Apriso Questions

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JewelsOK
Regular Member


Date Joined Jun 2007
Total Posts : 364
   Posted 8/19/2009 4:11 PM (GMT -6)   
My 10 year old daughter had her appointment the other day with her Ped. GI and she said the drug reps are pushing Apriso. Doctor gave us some samples and said it was up to us if we wanted to switch to it from Colazal (generic). The once a day dosing sounds nice, but I hate to rock the boat, you know?

My main questions are

1. The only dose mentioned that I can find is 4 per day which is what the doctor said my daughter would take (10 years old and 68 lbs.). Isn't that the adult dose?

2. Also, I don't see any info. on the dose for flaring verses remission - my son takes Lialda and takes 2 when in remission and can up it to 4 when flaring. What about Apriso? The literature said it is just for maintenance so what dose one do when flaring?

I asked the doctor when was the best time to make a medicine change - while flaring or when well and she said definitely when well.

The once a day dosing is sure tempting, but I just hate change. Colazal seems to be working quite well. She has been on it for 2 years now with just one real flare earlier this summer.

Thanks a bunch!
Julie

Mom of Son 17 UC dx 07/02, Prednisone 2.5 mg, Lailda 2 am & 2 pm, Azasan 100mg, Cortafoam (when flaring), folic acid, L. Reuteri, Culturelle, Zyrtec, Iron, Vit/Min

Daughter 10 UC dx 08/07 Prednisone 2.5 mg, Colazal 750mg x 4, 6MP 12.5mg, Iron, Vit/Min., Culturelle


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 8/19/2009 4:41 PM (GMT -6)   
I switched from Asacol to Apriso almost two months ago. The once-daily dosing most definitely rocks, and I think it'll be better for me in the long run as I had a lot of trouble remembering my noon dose, and sometimes my evening dose. I had an alarm set on my cell phone, but if it went off when I wasn't close to water, it didn't do me a lot of good! My GI said he thinks one of the biggest reasons people flare is b/c of not taking meds, whether that's by choice or by accidentally forgetting to take doses, so I was willing to rock the boat because of that.

I was taking 12 Asacol a day and now take 4 Apriso a day. I eventually want to taper down some, but my GI wants me to stay at the high dose for a long while b/c I was in such bad shape when I was diagnosed. I'm not sure if one can go higher than 4/day when flaring. Good question!
Status: Remission since May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently meds: Apriso (4 0.375g pills ONCE!! daily), mesalamine enema twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (currently tapering; 12.5 mg).


JewelsOK
Regular Member


Date Joined Jun 2007
Total Posts : 364
   Posted 8/19/2009 4:57 PM (GMT -6)   
Thanks for the feedback, fruitgirl. Glad to hear you like the Apriso! I will say that with 2 kids and over 7 years of dealing with this, we almost NEVER miss a dose. Every Sunday I fill each kiddos pill container (the type for 4 times per day dosing for 7 days). They are very responsible kids and I almost never even have to remind them. When my son goes out for the evening and suspects he may sleep at a friends house, he'll pack his meds and take them with him.

He love the once per day dosing of Lialda, but still has other meds, at other times (zyrtec, Azasan, etc.)

Thanks again.
Julie

Mom of Son 17 UC dx 07/02, Prednisone 2.5 mg, Lailda 2 am & 2 pm, Azasan 100mg, Cortafoam (when flaring), folic acid, L. Reuteri, Culturelle, Zyrtec, Iron, Vit/Min

Daughter 10 UC dx 08/07 Prednisone 2.5 mg, Colazal 750mg x 4, 6MP 12.5mg, Iron, Vit/Min., Culturelle


kelli_C
Regular Member


Date Joined Jul 2009
Total Posts : 130
   Posted 8/19/2009 7:40 PM (GMT -6)   
I was just prescribed apriso on Monday, and HOLY COW, those pills are huge!   So I don't know how your daughter is about swallowing pills, but this may be something to consider. 
Ulcerative Colitis, dx in 1998 at age 18
Rowasa morning and night, Asacol 2x4
Allergic to Sulfasalzine
Now I take no meds or supplements (but some asacol on-hand if I feel a flare-up coming on)


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5190
   Posted 8/19/2009 11:03 PM (GMT -6)   
Yes, the drug reps are pushing Apriso. It's more like Asacol than Colazal-- in that it's designed to start dissolving in the terminal ileum. It contains Aspartame, an illogical ingredient IMO. If Colazal works for your daughter in generic form, too-- there's really no need to switch meds now. Would your insurance cover Apriso regardless? / Old Hat (30 yrs with left-sided UC; taking brand-name Colazal, the Watson generic made me sick!)

fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 8/19/2009 11:16 PM (GMT -6)   
I called Salix about the aspartame, and they said it's in there to help patients swallow the pills (by giving them a sweet taste), because they are so large. The rep made it sound like a lot of super-large pills have artificial sweetners in it. I looked up the amount and compared it to what's in a diet soda, and the four pills that I take daily have a lot, lot, lot less than a diet drink would. So, I'm not too concerned about it.
Status: Remission since May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently meds: Apriso (4 0.375g pills ONCE!! daily), mesalamine enema twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (currently tapering; 12.5 mg).


