Advice needed on next step in meds

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Regular Member

Date Joined Jul 2007
Total Posts : 66
   Posted 11/15/2007 11:34 AM (GMT -6)   
I am trying to gather info and advice on changing meds. I have been on Asacol/Rowasa for 11 years. I have had much success in the past with these meds. For some reason when I started my current flare back in April, I have been unable to get on top of the symptoms to get in remission. I even was on Lialda for 5 weeks but my symptoms got worse.

I had an appointment with my GI yesterday and he suggested it is time to step up my meds. After I ruled out pred., he gave me a choice between Imuran and Remicade. He told me if it were him, he would chose Imuran. His thoughts were that it is an older drug and he has 20 years of experience prescribing it.

So many of you have had to be on both pred and Imuran or Remicade. I have been fortunate so far to be able to avoid pred. Has anyone else had experience with either of these drugs without being on pred too?

I almost feel guilty because these meds no longer work for me. It's almost like I have failed a major test.
left-sided colitis diagnosed after 3rd pregnancy 11 years ago: was in remission for 5 years
Current UC Meds:  12 Asacol per day
                          1 Rowasa enema at night
Other Meds:  Lipitor, Multi-vitamin, asadophilus, cinnamon capsules
In a flare since the middle of April

Veteran Member

Date Joined Jul 2007
Total Posts : 2148
   Posted 11/15/2007 11:50 AM (GMT -6)   
Hi Annie,

I was on 5ASA's for 7 years and can no longer take them, I have close to what you have, have only the first 30cm of my colon affected. I went cold turkey off the 5ASA's and had the worst flare ever (going 25+ times a day w/all the horrible UC side effects). I am on pred for a different reason and that took a long time to help me (2 mos w/my UC), I think the hydrocortisone enema's really got my flare under control, though that took a couple of weeks.

I have only been on Azathioprine (generic of Imuran) for about a month. The side effects I think I have (I am on so many different meds) gotten from it is being tired, but taking all the AZA at night has helped my groggines in the am, also my leg hair has pretty much stopped growing. I have not had any hair loss on my head, I have been taking 800mg of folic acid a day (I think that is supposed to help???).

The Imuran i'm told can take 3-6 mos to work, so my GI was going to put me on remicade to help stop the flare until the Imuran started to work but since I am doing really well right now b/c of the pred and hydrocoritsone e's (1-2 bm's a day almost fully formed, no D, B, mucous and cramping), that is on hold indefinitely.

I was really upset when I had to stop the 5ASA's b/c they worked so well for my UC, but unfortunately, no choice and I just want to be well again and have a few solid months under my belt (so to speak).

Beth, 32
UC Diagnosed March 2000 (30 cenitmeters)
Azathioprine 150mg 1xday nightly;Hydrocortisone enemas 1xday;Calcium and Vit D 500mg 3xday, Multi Vit, Folic Acid 400mg 2xday, Potassium 600mg 2xday, Probiotics.
Minimal Change Disease (Kidney Disorder) Diagnosed Sept 2007
Prednisone 60/40mg alt days 1xday, Simvastatin 20mg 1xday, Diovan 80mg 2xday. Fosomax 70mg 1xweek. MCD may be from hypersensitivty to 5ASA drugs.

Veteran Member

Date Joined Feb 2007
Total Posts : 640
   Posted 11/15/2007 12:53 PM (GMT -6)   
Hey, Annie:

I've been on Imuran for around six years, and I don't take pred with it. I don't believe most folks do. Perhaps if someone has a flare (I've had three mild ones) while on Imuran, the doc might prescribe pred ti nip it in the bud. But I've found that the medicated enemas of Rowasa or hydrocortisone meds work to get that problem back under control again.

Like you, I hope to avoid pred as much as possible.

Goood luck with your decision!

Sporadic proctitis since about 1985. Mother had J-pouch surgery 1983.
DX'd with clostridium difficile in 2000. Pred, two courses of Flagyl, then Vancomycin finally got rid of it. 2001 colonoscopy dx'd left-sided UC. . Treated with prednisone, Rowasa, Asacol. Asacol not working, switched to Imuran. Three small flares since in 2002, 2005, and 2007, brought under control with steroid and Rowasa enemas. Lap Chole performed October 26, 2007, after gall bladder attack in June, '07.
Daily meds: 100 mg Azathioprine and 225 mg Effexor XR (for chronic, longstanding depression), many vitamins and Primadophilus Reuteri

Old Hat
Veteran Member

Date Joined Feb 2007
Total Posts : 5187
   Posted 11/15/2007 12:59 PM (GMT -6)   
Since your UC is left-sided, it likely would be helped by steroid enemas, either hydrocortisone or budesonide. These do not produce the immediate side effects that oral steroids cause. However, the fact that you're middle-aged may be influencing your gastro's desire to avoid steroids & go for immunomodulators. He may be concerned about steroid's potential for damaging hipbones, etc. I posted reference to a Web article last week that might give you some useful info: New Online IBD Article Summarizes Current Medical Treatment Options-- now on page 4 here.
Did your gastro ever prescribe Colazal for you? It's a 5-ASA that has helped many of us who did not get results from Asacol. The Web article discusses the differences btw the various 5-ASA formulas & has a chart. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily; seem to be back in remission)

Elite Member

Date Joined Apr 2004
Total Posts : 23551
   Posted 11/15/2007 1:16 PM (GMT -6)   
Annie, I was in the same boat a few years ago. I took Asacol and Rowasa for years with success then all of a sudden my body didn't like it anymore. So my GI switched me to Colazal and put me on Colocort enemas. The Colazal helped tremendously but it didn't put me in remission and I couldn't get off the Colocorts so he decided to put me on 6mp. It took a while to work, but when it did start working I felt a ton better. I still get flares but not as major anymore - mini flares here or there.
Left sided Uc -'92 - Colazal, 6mp, Prilosec, Biotin, Forvia, Pro-Bio 
Allergies - Singulair, Astelin(got the script - just haven't tried it yet!)
Secondary Reynauds Syndrome - '04 - Norvasc
Fibromyalgia - '06 
@--->--Moderator for Allergies/Asthma and Co-moderator for UC--<---@


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