Switching from Asacol to Colazol (generic)

I have been in a UC flare-up for about a month, which is the longest I've gone in a flare before. I know it's a fairly minor flare compared to what many of you experience, and I know I've been lucky to have my flares be so short lived in the past. I'm typically having 5-10 stools a day, sometimes liquidy, sometimes more mushy (but very rarely formed). I'm seeing blood about 1/3 of the time, though I"m not so sure if it's flare blood or hemmie blood I've also been seeing several whole asacol pills in the toilet each day, so my doctor wants me to switch to colazol. My pharmacy can't get it until Monday, so until then I remain on the asacol. I am just wondering if any of you could share you experiences switching from one to the other. I know it affects everyone differently, I'm just hoping it will bring about some relief.

To add a little more background I started at 20mg prednisone a few weeks ago, then went up to 40mg when things didn't calm down (prednisone has always been my wonder drug in the past), and just yesterday increased to 60mg as per my GI's instructions, which is the highest dose I've done before. He also added in rectal mesalamine about a week ago (first time for me on rectal meds), and I do think it's helping with the bleeding, though I"m not sure if it might be making the D worse.

My GI ordered a bunch of bloodwork yesterday, so hopefully I'll be getting some answers and seeing some relief soon. He also advised clear liquids for about 24 hours to give my colon some rest, but I have to admit the prednisone munchies make the resist to snack very difficult. It's odd because there are moments when I feel really hungry like I could eat everything in sight, and other moments like right now where I really don't want to eat, and really don't want to deal with the after effects of eating.

My main question is really about the switch to colazol, but I also think I wanted to share my story with people who understand.

I started on asacol HD which worked. I switched to sulfasalazine which worked better but I had terrible headaches and a fever from it after 4 weeks. I asked for generic colazal and it has worked the best of all. It saves me $1200 a year over asacol in copays. I have been in remission for 2.5 years and on generic colazal for 2 years total.

There are 2 questions to consider when quitting Asacol -- [1.] First what is the acidity level of your colon? In recent yrs it has been found that Asacol works best for UCers with level 7 or higher pH; with lower level pH it may not dissolve properly. (Gastros can now test pH level with digital exam specimen.) AND [2.] Do you have right-side UC inflammation? Asacol & Pentasa are generally considered better for treating the right colon because they are designed to start dissolving in the terminal ileum whereas Colazal is activated by bacterial action within the colon, making it more effective toward the left side. Generic Colazal (balsalazide disodium) came on the market in 2008, but it does not work as well as brandname Colazal for many of us posting on this forum. RE Rowasa: it can be very effective in curbing inflammation in the rectum & sigmoid colon over time, but it does not solidify bms because it does not get absorbed the way steroid retention enemas do. You can try to mitigate the liquid effect thru diet, such as plain boiled rice, or by taking a psyllium supplement regularly. The 60 mg Prednisone should work quickly to reduce symptoms; make sure your doctor has an exit strategy for you to taper off it as soon as possible. / Old Hat (31 yrs with left-sided UC; presently in remission taking brandname Colazal)

Post Edited (Old Hat) : 5/19/2012 1:30:38 PM (GMT-6)