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Asacol foam. Not available in the US. Has anyone tried it?

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Posted 10/19/2007 4:34 PM (GMT -8)
I believe that there is a rectal foam version of Asacol that is available in the UK and other places but not in North America. Does anyone know anything about this?

I hate using Rowasa and Canasa and find that I can only handle Cortifoam. The downside, of course, is that the Cortifoam isn't great in the long term because of the steriods. So, I kept thinking, Why can't they make a foam that isn't bad for you?

Then I looked online and it appears that Asacol rectal form actually exists but not here in the States. Is there anyone in the UK (or somewhere else) who has tried it, seen it, or heard of it?
I wonder if it's exactly the same kind of applicator and process as using the Cortifoam or not.

Thanks.
Posted 10/20/2007 1:20 AM (GMT 0)
Hi Julee

I'm in Australia and we have it here. Asacol is known as Salofalk here. I really like the foam - very easy to use. I've never used Cortifoam so I don't know what sort of applicator that has but I'll try to describe the Salofalk foam applicator. It comes in a little aerosal cannister - about the length of my hand (and I have small hands). It comes with 7 applicators - you put on an applicator, shake the can, insert and then press down the nozzle. Each squirt of the nozzle is 1gm. Suggested dose is two squirts for 2grams. I find it a bit easier to use than the liquid enemas, although I really don't mind the liquid enemas. For me, I find the liquid ones get the medicine further up, so I use those at the begining of a flare and then use the foam during my taper just because it's easier.

The only things I don't like about it are that they only give you 7 applicators per cannister and I find I get about 10-12 double squirt doses out of each cannister. My Dr said to write to them and request extra applicators but they didn't reply so I just wash and dry the applicators and use each one twice. The other thing is that they don't put as good lubrication on the applicators as they do on the liquid enemas, but that is easily fixed with some lube.

I find I can also pop some foam in before I go to work in the morning (after morning BMs are done!) and it is easy to keep in all day. Handy for those times that you need a little something in the morning as well as an enema at night.

Oh, another thing (that's a bit gross) - it has a rather distinct smell when it eventually does come out with your next BM! I was seriously wondering what was going on with my body until I connected it with the foam! Not necessarily a horrible smell, just a distinct chemical type smell.

I also haven't noticed any side effects or problems from the foam. Let me know if you have any other questions.
Posted 10/19/2007 7:17 PM (GMT -8)
Thanks so much for the reply! I cannot believe that we don't have this medicine available here. This is so frustrating.

Thanks for the detailed info. From your description, it sounds very much like Cortifoam. Though Cortifoam comes with one plastic applicator that you rinse out and re-use. And there's no chemical/medicinal odor at all.

I should have tried to get some while I was in Europe. I had thought that it didn't exist anywhere yet.
Posted 10/19/2007 7:21 PM (GMT -8)
I have brought this matter up with my gastroenterologist several times! It seems that we IBD patients in the U.S. will have to lobby the pharmaceuticals to manufacture/distribute the 5-ASA foam here-- or else boycott their bloomin' suppositories 'til they are forced to market the foam for us. An outrageous situation-- because we need more convenient meds (+ environmentally sound packaging). / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily; seem to be back in remission)
Posted 10/19/2007 11:56 PM (GMT -8)
It's really annoying how the pharmaceuticals hold back drugs in countries. I think I've had this conversation with you before Old Hat - while it's great that we have the foam here, we don't have Lialda :-( That bugs me as I take 8 Salofalk tablets a day (Asacol) and I think Lialda would bring that down to 2 tablets a day with breakfast. I would be such a happy knitty cat if I only had to take 2 tablets once a day!

The other good thing about the foam is travelling. 28 days supply packs into a MUCH smaller space than a 28 day supply of the liquid enemas. Also, if you are camping or sharing a hotel room you can pop the foam in when you go to the bathroom just before bed, wash your hands and then hop into bed or your sleeping bag like nothing happened. That's a little harder to do with the liquid enemas!

Environmentally sound packaging would be great. I'm doing nightly enemas at the moment and feel really guilty about the huge amount of non-recyclable rubbish leaving my bedroom. Enema plastic packages, empty enema containers and the disposable gloves I use because you can't get up to wash your hands after inserting a liquid enemas. There is almost as much non-recyclable waste coming out of my room as there is for the household! (2 people). Oh well, can't be helped for now.
Posted 10/20/2007 9:16 AM (GMT -8)
I'm really surprised that the Chron's and Colitis foundations aren't organizing people to demand that all the safe and effective drugs become available more widely. Assuming that the pharma companies make a lot of money from successful drugs, I'm surprised they don't leap at the opportunity to sell us something else.

I might email the CCFA (the chron's and colitis foundation of america, I guess) and find out whether this is something they could work on.

Packaging -- I agree, this is a big issue. I think that they package these things for what they think people want... throw-away applicators, etc. The applicators that come with Coritfoam are such thick plastic that they could probably go in the dishwasher if you really wanted to clean it! I wish you could just buy refill canisters without all the extra plastic. Plus, the metal canisters aren't supposed to be incinerated and I'm not about to ask my local trash collectors whether "my empty cans of rectal foam" can be recycled!!

I'm still waiting for the day when I get asked to demonstrate what it is while going through airport security! So far, no one's asked. :)

Thanks again, Knitty Cat for providing the helpful info!
Posted 10/20/2007 6:42 PM (GMT -8)
You're absolutely right, Knitty_Cat, we did discuss this matter in another thread some months back! The blasted meds still have not become available. It annoys me no end, but Julee70 may have the best idea-- to organize a letter-writing campaign to the pharmaceuticals. / Old Hat (nearly 30 yrs with left-sided UC ... [etc.])
Posted 10/23/2007 6:56 AM (GMT -8)
bump

Posted 10/26/2007 7:29 AM (GMT -8)
Hi

I'm in the UK and have been using Asacol foam enema for years now.  I am very surprised that it is still not available in the US.  Can't understand why that is...

While most people I know who do use it are quite happy with it, I could never hold it in.  I find too much foam comes out even with just 1 squirt. So, I gave up using them and now have boxes of these lying around now as I have gone back to predfoam.  The salofalk foam is slighly better than the asacol one but even that caused me problems.

I also found the applicators in the asacol foam had hard sharp edges and they really hurt my ass when I tried to get it in!!  At least the predfoam ones are soft but the asacol ones are a nightmare. As if my ass doesn't hurt enough as it is!! lol

 

Posted 10/27/2007 10:50 PM (GMT -8)
Wow, I was wondering about this as well. The packaging waste of mesalamine enemas really bothers me, not too mention the difficulty of retaining a liquid enema at any time other than bedtime. I was pleasantly surprised to try Cortifoam and see it was just a small cannister, and you can use it any time. Seriously, how can we bring 5-ASA foam to the US?
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