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Maximum Asacol dosage?

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Ulcerative Colitis
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Posted 3/29/2010 11:43 AM (GMT 0)
The more I read, the more i realize that I am at the very high end of my Asacol mg/day. Ever since diagnosis, my GI has had me on the 800mg tabs x 6 per day. I seem to be way above the norm at 4800mg/day (plus some of the "extra" other end 5-asa's when needed).

Even during my previous flare, he raised it to 9 per day plus some enema's and suppositories....fun stuff.

Anyone else sustaining these level's, or am I on my own for this one?

Thanks,
kls.
Posted 3/29/2010 12:04 PM (GMT 0)
I take 16 of the 400 mg tabs per day, (6400 mg per day) plus some of the rectals.

My GI has said that because mesalamine is so poorly absorbed it's hard to overdose on it.

I know that when my son's GI raised his asacol to 9 per day (the 400 mg tabs) she said something about the amount he could take per his weight, so maybe that's a factor; I am overweight, so I can take that much.....?
Posted 3/29/2010 3:46 PM (GMT 0)
My GI also says it's hard to OD on mesalamine. I was taking 12 400 mg pills when I was still on Asacol and my GI was hesitant to reduce my dose, even when I gained remission, because I had been so very sick. Are you in remission, and if so, how long have you been in remission?
Posted 3/29/2010 4:27 PM (GMT 0)
Using much higher dosages seems to be popular. Clinical trials have shown that higher dosages are at least marginally more effective at bring about remission. I haven't seen trials that showed higher dosages are more likely to maintain remission.

I was told to take 4.8 gr of Asacol HD indefinitely. I was told to take 1000mg Canasa supp for the first 21 days also. I was well on my way to remission in a matter of days.

I reduced the Asacol on my own after 8 weeks to 1.6 grams. Can't afford that many pills. I had a moderate flare only reaching 3 cm into the sigmoid colon. I actually have continued to improve at the lower dosage. The high dosage gave me quite a bit of gas. I might take more if I didn't have to pay for it.

4.8 grams is the FDA approved dosage for Asacol HD.
Posted 3/29/2010 6:22 PM (GMT 0)
Thanks. I've read the studies re: Asacol HD and the beneficial dosing levels, but I have not seen many people on here that are taking the upper approved amount.
And to answer fruitgirl's question, I've been teetering on a flare for a couple months, so I wouldn't call it remission, but it is not full-on right now either...thankfully...

I will probably need to add a signature if i keep posting, sorry.
Posted 3/29/2010 10:59 PM (GMT 0)
I took 12 per day in the study for it, and during flares. Problem for many is that it is expensive.
Posted 3/29/2010 11:09 PM (GMT 0)
I took 12 400 mg per day. One month after off pred, GI said I should drop to 6. I flared pretty badly a month later. Now I'm up to 12 again on pred. I think I dropped to soon or shouldn't have dropped at all.
Posted 3/31/2010 10:47 AM (GMT 0)
Just out of curiosity, is 12 x 400mg cheaper than 6 x 800mg? If it were my choice, I would try to take as few pills a day as possible.
Posted 3/31/2010 3:54 PM (GMT 0)

I am also on 4 tablets, 3 times a day, total of 12.   I think that's 4800 mg right?   My GI says anything over 12 isn't going to help any more.  But i read several posts of people who are on 16 per day.   Either way, 12 or 16 is probably max and if not managing symptoms anymore, is time to move onto another treatement. 

That's basically where I am now.   3 years with NO flares after diagnosis & begin treatment...2 major flares in the last 2 years.   I don't know if Asacol isn't working as well anymore, or if i'm just in a more active phase of the disease.  I hate idea of moving onto Imuran or similar. 

Frustrating disease - you don't know if you're declining or just in a bad phase.  It's a guessing game.

Posted 3/31/2010 4:02 PM (GMT 0)
TP177, you could try adding mesalamine enema in for maintenance. It might help keep you in remission for longer stretches; studies show that people who use them twice weekly in addition to oral meds stay in remission for longer than those who only use oral meds. Just a thought.

kleetz, I think the easiest way to answer your question would be to call your pharmacy and see how much it is for a 30-day supply of both.
Posted 3/31/2010 7:11 PM (GMT 0)
i was just curious fruitgirl, I'm lucky enough to have excellent coverage.
TP177, have you tried adding a Pentasa suppository when you notice the beginning of inflammation? It's not really a party, but I've noticed that it can help me out if I get to it in time.
Posted 3/31/2010 8:18 PM (GMT 0)
Yes on the Rowasa.  Was fighting current flare with it for a couple of months; but had to resort to the Prednisone.   Am giving myself a break for a couple of weeks, but will add it back in as part of regimine.  Twice a week sounds like common use for maintenence.  Blah.

Posted 4/1/2010 10:54 AM (GMT 0)
I agree with the "blah". It gets frustrating.
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