PREGNANT AND ASACOL DOSAGE INCREASE TO 12 PER DAY... OH LORD!

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LULUBUBALA
New Member


Date Joined Dec 2008
Total Posts : 9
   Posted 2/14/2009 5:38 AM (GMT -6)   
i am 2 months pregnant and for many years been taking 6 asacol per day.  my doctor told me i could take 4 a day now that i am pregnant since i am not having flare.  i went to mt sinia hosptial to see specialist and she requested me to increase my dosage to 12 per day since all her patients take this amount.  is this a good idea?  she tells me it is safe for child, and she wants to ensure i do not get a flare up in summer like i do every year.  she hopes this may prevent it.  if it will prevent me from getting flare up and taking prednisone during my third trimester which would be summer, i am all good to do this, although i am a bit nervous of taking so many.  please help :(
 
 
female age 29, had ulcerative colitis since 20.  have flare up every summer and last two summers out of control which forced me to be on prednisone for 3 months each summer.  first child and nervouse about getting flare during 3rd trimester.
only med is asacol which increased from 4 to 12 per day. take folic acid and hypothyroid medication.
higly respect mt sinia and trust they are making good decision, but still hesitant. 

JM21204
Regular Member


Date Joined Dec 2008
Total Posts : 254
   Posted 2/14/2009 7:11 AM (GMT -6)   
Congratulations on your pregnancy!

I'm 36 weeks pregnant. I have been taking 8 per day the whole time and personally Asacol has been the least of my concerns medication wise. I was also on 25 mg of 6MP the first trimester and have been on 40mg of Prednisone twice so far because of flare ups, once in the first and once in the second trimesters.

Asacol is a Category B drug which means: Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester. It is discussed on the Asacol website: http://www.asacol.com/pdf/us-asacol.pdf

Prednisone is Category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. My doctor told me the biggest concern with Prednisone is there are studies loosely correlating it to cleft palates (which develops in the earlier part of your pregnancy not the 3rd trimester). Did some internet research on it myself as well. From what we can tell on the ultrasounds - we have lucked out thank goodness.

So, is 12 right because "that's what everyone else takes?" I have no idea. But if I had to choose between taking more Asacol to lower the risk of a flareup, which means prednisone for me, I'd do it. However, I tend to flare every 4 months like clockwork and knew I was bound to get a flare while pregnant.

Good luck!
33 yr old female
Diagnosed with Pancolitis in 1/2007
Baby due 3/2009
Meds:1600 mg Asacol a day, Ferrex, Pre-Natal Vitamins, Lovenox, on and off Prednisone (40 mg then taper)
 


Peety
Veteran Member


Date Joined Mar 2008
Total Posts : 2855
   Posted 2/14/2009 10:25 AM (GMT -6)   
Remember it's just an anti-inflammatory (like aspirin) coated so it won't dissolve until it reaches your colon. That's what makes it special, it's really not a strong medicine, just works in the right place.
I would not worry.

And congratulations!
49 year old female attorney, diagnosed UC/pancolitis 1985, no surgery but much suffering.
Asacol/5ASA 6x400 mg maintenance for 20+ years; use prednisone & Rowasa for flares. 
August 2008 sought care of naturopathic doctor. Food sensitivity test showed wheat/gluten, other intolerances; started diet without gluten, soy, dairy, tomato etc. Replete$$ probiotic powder, then Forte, now a stronger one (50 billion). Doing much better, but still having some bad days. 


Dr-A
Veteran Member


Date Joined Jul 2006
Total Posts : 2105
   Posted 2/14/2009 11:42 AM (GMT -6)   
Definately the lesser of the evils we have to take.
Proctitis DX 1999, Pancolitis DX 2008
Lialda 1 day
Immuran
Golimumab study
Vitamin E Enemas as needed
Probiotis/GreenTea/VitD+Ca/SuperDHA


quincy
Elite Member


Date Joined May 2003
Total Posts : 30993
   Posted 2/14/2009 12:38 PM (GMT -6)   
I think she should have put you on a maintenance dosage of rectal meds...twice a week at least and kept you at 6 asacol.

If you started to flare to increase it by two if you take it twice a day or by 3 if you take it thrice.

I don't think 12 asacol will ease rectal inflammation regardless......
She could put you on a maintenance dosage of 2grams Rowasa starting at twice a week and if you start to have symptoms increase it to nightly.

Treating the culprit where it starts makes more sense to me.....

