Lialda Dosing

I will soon be switching from Asacol HD to Lialda in a matter of days when my Asacol runs out. I am making the switch because I felt Asacol was both good news and bad news for me and I saw several posts where people switched to Lialda and got better. Recently I have been seeing posts where the same switch went the other way. With the Asacol I was taking one tablet (800mgs), three times per day for a total of 2.4 grams. With Lialda (1.2 grams each) they usually take the medication one time all at once in the morning instead of several times per day, but some take it several times per day instead of all at once. I don't particularly have a preference since taking meds several times per day does not bother me. My question is, which way do you think is better, UC wise? I can take the same 2.4 grams all at once in the morning or take one pill twice daily. My body is used to taking the Asacol more than once per day but then again I am switching hoping I will get better. Maybe it is better to have all 2.4 grams in your system all at once, one time per day instead of half the dose in the morning and half at night, giving you a smaller amount of medicine more times daily. Does anyone have any thoughts on the subject? Another option would be to start one way, say one pill twice daily, see how it goes, and then possibly switch to all at once at a later time.

I just switched from Delzicol to Lialda. I am taking 2.4 g also. My doc prescribed to take 1 pill twice a day but it seems to not be as well as taking them all in the morning. So now I take 2 in the morning and 1 at night (3 total). So far, I'm doing ok...but Delzicol started to make me feel like I was always on the verge of a flare even though it seemed to be the same for the first 2 months. Hopefully Lialda will work for me. I will keep you updated Gary.

Hey Gary, was it you who said they use Rowasa once every 2 weeks?

Post Edited (sirgumby) : 9/25/2013 7:59:10 PM (GMT-6)

When I feel well I take 2 Lialda in the am. When I'm flaring I take 2 twice a day.

My doc actually prescribed 3.6 grams per day because he thought I was taking 4 (800mg) Asacols per day(3.2g's). Due to reducing costs for these $500 per month drugs I had only been taking 3 Asacols per day (2.4G's) for quite a while. When I reduced the dosage it did not effect my condition at all and I had taken as much as 4.8 grams per day of Asacol and it actually seemed to make me worse or at least no better on the higher dosage. I have always suspected that Asacol made me both better and worse so that is why I thought about switching to Lialda.

Before Asacol I was having only 3 BM's per day but they were all 100% bloody diarrhea. Since switching to the Asacol my stools are usually always formed and rarely see blood but my BM's increased to 8-15 per day. I don't know if it is due to the progression of the disease or maybe that the Asacol was indeed making me both better and worse at the same time. My frequency and urgency seem to be 100% tied to gas which builds up inside me every 2-3 hours. I have gas almost every single time out of these 8-15 trips to the bathroom. Half the time it is just gas and mucus only. Looks like I am going to try 2 Lialdas in the morning only and see what happens.

I'm still not so sure about the progression of the disease. If I went from all of my BM's being nothing but bloody diarrhea to having formed stools and no blood, then doesn't that mean I got better? And, if I got better, then how come I went from 3bms per day up to 8-15? It seems kind of contradictory. One consideration I have regarding the immunemodulators and biologics is that I do not have a spleen so that gives me the fear that complications could very well be worse for me. Getting a bad infection even now could kill me in a matter of days so I'm not real thrilled with the idea of being on immunosuppressants which can bring on even more possibilities of infections or even cancers. I know someone with a spleen already who was on Humira for RA and wound up with a life threatening infection which required surgery. It was touch and go for a few days.

I asked my doc recently for a prescription for a short term dose of pred to see if that can bump me into a remission but I refuse to become pred dependent. If it doesn't work then it doesn't work. I'll be done with it. I'm waiting to see how my recent med changes work before starting it. In my case I believe it is my best health interest to not obsess over actual remission when the road to get there could literally kill me. Even though 8-15 bm trips is extremely annoying, my particular work and home situation has made it tolerable. Barely.

When I took Asacol HD I was taking it 3 times per day and the Lialda is designed to take all at once, one time per day, although it doesn't have to be taken that way. The very first day I took Lialda my UC during the day was completely amazing but the evening and through the night was really terrible, I guess because the medicine had run it's course by then. The next day I decided to take 1 Lialda three times daily instead of taking all three at once in the morning. That was a good decision as I have been doing better than when I was on the HD and have continued with that dosing. The Lialda is also cheaper for me than the Asacol was.