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Anyone else pooping out Asacol whole?

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Ulcerative Colitis
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Posted 9/23/2010 11:37 PM (GMT 0)
I've ahd alot of problem taking Asacol.  I got over the side effect and am taking a low dose, but I'm pooping out the pills whole with the coating still on it!  Yes, I did fish them out of the toilet with my toilet brush. I see at least 1 pill a day in the morning...sometimes two.  Who know what happend during the middle of the day when I have a bowel movement....don't have the tools to fish them out at work!  I did see one sticking out of my stool once. 

The pharmacy print out says to report this to the doctor if it occurs frequent. 

Well I'm definately not getting the whole dose and my GI doesn't believe me and/or is not concern about it, BUT she's having me taper off the enema completely.  I feel taking the enema is a saftey net for me right now.

Has anyone else had this problem with Asacol or another drug?  What's your story? 

Posted 9/24/2010 12:13 AM (GMT 0)
I had this problem frequently with Asacol HD when I was taking the full 4.8gr a day. Whole pills and partial pills. I had it less frequently when in remission on a lower dose. I am trying generic colazal now because I don't think my body likes to take off the coating and to save money. I took my last asacol yesterday morning and it came out whole this morning.

Sulfasalazine like colazal doesn't have a coating and breaks down biologically in the colon. It worked better for me until I had a bad reaction to it after a month.

Can't stand spending that kind of money then flushing it
Posted 9/24/2010 3:43 AM (GMT 0)
Check out this article.  It talks about Ph levels and some people have different levels.  Yours may be different, so the meds are not breaking down like they should.

http://www.gastroendonews.com/download/BB1015_GEN0910_WM.pdf

 

Posted 9/24/2010 5:31 AM (GMT 0)
I ended up switching from asacol to apriso because of this problem.
Posted 9/24/2010 3:47 PM (GMT 0)
My GI advises that this is okay (as long as your symptoms are being controlled).  The Asacol capsules have 'microfissures' that release the med in your colon.  The capsules does not necessarily have to break down for the meds to be released.  But you should mention that you are passing them.  Just one opinion.

Posted 9/25/2010 2:46 AM (GMT 0)
I'm pooping out the Lialda tablets whole some times too. Sometimes the L-glutamine tablet comes out whole too. Not every day but every few days I notice it. At least the BMs are now formed (with amitriptyline) so I can't complain too much.
Posted 9/25/2010 1:09 PM (GMT 0)
Thanks for all the info. 

The only reason my GI is not switching me is due to the insurance limitation of what drugs I can take. Apparenlty Kasier limits the drug choices considerably.  The only allow for Asacol in the anti-inflamitriy category.  Next step would be a step up to steriods  which would be over kill for my mild condition.

This really concerns me..what if my UC progresses BECAUSE I'm not getting the dose I'm being perscribe?  For such an individual disease we need our choices. I'll be switching back to BCBS. Maybe more expensive but my treatment choices are not limited and I go go anywhere for treatment ...even Mayo or Cleveland Clinic if it get to that!

Posted 9/25/2010 2:11 PM (GMT 0)
I see what appear to be whole Asacol from time to time. And also, my GI has said the medicine seeps out without the pill necessarily looking different.
However, I do wonder sometimes, and having read that great article (I got the gist of it anyway...) I wonder if in fact I'm not getting full benefit and that's why my old GI kept increasing my dosage - to the 16 I've taken for about the past 8 years. I'll definitely ask my doc when I next see him.
I'm tapering down from that 16 to the approved max of 12, and I was down to 13, but started to have some symptoms..... so I've upped the rectals and also re-upped the Asacol. I'm now back down to 14 on the Asacol.... but maybe I'm not absorbing it all and therefore really need the 16?
Worth a discussion with my GI, I'd say.
Posted 9/25/2010 7:12 PM (GMT 0)
My pills are pretty much an orange colour and flat and seem to remain in my colon long enough to do their thing.

Interesting regarding asacol when I had my c-scope a few months ago. I use the gallon prep, so I eat brunch and take all my meds. The clean-out happens in the late afternoon and I would assume everything is out. I don't take my night-time asacol since I"ll be taking them in the morning with breakfast after the scope.

But, this time....there was one lonely asacol pill split with some medication around it....one would think that after all the purge it wouldn't have still been there. Wonder where it was hiding all that time? Even the doc was surprised..lol.

q
Posted 9/26/2010 12:54 AM (GMT 0)
The pharma reps tell the doctors that it is "normal" to see whole pills.  I think that they think we don't know the difference between whole pills and empty pill shells.  It is obvious to me that if whole pills are coming out with shells intact (and rock hard like my son's were!) that the dosing is not consistent.  If I were you I would try switching to either Colazal or Apriso. 

Also, sometimes a letter from your doctor to the insurance company will succeed in "allowing" other medications that aren't on your approved drug list...

Jo

Post Edited (JoMarie) : 9/25/2010 6:57:53 PM (GMT-6)

Posted 9/26/2010 4:46 AM (GMT 0)
I should say that almost every day I got empty shells but the partial and whole pills I am talking about contained medication. I looked.

The price of generic Colazal has dropped by more than 50% since last winter. When I went to the doctor last week they still had it listed as more expensive than asacol. It wasn't when I got the EOB from insurance. $195 for 270 generic colazal v. $375 for 180 asacol. Asacol and asacol hd have been going up.
Posted 9/26/2010 11:12 PM (GMT 0)
The article psted by ithurtsmom definately explains what's happening to me. Apparently you need a pH level of 7.0 + to dissolve the outter coating of Asacol!  My pH mustn't be hing enough!  So yea...sounds like it's SUPPOSED to dissolve!

Apparently only Apriso need a lower pH level of 6.0+.

Thanks ithurtsmom for the article!!! smilewinkgrin

I just email my GI with the info...let's see what she says!  So far she discredited all the other 5-ASA choices out there.

Just did some research apparently the coating is supposed to dissovled. See the following drug info:  http://www.medicinenet.com/ulcerative_colitis/page5.htm

 

Posted 9/27/2010 4:39 AM (GMT 0)
Hope you find what your looking for and get some relief
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