Hope your pregnancy goes well and that your UC symptoms are minimal throughtout.

quincy
*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 !!!
 


mjw82704
Regular Member


Date Joined Dec 2006
Total Posts : 251
   Posted 2/14/2009 1:52 PM (GMT -6)   
I took 12 throughout my whole pregnancy. It is safe according to my GI. Now be careful when you have your little one because 12 is too much for breastfeeding according to Dr. Hale's Meds and Mothers Milk reference book, but I am sure a knowledgeable physician can help you with this when the time comes.
Female Currently Breastfeeding (All my meds are approved by the doc. for breastfeeding but they still make me nervous)
Left-sided colitis diagnosed at age 28 in 2001
3.5mg Low Dose Naltrexone, Prednisone 15mg and tapering,Zoloft,Prenatal vitamins,Juice Plus,Expecta DHA,Emergen C,Probotic Just ordered VSL $$$$$and Udo's Oil when I remember:(


JM21204
Regular Member


Date Joined Dec 2008
Total Posts : 254
   Posted 2/14/2009 11:15 PM (GMT -6)   
mjw82704 said...
I took 12 throughout my whole pregnancy. It is safe according to my GI. Now be careful when you have your little one because 12 is too much for breastfeeding according to Dr. Hale's Meds and Mothers Milk reference book, but I am sure a knowledgeable physician can help you with this when the time comes.

Just curious - what is the "safe" amount for BF'ing?  Is 8 ok?  My doctor hasn't said it isn't.
33 yr old female
Diagnosed with Pancolitis in 1/2007
Baby due 3/2009
Meds:1600 mg Asacol a day, Ferrex, Pre-Natal Vitamins, Lovenox, on and off Prednisone (40 mg then taper)
 


Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4538
   Posted 2/15/2009 12:15 AM (GMT -6)   
If you're not flaring, I don't see why she would want you to increase your Asacol. And it's strange that she told you all her patients are on 12/day. Wouldn't each patient require a different maintenance dose? I don't know about the safety of 12/day while pregnant (I'm sure it's fine, if the doc. told you so), but I question her logic of upping your dose unnecessarily. Personally, I would rather stay on the lowest possible dose so that if I do flare, I know I can up the Asacol at that time instead of going on pred or something else. Four Asacol/day is a very low dose though.
Diagnosed with UC March 2007; Asacol 4 tablets 3x/day; Rowasa; Canasa; Viactiv; Metamucil wafers; multivitamin; sublingual allergy drops; Ortho Tri-Cyclen


mjw82704
Regular Member


Date Joined Dec 2006
Total Posts : 251
   Posted 2/15/2009 9:33 AM (GMT -6)   
JM21204,

From my research on Dr. Hales forum 3200mg (8 pills) is the cut off. I've been taking 8 per day.


http://neonatal.ama.ttuhsc.edu/lact/medicationforumspage.html

Here is a link to his site just click on enter as a guest then the search icon on the left and type in Meselamine. There are some interesting discussions. After reading them my husband and I felt 8 was safe and I suspect 12 would be too as long as the baby does not get diarrhea. I am just not comfortable trying 12. I unfortunately did take 12 in the beginning because I was told it was okay. Thank goodness my little guy was okay. Now I do my own research on this stuff along with the doctors okay.I want to make extra certain that my baby is okay. I'm breastfeeding to help my baby not hurt him:)
Female Currently Breastfeeding (All my meds are approved by the doc. for breastfeeding but they still make me nervous)
Left-sided colitis diagnosed at age 28 in 2001
3.5mg Low Dose Naltrexone, Prednisone 15mg and tapering,Zoloft,Prenatal vitamins,Juice Plus,Expecta DHA,Emergen C,Probotic Just ordered VSL $$$$$and Udo's Oil when I remember:(


Chasblah
Veteran Member


Date Joined Feb 2007
Total Posts : 788
   Posted 2/17/2009 12:19 AM (GMT -6)   
I took 12 during my pregnancy b/c that is what I was on b4 pregnancy. I also took prednisone throughout.
I went to a high risk OB along with my regular one. They monitored my baby with ultrasounds pretty frequently.
I was told that both drugs are just fine for pregnancy.
For Breastfeeding, I did have problems with 12 asacol/day. My daughter started to get diarrhea from it-which I was told was rare, but a possible side effect. I hoped it wouldn't happen, but it did. So I decreased it to 2 in the a.m., 3 in the afternoon and 2 in the p.m. I know it's weird, but it was the lowest my body would let me go without also increasing my pred. We then gave her soy formula for a couple of weeks along with 1-2 BF meals a day. Then once things settled down, The pediatric GI told us we could start trying BF again, Slowly to see how her system would react. She was fine after that! Her GI said her body just couldn't handle that much asacol.
I BF exclusively for 6 months, then stopped BF at 9 months so I could have surgery.
My DD is a healthy beautiful child!
But I will probably forever be obsessed with her poo.

I also think it's dumb to increase your asacol when you don't need it increased. I just don't get that.
Chassity
28 yrs. old. married with one beautiful daughter (born 11/20/07)
-diagnosed with severe pancolitis u/c 2002 had total colectomy 12/19/08; emergency surgery due to abscess-had to redo ileostomy and switch to left side 12/25/08; 1/15/09 found blood clot in superior mesenteric vein (prob. from inf. and surgery inflammation)
pred. taper, coumadin, carafate, prenatal vit., and pain meds
(ileostomy temporary....not so sure?)

"Things turn out the best for those who make the best of the way things turn out."

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