I am going to be switching to Apriso as soon as my Asacol runs out, which is similar to Lialda in that it's a once-a-day mesalamine. My doc told me to take all four in the morning. However, you can call your pharmacist, who should be able to answer that question (or perhaps check on the Lialda website).
Honestly, I'd go ahead and up it to four...why take the risk on letting the flare get worse if three doesn't work? You can always wean down later, but if the flare gets bad, it may take a lot to get him back to normal.
That's great the headaches are gone. I don't know if I'd necessairly blame the flare on the switch to Lialda, because of that recent blip. Maybe he would have gone into a flare anyway even if he'd stayed on sulfasalazine.
I don't know what he can/can't do on the cortafoam, as I've never used it. I do think I've heard of people using a suppository in the am and an enema in the pm.
Hope he gets better soon!
Status: Remission since late May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Eased for ~3 weeks in December, possibly b/c of probiotic use?
Returned in January 2009 (with a vengeance), diagnosed with pancolitis on January 30.
Currently taking Asacol (400mg 4 pills 3x daily), Rowasa twice weekly, Culturelle probiotic, and Zoloft (25 mg).