Change of medications

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

Christine1946
Veteran Member


Date Joined Aug 2008
Total Posts : 5965
   Posted 7/2/2009 4:51 AM (GMT -6)   
     Have any of you had success by changing medications?  I've had UC for almost eleven years now and flares seem to be getting closer together and tougher to treat.  My GI doctor has had me on a steady course of Colazal (actually Balsalazide) since 2000 after deciding that the Asacol was not the way to go because me UC is located in the rectum.  He has never mentioned Lialda, Humira, Entocort (or is Entocort an enema?)  At the moment, I am in the fifth week of a flare, 20 mgm of prednisone (just read over the horror stories, so decided NOT to increase it), 100 mgm of 6MP (doc increase this last week from 75), Cort enemas, Canasa and of course the Colazal.  No change in five weeks.  He brings up Remicade from time to time but like I mentioned in previous posts, I am not a candidate for it being exposed to the TB virus back in the 60's I test positive for it on my skin tests.  Even his associate said NO WAY to Remicade.
62 yr old granny. South Jersey
Diagnosed with ulcerative proctitis in 1998 in hospital
Hospitalized (2nd time) in May 2008
Meds as of June 09: Colazal (6 per day), 6MP (50 mgm), Probiotic (upped to 3 per day), Fish oil capsule, calcium, multivitamin, Cort enema nightly, Canasa in morning.  Also taking Benicar and Toprol to control high blood pressure.  Getting old is a b****.


notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 16288
   Posted 7/2/2009 7:36 AM (GMT -6)   
Can you try Humira even though you can't use Remicade? I think if I were in your shoes I would give anything a try at his point. I wouldn't rush to try humira but I would try strict dietatry changes and some natural antiinflammatories. I would also see about increading the colazal to 9 or 12 pills a day and if I had to take a higher dose of pred, I wouldn't be against it. Your options are limited and it's best to stay off the biologics for as long as possible. I say this because when/if those drugs stop working, you will probably need to have surgery. Are you using the enemas morning and night?
 
I am sorry you're having so much trouble getting this flare cleared up. I hope you see improvement soon.
Diagnosed with mild proctitis in March 2007: Treated with Canasa (as needed)
December 08: Began treating with Asacol 400mg (9/day) + Canasa 2x/day - Anemic
May 09: Off Canasa, taking Asacol (9/day)
Back on Canasa every other night + Asacol (9/day) + Probiotics + Iron
Reducing to 6 Asacol/day + Canasa + Probiotics + Iron - So far so good!!! -SPOKE TOO SOON! Back to 9/day...


jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10407
   Posted 7/2/2009 9:00 AM (GMT -6)   
If I'm not mistaken, Humira has the same caveat as Remicade regarding tuberculosis. Lialda is Mesalamine, the same drug as in Asacol, jut in time-release form. Entocort is a steroid that is thought to have less systemic absorption than Prednisone. Depending on how sensitive your body is to steroids, it in fact may produce long-term side effects the same as Pred.
Judy
 
Ulcerative colitis forum co-moderator
 
Moderate to severe left-sided UC diagnosed 2001.
Flared for 5 years, finally in remission with Remicade since March 2006.
Avascular necrosis in both shoulders is my "forever" gift from steroids.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. 
"My life is an ongoing medical adventure"
 


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 7/2/2009 9:13 AM (GMT -6)   
Honestly, Christine, I can't think of anything else to try. I can't see that Lialda would be better than Asacol, since it's the same active ingredient and is designed to treat the entire colon. Do you think you could do a mesalamine enema at night and cortifoam in the morning?

What about trying Imuran instead of 6MP? I know they are essentially the same thing, but I think they are broken down a bit differently, so maybe Imuran would work better. It's a long shot, but you never know. When my doc and I were discussing the "what ifs" of future treatment, he said that he'd likely move me on to Remi (not at all suggesting you try it!) before trying Imuran or 6MP, but that if I wanted to try one of those first, he prefers Imuran over 6MP. Apparently, his patients have had more success with Imuran.

Like Judilyn, I'm also pretty sure that Humria, like Remicade, has the same TB issue.

