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Passing 2 of 4 lialda undisolved

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Ulcerative Colitis
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Posted 9/30/2018 3:34 AM (GMT -7)
Hi all ,
I have left sided colitis and take generic Lialda 4.8 gm . Why is it that of the 4 pills I have two dissolve and two come out partially dissolved . If the ph level was wrong how come two are dissolving . I take two at lunch and two at dinner . Any thoughts
Thanks
Best regards
(I added a subject)

Post Edited By Moderator (iPoop) : 9/30/2018 1:29:05 PM (GMT-6)

Posted 9/30/2018 7:08 AM (GMT -7)
I can't answer your question but you could try skipping either the lunch or dinner dose for several days to see if it is consistently one or the other that is not dissolving. Adjust your pill time accordingly.
Posted 9/30/2018 7:12 AM (GMT -7)
I wouldnt skip the doses....I would suggest you take them all at the same time....try a week of early, and a week of late

Are you flaring? Because your active times will increase peristalsis and once in the colon.

They dont match food transit time, however....they hang out longer.

q
Posted 9/30/2018 12:30 PM (GMT -7)
Try taking them all in the morning. What's the pill code? 711 or s476?
Posted 9/30/2018 4:50 PM (GMT -7)
This happens to me every so often. I think it isn’t usually an issue if it is a one off event. If it happens often I would be concerned. You could try and take two in the morning and two in the evening and see if thisbstill happens. I wouldn’t skip a dose. Or take all 4 at once.
Posted 9/30/2018 5:56 PM (GMT -7)
Ask your doctor and do what they say. I had the same exact question years ago for my doctor. There are several oral forms of mesalsmine anyways. At some point your dr may have you try another brand but go ahead and tell them what you’re seeing. It has happened to me and others!
Posted 10/1/2018 5:44 AM (GMT -7)
It's okay to infrequently pass a whole pill, however, it should not happen on a regular basis. If passing whole pills regularly, then the medication is not working, and you need to try a different brand/make. Each has a unique chemical, delayed-release coating and some work better for us than others.

Most (other than pentasa and zydus generic lialda code 711) are PH-based delivery. If your PH is different than expected, and/or your mouth-to-anus transit time is too fast for the coating to dissolve, then you pass whole pills regularly. Different brands have different target PHs and dissolve times.

Pentasa and zydus generic lialda code 711 use a time-delayed release with an etha-cellulose coating that does not use PH at all.
Posted 10/1/2018 7:13 AM (GMT -7)
Hi ,

Thanks for all the replies . I live in India so there is mesalmine is 1.2 gm available here under two brand names . I have been using one of them for the past so many years and this problem is only lately cropped but though did happen infrequently in the past . I did speak to my doctor and he just said it happens and to take the pill with food .

So yesterday I took all 4 pills with lunch , lo and behold today all four passed out clumped together . The red coating on them had dissolved but a lot of the medicine had not dissolved .
This morning I switched it up a bit , took two pills with breakfast . Definitely mouth to anus transit time for me is very fast coz when I pooped in the evening after around 8 hours of breakfast again one pill showed up , one had dissolved and was gone , the other again , the red coating had dissolved but most of the medicine was still there .
I don’t know how to slow down the food transit time , any suggestions . Should I try Imodium for a few days to see if that helps .
My doc is travelling for the next ten days so if it keeps happening , will go to him . It has happened in the past but it used to be infrequent and very little of the pill used to remain . Lately seeing this very often of not every day . Sorry for the long post but was trying to answer all the questions

Best
Ritu
Posted 10/1/2018 7:26 AM (GMT -7)

Kickucbutt said...
The red coating on them had dissolved but a lot of the medicine had not dissolved.

Well the coating dissolved as expected then, that's good. The medications do include a lot of inactive, filler ingredients that we can see within our stool. That's normal and okay. I've seen white, chalk-colored powder clumps within my stool. With asacol hd 800MG, that's normal, and I'd see a whole capsule with split on the side and some of the white inside left (normal). With lialda/mezavant 1200MG, all I would see is orange flakes and no pills. Your formulations within India are likely different than what I can get within the USA, so I cannot say whether with your brand that's an okay result or not. I'd ask your pharmacist.

You can try another brand of mesalamine. Alternatively, you can ask for precursor to mesalamine without the coating: sulfasalazine or balsalazide disodium. Those medications are more complex molecules that gut bacteria break down into mesalamine and a byproduct. Sulfasalazine is also available in a syrup, measure in a spoon and drink. So there are other options available to you, if you fear that the medications are not reaching their target as expected.

Kickucbutt said...
I don’t know how to slow down the food transit time , any suggestions

Healing your UC flare is the best way possible. Inflammation causes fast food transit times.
Posted 10/1/2018 11:17 AM (GMT -7)
Hi ,

Thanks for the reply , am ok at the moment , going 3-4 times a day , sometimes less which is my norm with firm stool and my blood work done a month back showed everything in place with Crp normal and a faecal calprctein of 57 which my doc said was ok but I do have IBS like symptoms at tones . don’t know if that plays a role in fast food transit times

Best
Ritu
Posted 10/1/2018 12:09 PM (GMT -7)
Post script .....

Also use the 4 gram messlmine Enema every time , along with the 4.8 gm orally , there’s not much else I can do . My doc wants me to taper my meds but am scared too
Posted 10/1/2018 12:11 PM (GMT -7)
Taper which meds and to what dosage?
Posted 10/1/2018 12:31 PM (GMT -7)
Hi

He wants me to reduce the oral mesalmine to 3.6 grams and go away with the rectal meds 🙈. Also is faecal calprctein of 57 a cause for worry

Thanks
Posted 10/1/2018 1:10 PM (GMT -7)
My last F Calprotectin test was 46.0 with anything less than 50.0 considered to be normal. If your scale was the same, then you are just slightly above normal but not by enough to be worried about it.

You can try to reduce to 3.6 grams for 2-months and keep the enemas. If you're still doing fine, start reducing the enemas. If you;re truly unsure about this reduction, you can always wait longer, and/or ask for endoscopy to prove you're in a remission.
Posted 10/2/2018 6:27 AM (GMT -7)
Is your disease considered mild/moderate or moderate/severe.
Posted 10/2/2018 11:40 AM (GMT -7)
Do away with rectal meds isnt a wise regimen.....but you can start to reduce them at every second night for a few months.

q
Posted 2/23/2020 7:13 AM (GMT -7)
Hi Ritu,

I am also from India and i've the same problem with sun pharma's mesacol OD. I have also tried other brands like dr reddy's, torrent etc they are all the same. Sometimes i have the doubt whether these tablets are working or not as i see UC symptoms comes back as soon as i stop the enemas. Recently my DR switched me to rowasa pellets and that seems to be dissolving as dont see anything coming out in toilet. But i have other problems with granules that they are causing frequent migraines and i am not sure what i've to do now.
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