azulfidine vs asacol

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Regular Member

Date Joined Oct 2007
Total Posts : 348
   Posted 10/18/2007 10:08 AM (GMT -6)   
I have had colitis for 26 years now.  For the first 15 years of so I was on Azulfidine which worked well without any side effects.  I then took myself off the meds because I was doing so well, go a little cocky I guess.  I continued to do well for many years.  I have now been having problems again with the uc for a few years and my doctor (which is different than the one I had many years ago) has put me on asacol.  400 mg tabs, 3 tabs 3 x a day.  This does not seem to help much at all.  I have been on and off sterroids (predniseone, pill form.  and the enemas)  once I stopped taking the pills, problems started right back up.  I have a little better luck with the enemas, but it's just not putting it back into remission.  I should also add that when I was first diagnosed, I was told I had lower left sided colits, now it has gotten much worse, it now involves 3/4 of my colon..  The asacol sometimes is not being absorbed.  Has anyone had the problem with the asacol not be absorbed?  I'm thinking of asking my doctor for the azulfidine again, because that worked alot better.

Old Hat
Veteran Member

Date Joined Feb 2007
Total Posts : 5190
   Posted 10/18/2007 10:59 AM (GMT -6)   
Hello! We were probably diagnosed with left-sided UC around the same time. I never had any luck maintaining remission until my gasto put me on Colazal in 2003. You can ask about switching to Colazal or the newest oral 5-ASA med, Lialda, if Asacol does not seem to be working. Since Azulfidine has the sulfa bonding agent, I would not want to go on it long-term, but there are members writing to this site who do o.k. with it. If your UC has spread upward, though, you really need to stay on med permanently-- otherwise, it is likely to get worse. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily; seem to be back in remission)

Veteran Member

Date Joined Aug 2007
Total Posts : 2204
   Posted 10/18/2007 1:40 PM (GMT -6)   

If something's not broken, why fix it? If sulfasalazine (Azulfadine) worked for you before and Asacol is not working, why not ask your doc to put you back on it?

Sulfasalazine is considered to be the drug of choice by Elaine Gotschall, developer of the Specific Carbohydrate Diet, for UC and Crohn's colitis. Alot of folks who've had problems with Asacol favor it - I'm one of them. Here's an article you might find interesting:

Diagnosed with ulcerative colitis spring 1999
C-scope confirmed UC diagnosis 9/18/2007
No explanation for right side pain and thickening of bowel wall
Maintenance dose sulfasalazine, back on a pred taper for first flare in years
Probiotics, l-glutamine and fish oil caps. George's aloe vera juice and Mucosaheal.

Regular Member

Date Joined Oct 2007
Total Posts : 348
   Posted 10/18/2007 2:03 PM (GMT -6)   
I'm planning on asking my doc to put me back on the azulfidine.  When I did inquire about it several months ago, she felt that the azulfidine had more side effects because of the sulfa.  But at least those were dissolving.  If some of the asacol is not dissolving, how can it work, right?  But at least she had written me a script for the azulfidine which I ended up throwing away and giving the asacol a longer period of time to work.  I think I've given it long enough...................

Veteran Member

Date Joined Mar 2007
Total Posts : 2832
   Posted 10/18/2007 3:05 PM (GMT -6)   
Hmm, thanks for posting the Dr. Present link, princesa. I may ask my GI for a few tabs of old style sulfasalazine. I'm scared to death given how badly I have reacted to every 5ASA I've tried (incl. the enteric-coated sulfasalzine, I might add, which obviously cannot be chopped into smaller bits), but at least with an old fashioned sulfa tab I could break it into an eighth or so and see if I have any chance using that desensitization strategy.
Pancolitis dx'd 1986, full med-free remission 88-97
Flaring or simmering ever since
10 20 mg pred, 100 mg Imuran
Probiotics (mainly Primal Defense)
Turmeric/circumin, various vitamins/minerals,
Low-carb version of Specific Carb Diet

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