Scientific studies have NOT shown a statistically-significant efficacy improvement in taking the newer delayed-release MMX coatings of the various oral mesalamines (lialda/apriso/asacol/delzicol) versus the older proto-mesalamine meds (Sulfasalazine, Balsalazide Disodium, Olsalazine).
The proto-mesalamines are a different means of delivery but achieve the same goal. They're more complex molecules that gut bacterium cleave into mesalamine and a byproduct. Mesalamine is delivered to the large intestine, just as it is with lialda (whereas lialda uses a MMX-plastic, PH-dissolving coating to deliver to the large intestine).
1.) Sulfasalazine does have a higher incidence of side effects (sulfa can be an allergen to some) predominantly headaches. Not everyone gets them, you could try it and see. Worstcase is you switch to something else.
2.) Balsalazide Disodium does not have the headache risk or the sulfa component. Generally the safer bet of the two, but at a slight premium over the other.
Certainly there is some degree of risk in changing your medications, from something that's working to an unknown. Whether you're willing to accept that risk is something to ponder. Certainly something to discuss with your gasteronenteroligist, risks/benefits of switching. If the cost of Lialda is prohibitive due to your High Deductible Plan, then I'd strongly consider the proto-mesalamines. Something I know all too well is that money disappears waay too fast, as it is.
We have some regular posters who take Balsalazide Disodium or it's brand-named Colazal version. Many have been taking it a very long time (some a decade or more). There's some who take Sulfasalazine as well. Olsalazine/Dipentum is a rather uncommon one, rarely asked about
here (but part of the same proto-mesalamine group).
Post Edited (iPoop) : 7/10/2018 8:02:10 AM (GMT-6)