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Pentasa vs Salofalk tablets

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Ulcerative Colitis
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Posted 9/29/2013 8:43 AM (GMT 0)
My prescription is for Pentasa brand tablets. The pharmacy always has to order them in for me. This weekend I went to a different pharmacy and they have given me Salofalk brand tablets instead. I read online that you shouldn't switch brands as they can be released into different areas of the intestines ... my regular pharmacy was shut and I had no more Pentasa. Can anyone advise me on this issue ?

Here is the excerpt from netdoctor.co.uk

There are several different brands and forms of mesalazine available. The way that the mesalazine is released from these different products varies and allows the mesalazine to be released in specific areas of the intestine. You will be prescribed the brand that allows the mesalazine to be released in the part of your intestine that needs it most. For this reason, it is important that you always use the same brand of mesalazine. You should make sure you know which brand you normally have and check that you have been given the correct one each time your medicine is dispensed.
Posted 9/29/2013 2:43 PM (GMT 0)
Especially with Pentasa compared to Salofalk or Asacol or other 5ASA orals.....the release area is specific.

Call that pharmacy and say that they gave you the wrong medication. If your Rx says Pentasa, that's what you should have gotten.

q
Posted 9/30/2013 5:31 PM (GMT 0)
I have now been told (by a US based nurse) that Pentasa is given for small intestine inflammation and that Salofalk is given for colon inflammation. Can anyone confirm this ?

From my amateur research, I'm worried that I've wasted two months taking the incorrect meds as my inflammation/ulcers extend to 40cm (17inches) and not into my small intestine.

Any input would be greatly appreciated.
Posted 9/30/2013 5:43 PM (GMT 0)
Pentasa would probably be better for someone who has their whole colon affected than just the lower part, but it would still keep any inflammation throughout your colon at bay.

It does release in the small intestine then into the colon....so it's not going to hurt you unless you're having some side effects from it assuming it's from UC.....

But...see how you do on the Salofalk. What dosage are you taking? It will still start releasing in the terminal ileum and then into the colon.

q
Posted 9/30/2013 6:21 PM (GMT 0)
I'm on 2x500mg tablets, four times per day. I'm trying to get into my GI doc this week but having found this out, I'm a little concerned that I was put on the incorrect meds. Figured if I could go in there with a little knowledge, it might make the appointment more useful. Thanks for the really quick replies.
Posted 9/30/2013 6:29 PM (GMT 0)

quincy said...
Pentasa would probably be better for someone who has their whole colon affected than just the lower part, but it would still keep any inflammation throughout your colon at bay.

It does release in the small intestine then into the colon....so it's not going to hurt you unless you're having some side effects from it assuming it's from UC.....

But...see how you do on the Salofalk. What dosage are you taking? It will still start releasing in the terminal ileum and then into the colon.

q

quincy,

Currently, I am taking 3 g Pentasa tablet, and one 500 mesalazine suppository daily.

Is it too much? Overdose ?
Posted 9/30/2013 6:31 PM (GMT 0)
You're welcome...

You weren't put on "incorrect" meds...Pentasa is still used for UC. It's another option.  It's also at least an option for CDers with disease in their small intestine (others don't release there)...

Four times a day is crazy (although that's my perspective)...you can request to take them twice a day. AND....that's a fairly high dosage of oral 5ASA to take for distal UC....

Again...my opinion, especially since you're on the rectal meds and limited UC site.

I'd suggest you talk with your doc to start with a lower dosage of oral and increase if you need it.

q
Posted 10/3/2013 10:46 AM (GMT 0)
dont toy with it, they are different.
Posted 10/14/2013 6:58 PM (GMT 0)
I got an appointment with my GI, having been on the salofalk for six days. I had felt relatively symptom free up to that change of med brand. By the time I got to see the doc, I had urgency, gas, gurgling, loose stools and blood ! The only improvement was the pains in my hands had lessened. It appears that she hadn't picked up on the finger/hand pain in our earlier conversations and she said that I have extra intestinal symptoms which steps me up to the moderate grading from a mild grading (she uses mild, moderate and severe).

She has given me two weeks back on Pentasa & salofalk enema at which point she wants a full blood test and wants to change me to Prednisone for six weeks (32mg). She said that the quicker I could get into remission, the longer the remission lasts (generally). I was hoping to stay off the steroids as this is my first flare and I was hoping not to step up into the more serious spheres of drugs.

