Other members have written here that they got in trouble by going below 8 Asacol daily. / Old Hat (nearly 30 yrs with left-sided UC; original Colazal is my best med to-date for maintaining remission)

Veteran Member

Date Joined Aug 2008
Total Posts : 5975
   Posted 2/5/2009 1:48 PM (GMT -6)   
     I agree with Old Hat.  I know where you are coming from though Sister (by the way, are you a nun?).  I lowered my Colazal to six a day a few months back but still not flaring.  I also lowered my 6MP from 75 to 50 mgm because my white count is waaaay too low.
62 yr old granny. South Jersey
Diagnosed with ulcerative proctitis in 1998 in hospital
Hospitalized (2nd time) in May 2008
Update 11/03/08...finally in remission!!  Hope I don't jinx myself.  Off the prednisone since 11/01/08...now see if I can stay off for longer than two weeks.  Other meds: 6MP (75 mgm), colazal (6 per day), Benicar and Toprol (high blood pressure meds), Probiotic (2 per day), fish oil capsule and multi-vitamin and calcium with vitamin D.

Elite Member

Date Joined May 2003
Total Posts : 30999
   Posted 2/5/2009 5:27 PM (GMT -6)   
Hi..it's too bad the doctor put you on pred rather than rectal meds of some sort.

Lowering your Asacol was OK...even going down to 6...it doesn't mean that's what caused your flare..it could mean that you were starting to flare anyway and din't recognise the symptoms (considering the Asacol won't treat the rectum anyway).

Rectal meds...consider them...

*Heather* Status..Asacol  (3 x2 daily); flaring /Dec 22, tapered to every 3rd nite..back to nightly (Jan 22)..tapered too fast
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(Natural Factors Protec, Primadophilus Reuteri Pearls, Natural Factors Ultimate). @ bedtime
~various digestive enzymes as needed; started Omega 3 
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!

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