Major reaction to Lialda?

Help. I ended up in the ER last night on IV pred, and I think that it was the Lialda.

I started taking it about a week after my colonoscopy, three days later I was into a massive flare. I stopped taking it and as it worked it's way out of my system, my Gi put me on pred 40mg. I started taking the Lialda again about a day and a half into the pred, and by the time I was back to full doses of Lialda, the pred stopped working. about 4 hours after I took the Lialda last night, I was on my way to ER for 125mg of pred to stop what felt like I was being torn apart from inside. This morning I took my normal dose of Pred, no Lialda, and things are getting back to normal.

Is this possible? My GI swears that I couldn't have that kind of reaction to Lialda, but there ARE severe side effects and someone has to have them, right?

did the ER docs think you were having an allergic reaction to the Lialda? What bananagirl describes is a classic histamine response. Your description of gut pain doesn't sound that way to me, but we are not drs here. What's going on in your bowels?

Pred does not "stop working." If you are taking too little pred to control the flare then the addition IV steroids you got last night will help. Is it possible that you are ovulating? I once had an incredible painful mittelschmerz that had me on the floor in tears.

From the FDA webpage on Lialda:

"Mesalamine-Induced Acute Intolerance Syndrome

"Mesalamine has been associated with an acute intolerance syndrome that may be difficult to distinguish from an exacerbation of ulcerative colitis. Although the exact frequency of occurrence has not been determined, it has occurred in 3% of patients in controlled clinical trials of mesalamine or sulfasalazine. Symptoms include cramping, acute abdominal pain and bloody diarrhea, and sometimes fever, headache, and rash. Observe patients closely for worsening of these symptoms while on treatment. If acute intolerance syndrome is suspected, promptly discontinue treatment with Lialda."

If you are intolerant of mesalamine, it seems like the biologic meds just got more likely for your future treatment options!

Thats too bad if you are not tolerant to Lialda. I found it to be such a good drug for me. Especially since I am nearly allergic to everything. If you continue to have problem while off of Lialda, it could be simply a flare.
Hope you are feeling better soon!

edit: wow apologies for the very long post.. my last paragraph is a summary of my question

Sorry for the bump but I may be intolerant to mesalamines. Ever since diagnosis 3 years ago I've been having the same cycle - 3 months remission, 3 months flare. I started out with Asacol right after colonoscopy but it seemed to make my flare worse within the first week. Of course it was my first flare and it was really bad as it was. May have just been the flare getting worse.

Doc dropped Asacol and we tried Colazal. Colazal wasn't help but not making me worse, and we stayed on Colazal but he also prescribed me Rowasa. The next day I was in horrible stomach pains like air bubbles were trapped in my stomach and rising up, this happened every minute or two for an entire week. So I never took Rowasa again.

So he gave me pred 40mg which helped me get out of a flare. Since then I was just on Colazal and been getting 3 months on 3 months off flares.

Then Colazal discontinued production and I got Apriso. Around the same time I started taking Apriso I started getting a lot of stress from work related interviews. A month after the interviews began and also started taking Apriso, I got into another flare that is going on for 2 months now.

So I may be intolerant and thinking of dropping Apriso for 3-7 days to see if there is improvement although I'm deathly afraid my UC will be even worse and I really really don't need that right now because I just got a new job. Thankfully I am only going twice a day with urgency only right before my scheduled poop time but it's all bloody diarreah and starting to get painful. Steady increase in symptoms.

I also don't have insurance (on PAP with Salix so I get Apriso for free) so I can't try other medications.

So my options are: try dropping Apriso for a few days, but risk a terrible increase in flare symptoms (?)

Or prednisone which I really do not wish to take. Plus maybe it is Apriso causing the flare.

Sorry about the long post but basically I'm just in need of advice. Does this sound like intolerance to mesalamine? I searched the forum here for mesalamine intolerance and the threads that came back, people said they gotten worse BMs and symptoms within days/hours of starting mesalamine, not a month like I am