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From Apriso to Balsalazide

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Ulcerative Colitis
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Posted 12/17/2020 3:32 PM (GMT -8)
I've been in remission for several years on Apriso, but my insurance will no longer be covering this medication. My Dr. has now put me on Balsalazide (Colazal). Any tips? Does it work well? I've been on it about a week and feeling some undesirable discomfort. I'm hoping it's just an adjustment to the new med. However, 9 pills a day stinks. I feel like all I do is pop pills. Any advice would be helpful.
Posted 12/17/2020 4:51 PM (GMT -8)
I used to take Apriso but it wasn’t covered by my insurance so I enrolled in their patient assistance program and got it for free. I’m no longer taking it because entyvio put me in remission. Medicare doesn’t let me qualify for the copay cards but they did have a free program. I think they do have a copay program that would lower your costs and if not you might qualify for the patient assistance. I’ve learned it doesn’t hurt to try and the paperwork is a bit of a hassle but worth it in the end. Look up the manufacturer on the web and then give them a call.
Posted 12/18/2020 8:05 AM (GMT -8)
Sorry to read that this problem has been foisted on you. The insurers don't care to understand that 5-ASA oral meds differ in effectiveness/tolerance among UC patients; they'll impose anything for the sake of their bottom line. Many of us have fought to stay on brandname Colazal because Balsalazide generics differ and can bring on or bring back unwanted symptoms like mucus in bms. We did threads on generic problems in past years and, as I recall, the Balsalazide made by Roxanne Labs (bright orange caps) reportedly was more unreliable than others. I agree with you that 9 caps daily is a nuisance, especially if you're in remission. Our past threads also gave info that generics can legally get approval even if they only contain 80% of the active component! / Old Hat (40 yrs with left-sided UC; in remission taking Colazal) P.S. Just noticed that you had pancolitis; Balsalazide & Colazal are formulated to treat left-sided UC, not pancolitis-- therefore, they're not giving your colon the same coverage as Apriso.

Post Edited (Old Hat) : 12/18/2020 9:11:21 AM (GMT-7)

Posted 12/19/2020 8:01 AM (GMT -8)
You get the same amount of mesalamine delivered to the large intestine, just through different means. Most gasteroenterologists and pharmacists will say there's little if any difference among the mesalamines. Ancedotally, some here do report one working better than another. As there's difference in delivery mechanisms and non-active ingredients among them.

I'd try it with an open mind. See if anything changes within the next month. If it does see if you can get back on the Apriso though an appeal.
Posted 12/19/2020 3:10 PM (GMT -8)
Most gastros & pharmacists are NOT IBD subspecialists who participate in research & clinical trials to determine how exactly the 5-ASAs differ. They are not all equivalent because some like Lialda, & Asacol formulations activate in the ascending colon*; brandname Colazal activates in transverse colon. It was a replacement for Dipentum. I know that because I participated in an NIH clinical trial for Colazal in 2002-3, having used Dipentum previously. (Also several other UC meds, including orals, Rowasa brandname & generics, & steroids.) The gastros in the practice I've been with since 1990s write & update med school textbooks on IBD treatment. These are very dedicated pros who practically breathe IBD concerns. Therefore, it bugs me when anyone with less experience/exposure claims that 5-ASAs are all equivalent. If that was true, I wouldn't have suffered 3-4 flares annually for 20 yrs. / Old Hat (40 yrs with left-sided UC) *** [P.S. *Pentasa may activate in terminal ileum; I had a dentist with Crohn's who was helped by that.]

Post Edited (Old Hat) : 12/19/2020 4:24:52 PM (GMT-7)

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