Different types of Mesalazine

Don't know much about the differences but that seems like too much of a coincidence to be well, a coincidence

My Asacol is 400mg and are maroonish or dark red brown and oblong- It never is different. Where I live
there is no generic- Ive lived in Dallas Tx and Kansas City Missouri and they are always the same.

Carlie

Wavey, even though meslamine is available under a variety of brand names and generic variations the release mechanism is often a little different in each med. Delayed-released tablets use a coating that releases meslamine at a specific PH level and rate (so it could start at a different place with different meds). One type of meslamine might just work better for you, so stick with what works if you have a choice in the matter.

An important consideration when evaluating the differences in the various mesalamine formulations is to remember that 80% of the mesalamine does not get absorbed. It stays right in the lumen (which is why this drug is commonly used in UC). Some formulations allow the release of the drug farther down the colon than others, allowing higher concentrations of mesalamine to be achieved closer to the end of of the large intestine.

There are various mechanisms by which this can be achieved. One relies on bacteria in the colon to break covalent bonds to activate the drug. This allows the inactive drug to pass through the small intestine relatively unchanged until it reaches the colon where the bonds are cleaved by the normal bacteria and activates the drug.

Other formulations use different methods, but with out going into too much more detail there are many variables that factor in to determine efficacy. One important factors is pH. If you happen to take a drug or food that affects the pH in your stool or the flora in your gut is associated with an intrinsically higher or lower pH than most then this will certainly change the effectiveness of the drug. Generally speaking a lower colonic pH can reduce the effectiveness of mesalamine. I am sure that there are other variables that play a role here, but ultimately proper pH is required for maximum mesalamine efficacy.

As for generic equivalents, that's kind of tricky subject since the FDA uses bio-availability to determine bio-equivalency for most drugs. The problem with mesalamine is we don't care so much about the fraction (~20%) that does get absorbed, it's more about how much and where the mesalamine is released in your colon. So to an extent, bio-equivalency assays are meaningless in this case.

So if you get your doctor to write the prescription to read mesalamine 400 mg then you can ask the pharmacist for which ever formulation you want.

Wavey, I have one question about the ASACOL, I can see the majority of it being released after 4.5 hours like you stated, but I am not sure what benefit can be derived from any mesalamine being released after 19.5 hours. Even if I am not having a flare, 19.5 hours after I ate something it's long gone, and probably hanging around my toilet drain pipes by that time. However, if I am having a flare, sometimes it takes less than 4 hours for something to go from my mouth to the toilet, so after 19.5 hours I am sure that most of the mesalamine has made it to the sewage treatment plant by then.

Glad you are getting relief from the Ipocol!

Good Luck :P