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Pausing Pentasa (Mesalamine) for a week

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Crohn's Disease
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Posted 1/9/2018 4:51 AM (GMT 0)
Hi all, I just got diagnosed with mild Crohn's a month ago and got prescribed Pentasa (Mesalamine). I'm about to run out of my first 30 days prescription and I'm out of the country so it will be 7 days before I can get a refill back home. It is maybe possible to get medications here (in Thailand) but it's very uncertain and will require a lot of effort.

Does anyone know how damaging this could be? I don't mind a return of symptoms (mild discomfort and chronic diarrhea), but I'm worried whether symptoms might get worse or I'll need even heavier medications. When people talk about stopping their medications and getting a flare up, how soon does that take? 1 week? A month?

I've reached out to my GI but I don't know when I'll get an answer and so I'm hoping for any helpful information you all might have.

Thank you!
Posted 1/9/2018 12:21 PM (GMT 0)
It's good news that you've been diagnosed as a mild case. Hopefully, you remain mild as long as you have to deal with having Crohn's.

Pentasa, and all of the Mesalamines are considered anitquated in the treatment of Crohn's. Most GI's don't bother prescribing it anymore. Many here will tell that it's downright useless. There is some effectiveness argued with the treatement of UC though.

Since Pentasa doesn't have to reach a therapeutic level, you shouldn't have any issues being without it for a few days or a week. If you are actually showing a marked improvement in you symptoms, then by all means stay the course, no matter what the evidence suggests. Hopefully your GI returns your calls asap.
Posted 1/9/2018 5:55 PM (GMT 0)
Could you slightly reduce your dose so you make it through your trip? Better to take some each day rather than none. A typical Pentasa dose is 8 pills a day. You could take 6 pills for a few days to have some left overs for a reduced dose on the last 7-days of your trip.

From the UC side, it varies quite a lot on how long a patient can go without pentasa/mesalamine before symptoms start reappearing again. Sometimes a patient can go several months or longer, sometimes symptoms reappear the very next day, and anywhere in between. It's kinda like Russian-roulette, and a bit of a gamble. Everyone's different so there is no knowing how you'll react.

Pentasa is a 90 percent topical anti-inflammatory that is cleared from our bodies within about 24 hours, so it does not have a lasting affect on us. Inflammation tends to buildup slowly when we are under-treated until we reach a tipping-point where symptoms return in full-force. The rate in which cumulative inflammation builds varies a lot by individual and by disease severity.
Posted 1/10/2018 4:03 AM (GMT 0)
Thank you for the responses, they are very helpful.

I did not get to speak directly with my GI, but his office forwarded my question and the response is that taking a week break should be fine. Note again that I have a mild case. I have been taking 4 pills a day (2 grams) and I only have 4 pills left, so I'm not sure extended this out will be much help at this point.
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