balsalazide + mesalamine enema?

Hi all,

Are you allowed to combine oral balsalazide with mesalamine enemas? I wasn't sure because there was a possible interaction online when I checked but my GI says it's okay. Anyhow know?

Common to take an oral mesalamine (balsalazide) and an mesalamine enema together. It's the recommended treatment, treat from both ends produces the best results.

No adverse interactions. No worries.

Jane, are you asking because you have a long history of UC treatment with mesalamines? I know from my own experience that it's possible to suddenly "top-out" of Rowasa, which happened to me after 14 yrs of successful intermittent use. My gastroenterologist has sub-specialized in IBD treatment since 1980s, and wasn't particularly surprised when it turned on me, causing gnawing left-sided pain. I needed to stop using it. Thankfully, brandname Colazal controlled my UC afterward, but I could not tolerate Apriso (fewer caps daily but strong respiratory side effects). UCers are known to have heterogeneity in response to Rx meds; that's why many MDs can't really help us when things go wrong. If you're near any medical school experts, it's a good idea to inquire about their possibilities for consultation. The reliable ones won't push you onto immunosuppressants, if that worries you, nor will they brush you off for reporting exceptional symptoms like SFN. / Old Hat (40 yrs with left-sided UC; in remission taking Colazal)

Post Edited (Old Hat) : 12/26/2020 12:00:04 AM (GMT-7)

Sorry that you're between a rock and a hard place right now. Maybe you could get a video visit with an IBD subspecialist who'd be willing to review all your records and advise you on coordination of care. Due to the pandemic some of these doctors are more accessible now and willing to do tele-consults + insurance will pay for it. In the more experienced IBD centers the doctors will get together to "brainstorm" exceptional patient situations. You need an experienced practitioner who finds your complication interesting and keeps up with the latest research, I think; then you'll get on a more helpful track. At least you should have one who is willing to monitor you if you do decide to go off mesalamines for an interval to gauge whether that would affect your SFN symptoms, and who appreciates your effort to research on your own in pursuit of a viable solution. Some doctors are more responsive to questing patients than others. / Old Hat

Post Edited (Old Hat) : 12/26/2020 1:16:11 AM (GMT-7)