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Different kinds of mesalamine

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Ulcerative Colitis
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Posted 1/21/2009 4:46 PM (GMT 0)
Everyone may know this already, but my husband and I didn't so I thought I would share our experience...

My husband has UC and was dealing with it for 2 years. We went to a GI in our town and to the mayo clinic.  We tried Asacol, Asacol enimas, and prednisone. None of these worked so one Dr wanted to remove his colon and the mayo wanted to start him on immunosuppressant drugs.  We decided to get one more opinion.  This new doctor said that there are different types of mesalamine drugs that are made to release in different places in the colon. We had no idea and had done quite a bit of research.  My husband got on Pentasa and two weeks later was back to normal! We were so happy and I recommend trying the different types of mesalamine before going to more radical treatments.  It's been a year now and UC isn't even an issue.  As a side note though - when stressful things would happen, his stools would get a little loose so he's now on Lexipro for stress and that keeps the little flare ups from occuring.

(Also, keep a food journal to see which foods help and which ones hurt. I've noticed that it differs for all UC patients).

Posted 1/21/2009 5:08 PM (GMT 0)
I am curious to know where in the colon different mesalamine drugs are released? I am taking asacol right now and I don't feel like it is working the best... Where in the colon is Asacol released versus Pentasa??
Posted 1/21/2009 6:20 PM (GMT 0)
Asacol is designed to be release at the beginning of the colon and the med gets dispersed downward toward the rectum. However many people do not have the proper PH level in their colon to break down the hard outer coating of the Asacol and they don't get the right amount of medication to the correct area. Colazal is not a mesalamine but a basalazide. It is still a 5-ASA and it's release mechanism is a bit different. It releases it's medication lower down into the colon and is usually the more ideal med for people with left sided to proctitis. Lialda, the newest of mesalamines, is the same as Asacol - it just has a time released mechanism so less pills can be ingested. I can't speak about Pentasa because honestly I don't much about that medication.
Posted 1/21/2009 8:46 PM (GMT 0)
I have pancolitis and am taking Asacol - so what I'm thinking is that maybe the meds are not making it down to my rectum if they are dispersed from the beginning of the colon downwards.... hmmm....
Posted 1/21/2009 9:36 PM (GMT 0)
I've taken Salafolk (?sp) and I understand that it dissolves pretty far down in the intestine. Since changing to Asacol about a week ago I notice a huge difference. Thank God!! But I am not sure where it dissolves. I thought it dissolved near the same place as Pentasa...I'll have to do some research and I'll post what I find :)
Posted 1/21/2009 9:51 PM (GMT 0)

I got this off a website. Hope it helps :)

 

How does Pentasa differ from Asacol
Both Pentasa and Asacol are prescription forms of mesalamine. The difference between Asacol and Pentasa is in the outer chemical coating. Oral Pentasa has a unique formulation. The active ingredient is contained in coated microgranules, which enables a prolonged release of the active substance throughout the intestinal tract, from duodenum to the rectum. Therefore the Pentasa preparation is more useful for Crohn's patients who often have inflammation of the small intestine. The average small bowel transit time is approximately 3-4 hours in healthy volunteers.

Asacol is a delayed release enteric-coated tablets which generally releases the active ingredient only in the colon. While there are always clinical exceptions, Asacol is generally suitable for patients with colitis only (ulcerative colitis or Crohn's colitis), but not disease involving the small intestine.

Posted 1/22/2009 1:14 AM (GMT 0)
Thanks for the research!!! That helps alot! I almost think that because of the eneric coating on the Asacol that I may not be absorbing the drug properly.
Posted 1/22/2009 8:49 AM (GMT 0)
I agree, Pentasa is a great 5-ASA drug! Too bad I can't take it anymore, 'cause it gives me severe stomach pain... But it did help with my proctosigmoiditis immensely :)
Posted 1/22/2009 1:14 PM (GMT 0)

HI all-

 I went from Asacol to LIalda to Colazal. I really think the Colazal has helped somewhat whereas the other two did not. Then again, I don't know since I take so many other things also.

I wonder how many people are really helped by these drugs, though. It seems that most of us take these and they are not effective ( we end up taking a ton of other things also)

 

Posted 1/22/2009 1:52 PM (GMT 0)
I see that people here often note that they cannot take mesalamine or that it causes side effects such as stomach pain and so on. I got that type of reaction to rectal mesalamine and I think the oral route, Pentasa, may also cause me stomach pain, D, and urinary retention and so on. Anybody else find these types of reactions from both types of mesalamine, I wonder?

Posted 1/22/2009 2:14 PM (GMT 0)
There is a new drug Apriso (sp?) that is mesalamine that breaks down in the colon at a ph >(or =) 6 which should help those whose ph levels were too low to get through Asacol's outer shell which requires ph >(or =)7(as red34 mentioned above).
Posted 1/22/2009 3:23 PM (GMT 0)

I found a site with more info on Apriso if anyone is interested...

http://www.rxlist.com/apriso-drug.htm

Posted 1/23/2009 3:01 AM (GMT 0)
Colazal was my break-through 5-ASA in 2003 because I have left-sided UC, which the older oral meds like Azulfidine & Asacol only helped minimally. Dipentum, a drug of the mid-1990s, was a bit more helpful in controlling inflammation, but I still had D while on it. Recently I found out the hard way that the generic Colazal (Balsalazide) made by Watson Pharma does NOT control D, at least not for me. So I'm back on original Colazal, my ticket to remission. / Old Hat (nearly 30 yrs with left-sided UC ... [etc.])
Posted 1/23/2009 5:21 PM (GMT 0)
Wow, everyone is so knowledgeable, I love it! And Megan, my husband actually had some whole pentasa tablets in his stool which confirmed for him, that it wasn't releasing in the right place at all. 
Posted 1/25/2009 3:08 PM (GMT 0)
Hey all...I was diagnosed with Pancolitis in Nov...I started on Asacol (2 pills 3 x day). I didnt really see much difference in my syptoms. I then got on 30mg of Pred which did wonders...I'm assuming it greatly reduced my inflamation...i am still currently on Asacol and it seems to be working ok. I reguarlly have 1-2 bm's a day (some lose, some mushy...none formed). I have my 2nd colonoscopy in 3 months tomorrow...so hopefully I'll get some more answers..

Good luck to you!
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