I hope you find something that works!
Status: Remission since late May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently taking Apriso (4 pills ONCE!! daily), Rowasa twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (25 mg).


lovemyboys09
Regular Member


Date Joined Apr 2009
Total Posts : 249
   Posted 7/2/2009 9:43 AM (GMT -6)   
I am in the same position as you are in. My disease is in the same area as you and nothing seems to be working for it which stumps my dr completely. I can't get lower than 10 mg of prednisone without all symptoms coming back and ever since my GI uped my pred to 10 again I still haven't gone completely normal. Asacol isn't working for me either and im in an appeals battle to get colazal covered through my insurance company. My GI told me at my last appointment (1 week ago) that if the colazal fails then Remicade is the next step.....seems pretty fast since i was only diagnosed in oct 07. I am 26, work FT, and have 2 boys ages 5 and 10 months so going in for infusions doesn't sound very easy on my schedule but I guess you have to make time for your health. :)
Colonoscopy on 4/23-diagnosed with severe ulcerative proctitus
 Meds:
12 Asacol/day - don't think it actually is working
proctofoam at night
prednisone (10 mg) tapering - upped it again til august 6
Vitamin D
Calcium 
Azathioprine (50 mg)   serum sickness reaction 
pentasa  didn't work
canasa   didn't work
 
 
Waiting to feel healthy again and waiting on the next plan of action since can't take azathioprine....
 
 
 


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 7/2/2009 9:48 AM (GMT -6)   
What about a probiotic enema? Just thinking a bit outside the box here....
Status: Remission since late May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently taking Apriso (4 pills ONCE!! daily), Rowasa twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (25 mg).


Christine1946
Veteran Member


Date Joined Aug 2008
Total Posts : 5965
   Posted 7/2/2009 10:44 AM (GMT -6)   
     Thanks for all your suggestions.  I do take a probiotic and fish oil supplements.  I am watching my diet (except for that salad I ate on Monday and paid dearly for) like a HAWK!  I insert Cort enemas each a.m. and p.m., although have a hard time keeping them in.  Today, I feel a bit of relief, not much pressure in the rectum.  I only had two bowel movements today and it looks somewhat normal!!!  Very narrow though, but I know that is from the inflammation.  There was some blood, but only on the paper.  God bless you all for your help...wouldn't know what do do without all you wonderful people!
62 yr old granny. South Jersey
Diagnosed with ulcerative proctitis in 1998 in hospital
Hospitalized (2nd time) in May 2008
Meds as of June 09: Colazal (6 per day), 6MP (50 mgm), Probiotic (upped to 3 per day), Fish oil capsule, calcium, multivitamin, Cort enema nightly, Canasa in morning.  Also taking Benicar and Toprol to control high blood pressure.  Getting old is a b****.


notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 16288
   Posted 7/2/2009 1:09 PM (GMT -6)   
I have proctitis and Asacol helps me a lot. My proctitis actually had spread a bit and wasn't confined to the rectum anymore. I wonder if Colazal would have helped as much as Asacol? Maybe it is worth trying Asacol if you don't see improvement soon. Seems like you are seeing a little now so give yourself some time, if you think you're not improving, give Lialda or Asacol a try. In my opinion, It's worth a try before considering surgery. I hope you have a great 4th of July. Don't eat too much junk food!! nono


Diagnosed with mild proctitis in March 2007: Treated with Canasa (as needed)
December 08: Began treating with Asacol 400mg (9/day) + Canasa 2x/day - Anemic
May 09: Off Canasa, taking Asacol (9/day)
Back on Canasa every other night + Asacol (9/day) + Probiotics + Iron
Reducing to 6 Asacol/day + Canasa + Probiotics + Iron - So far so good!!! -SPOKE TOO SOON! Back to 9/day...

New Topic Post Reply Printable Version
Forum Information
Currently it is Saturday, June 23, 2018 3:30 PM (GMT -6)
There are a total of 2,974,572 posts in 326,192 threads.
View Active Threads


Who's Online
This forum has 161289 registered members. Please welcome our newest member, boatlover.
406 Guest(s), 9 Registered Member(s) are currently online.  Details
Balladeer, HarryN, RobertC, Serenity Now, Noah2112, Saipan Paradise, Octorobo, Hoosierhousewife, suchatravesty