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Bad reaction to Asacol -> Lialda?

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Ulcerative Colitis
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Posted 11/12/2011 1:49 PM (GMT 0)
Hi Everyone,

I was firsts diagnosed with UC a few months ago. At the time, my symptoms were very mild but had been going on long enough that I needed to get checked. After a quick colonoscopy I was diagnosed with pan-colitis and put on Asacol HD 1 pill 3x daily.

After about 10 days of asacol I was seeing minor improvement when I suddenly had a bad reaction to the drug. I was making 10-15 bathroom trips every day, couldn't eat without throwing up, and ended up losing about 20 pounds in 4 days. Within two days of stopping Asacol I was nearly 100% improved. Even my pre-asacol mild symptoms went away for a few days.

Now the doc has prescribed Lialda. 3x1.2g every day ~$150/month. Just started yesterday.

My question is, has anyone had a bad reaction to asacol, but successfully tolerated lialda? My understanding is that they are nearly identical.

Thanks,
Posted 11/12/2011 1:55 PM (GMT 0)
My reaction to Asacol took a bit longer to manifest than yours did - 12 years actually. But I believe for me it was a gradual thing. My GI didn't want to take the chance so he just pulled me off mesalamines and placed me on Colazal. I seem to be okay'ish with Colazal.

Who knows? Maybe you will have success with Lialda where Asacol failed. If you have a reaction to Lialda, than you probably can't tolerate the mesalamines and should consider all other ones off limits as well.
Posted 11/12/2011 2:10 PM (GMT 0)
Sounds exactly like what I went through. I started with Lialda, was fine for about 2 weeks then started having baaaad reactions. Increase in bathroom trips, fecal incontinence (which I never had before), bloody stools (didn't have), stomach pain and a strange dry cough. GI tried me on Asacol and Colazal after that - same bad symptoms but throw in stomach pain that almost sent me to the hospital and joint pain. I went back to my "normal" after I stopped taking the pills. My GI tried to say that it was just my flare causing the problems but I know my body better than that. Turns out I'm allergic to mesalamines. I hope they work for you though! Good luck.
Posted 11/14/2011 1:41 AM (GMT 0)
I've bee on Asacol for many years without a problem. Dr. Switched me to Lialda a week ago and by this past Tuesday I had severe abdominal pain, cramping, bloody D, headache, nausea, and even chills. Stopped Lialda and went back to Asacol and am doing fine.


Sure hope you don't have the same reaction I did. It was way worse than the disease. Good luck
Posted 11/14/2011 4:16 AM (GMT 0)
I have never taken Asacol but Lialda made me very sick. I started going to the bathroom A LOT (15x a day), got a horrible rash all over my face and hands, and my bleeding worsened. I was only on it for a month, but I stopped after that because it wasn't helping.
Posted 11/14/2011 5:04 AM (GMT 0)
Yes, Asacol was the first drug I was on for my Crohn's (now UC, I guess). It made me worse within a couple weeks. I then went immediately to Remicade (ugh don't ask--was not educated enough) but a few years later went on Lialda and tolerated it fine. My GI said that this can happen in some patients. I'm now on Apriso and it's been working great.
Posted 11/14/2011 12:36 PM (GMT 0)
tensai,

Welcome to the forum.

Yes, you're probably having a problem tolerating mesalamines. I did too.

I agree with Red, perhaps you should try Colazal instead?

Let us know what happens.

Posted 11/16/2011 11:09 PM (GMT 0)
Thanks for the responses everyone. I will talk to my doctor about Colazal if the Lialda doesn't work out. mkl11 and DonewithUC, thank you for your answers, that is exactly what I was wondering. I certainly hope my previous reaction was to Asacol's mesalamine wrapper and not to the mesalamine itself. Time will tell.

As for life right now, my symptoms are worse than they've ever been with the exception of the 4 days I was having my reaction to the Asacol. I'm on day 6 of Lialda with no improvement, but no side-affects either. Hopefully things start to get better soon, this is horrible.
Posted 11/17/2011 6:47 PM (GMT 0)
Starting to question the Lialda. When I take my pills tonight it will be my seventh dose of Lialda, and so far it is not helping at all. In fact, symptoms seem to be getting worse. I'm up to about 10 bathroom trips per day, and bleeding is getting worse. No nausea or dizziness like I had with the asacol, but I may get there yet.

For those that did have a positive reaction to Lialda, how long were you on it before things started to improve?

Thanks!
Posted 11/17/2011 11:02 PM (GMT 0)
Tensai,  you wrote that you are on Prednisone and it had it's own bad reactions.  What were they if you don't mind me asking?  I've been on it for 4 days now, 40 mg's tapering 5 mg's per day.  I'm also on Lialda for my Lymphocytic Colitis and have been for about 4 months with no reactions that I'm aware of.  In fact, I was in remission for a little over a month, but that ended about a week ago.  It was nice after over 4 years of non stop watery D. 

Posted 11/17/2011 11:02 PM (GMT 0)
FWIW, I had an increase of symptoms when I switched from Asacol to Colazal for almost two weeks. I thought that I was having a bad reaction but than it completely turned around. Perhaps you should call your doc to see if that is normal? Or maybe wait it out another week to see if your body is going to get used to it?
Posted 11/17/2011 11:31 PM (GMT 0)
@Rhyes,

I'm sorry to hear that your remission ended. A small break is better than nothing right? Hopefully another one is coming up for you soon.

A 5mg/day taper seems really fast. When I was on prednisone, I started at 40mg and did a 10mg taper every ten days. At first, while on 40mg I noticed no side-effects at all. By the time I dropped to 30mg my bowel movements were as close to 100% normal as they've ever been, but after a few days of 30mg i started breaking out with terrible acne. Face, neck, chest, back down to my waist, even my arms all the way to my wrists. It wasn't the worst side-effect imaginable, but it led to some awkward questions from people. My wife says I seemed pretty mopey/depressed while on the prednisone. Also, joint pain (knees, shoulders) was starting in by the time I got to 10mg.

I reached the end of my taper about a week and a half ago. The acne is still here, although it seems to be improving somewhat. Mopeyness/depression, maybe a little better. Joint pain is (mostly) gone.

I hope it works well for you and gets you back into a remission soon. Good luck!

@Sherry

Thanks again for your input. I'll give the Lialda a bit more time. I'm still trying to be a little optimistic about this. Like you said, it could still help, or maybe next week I'll add "unable to tolerate mesalamines" to my signature too. :)
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