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5190
   Posted 8/20/2009 9:12 AM (GMT -6)   
Salix is mainly concerned with increasing their profit margins. / Old Hat (30 yrs with left-sided UC ... [etc.])

fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 8/20/2009 10:10 AM (GMT -6)   
Of course, but what drug company (or ANY company) isn't?
Status: Remission since May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently meds: Apriso (4 0.375g pills ONCE!! daily), mesalamine enema twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (currently tapering; 12.5 mg).


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5190
   Posted 8/20/2009 10:53 AM (GMT -6)   
The patient in question here is a 10 yr-old child, who should not be experimented on, which makes the pitch for Apriso all the more odious. / Old Hat (30 yrs with left-sided UC ... [etc.])

fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 8/20/2009 11:20 AM (GMT -6)   
Understandable. But the patient's GI didn't really push it...just presented it as an option and said it was up to them. And of course the drug reps push it as it's their job. It's not a job I'd ever want, but then again, I'd never want any job in sales. I wasn't pushing it...I just provided my personal experience with it, which has been positive, and I felt I should answer the OPs questions as I am one of the few people on here who are on Apriso. I feel like I'm in a more solid remission since I've switched. Whether it's because more time has passed and my colon is less inflamed, or because the Apriso dissolves better for me (I was finding whole Asacol in my stool, even though I was in remission, had formed BM's, and a "normal" transit time) as it starts dissolving at a lower pH, who knows.
Status: Remission since May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently meds: Apriso (4 0.375g pills ONCE!! daily), mesalamine enema twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (currently tapering; 12.5 mg).


JewelsOK
Regular Member


Date Joined Jun 2007
Total Posts : 364
   Posted 8/20/2009 8:53 PM (GMT -6)   
Thanks for the feedback. I think Apriso sounds like a med. to keep in mind for possible future use, but for now will go with the "tried and true". Kind of since "it's not broke, don't fix it".

It's a bit of an inconvenience taking meds throughout the day, but we have done it for so long, it is second nature. Perhaps a once a day Colazal will be in the future....

Thanks again,

Julie
Julie

Mom of Son 17 UC dx 07/02, Prednisone 2.5 mg, Lailda 2 am & 1 pm, Azasan 100mg, folic acid, L. Reuteri, Culturelle, Zyrtec, Iron, Vit/Min

Daughter 10 UC dx 08/07 Prednisone 2.5 mg, Colazal 750mg x 4, 6MP 12.5mg, Iron, Vit/Min., Culturelle


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 8/20/2009 10:26 PM (GMT -6)   
You're welcome. I think you've gotten a good system worked out to make sure your daughter doesn't miss doses of Colazal, so I totally think it's the best thing to stick with it. I WAS having a problem remembering, so for me, it made a lot of sense to switch.
Status: Remission since May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently meds: Apriso (4 0.375g pills ONCE!! daily), mesalamine enema twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (currently tapering; 12.5 mg).


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5190
   Posted 8/21/2009 9:38 AM (GMT -6)   
I agree, Keylime. My experience with Colazal goes back to 2003 when my gastro was participating in Phase 2 clinical trials for it. It tends to work for patients with poor response to Asacol. Apriso = Asacol with extended release properties + touted lower pH dissolution rate. My feeling is that Salix was eager to rush it to market as competition for Lialda by Shire Pharma, not because it's 100% appropriate for every UCer, be it child or adult patient. / Old Hat (30 yrs with left-sided UC ... [etc.])

Jen O
Regular Member


Date Joined May 2009
Total Posts : 136
   Posted 8/21/2009 6:49 PM (GMT -6)   
I do have to chime in, too.

I am one of the other few on Apriso here.

I will second Fruitgirl's opinion. The once-daily dosing is wonderful. And I agree with her, too, in that it has allowed me to be in a much better remission. I changed a bunch of meds at the same time, though, so I can't be 100% sure that it is the Apriso that did the trick.

Good luck with your decision!

Jen
Age 34, Diagnosed with UC September 2008
Current Meds:
Started Azathioprine 100 mgs 6/22/2009 and Apriso 4 tabs daily 6/11/2009
Biotin 5 mg
Vitamin D 2,000 IU per day
Calcium 1500 mg per day
Flaxseed Oil 3000 mg per day
Multivitamin
Rite Aid Probiotic
Also tried: Remicade, Asacol, Rowasa, Cantasa, Prednisone 2 times for about 3 months each

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