If anyone has any comments, I'd really appreciate it. I know that we all react differently, but how long would one anticipate being on mesalazine before going into remission? (A US based GI (friend of friend) told me that he would expect to stay on prescribe mes for four years before considering tapering)
Posted 10/14/2013 7:08 PM (GMT 0)
See how you do on this combo and go from there.

I strongly suggest you give this a fair go before the prednisone "threat". You don't need to go into remission FASTER...you need to heal and make sure that the meds you're using are doing the right thing first.

My thought is this.....so, she puts you on prednisone. So, you do well, but crap while tapering. You still don't know what 5ASA oral/rectal meds can work for you best...

I've never been on prednisone, and have used oral/rectal 5ASA for almost 25 years. It takes time to get into remission....and you have to taper your rectal meds to find the right dosage for you to remain to maintain.

Hang tough....it doesn't matter what your friend of a friend GI said...there's no written in stone med regimen. You see that here.

q
Posted 10/14/2013 7:24 PM (GMT 0)
Thanks Quincy. That was my gut reaction, I'd like to try to stay on 5ASA without stepping up.

I think that that's what the US friend of friend GI doc was suggesting too. To stay on the 5ASA meds to give the colon enough time to completely and fully heal before attempting to taper.

You say it takes time to get into remission ... do you have any sort of guideline on that time as I have just no clue ? I started my meds on 6th August, felt relief from symptoms within the first week. It was such a shock to the system to find the symptoms flooding back just from this error of change of meds (thanks pharmacist!!)
Posted 10/14/2013 8:08 PM (GMT 0)
Hi Caycro,

I have had a bad flare since February with bleeding but especially from the end of July with all the worst symptoms as the hospital didn't increase my medication at Easter which I think made things worse. Anyway since the end of July my medication is double my usual dose of 5ASA tablets and I am currently taking exactly the same medication as you. I had to go to an emergency clinic in July and they were keen to put me on steroids because there was apparently a severe biopsy result from Easter that they hadn't mentioned or acted on before. It was meant to be an 8 week plan of 5ASA maximum dose before review and was my suggestion. I was very worried that I wasn't better by the end of the 8 weeks because of their keenness to try steroids. However, once I was able to report improvements in symptoms, even though I am still not fully recovered even now, they were okay about leaving me on that dose for an extra 8 weeks without steroids and were satisfied things were settling and would probably continue to do so. They don't want to review me now until the end of November to give you an idea of possible timescales.

I also take Pentasa and always have done but at the moment with the Salofalk enema. They usually prescribe Pentasa for UC in the UK as they think it is a "clean drug" whatever that means.

The 5 ASA treatement is a slow route according to a different consultant rather than a quick fix. I felt slightly better each week and still notice a small improvement week by week.

I am keen to go back to half the dose when the flare is over. My research suggests you should wait a month after all symptoms have subsided. The latest hospital consultant talked about staying on them indefinitely which I don't want to do. Does anyone have any thoughts on tapering down mesalazine tablets?



J
Posted 10/14/2013 8:20 PM (GMT 0)
You're new at this, and in truth, my first year was difficult with trying to taper meds. I flared many times the first 2 - 3 years, but eventually the dosage process got figured out and my doc gave me full control of the tapering and increasing of the enemas.

Don't give up, and don't be forced into a remission with prednisone. You'll be hopping onto a train ride with a destination where you have no idea.

Basically...oral 5ASA and the enemas until you're "normal"...then consider to taper the enemas. It's a process. With the oral 5ASA, hopefully, it'll take care of the descending/sigmoid and stay calm nicely. With the rectal meds, you should be able to control your flares earlier and quicker.

Step one...patience. That's the word my doctor used many times. Yes, I even ONCE asked "should I be put on prednisone"...he lowered his head and peered at me, smiled and said "no". Stick to the regimen and see me in a month..lol. I was on the enemas for 4 months nightly, and eventually got back on track.

You do have choices...see if one regimen can work and if you're improving. If you do NOT improve at all...you'll have to change it. There are options.

q
Posted 10/14/2013 9:18 PM (GMT 0)
Hi J & Q, Thanks a million for your detailed responses. You've given me the information to go with confidence to talk with my GI about continuing on current meds. I really appreciate it. J are you UK based?
Posted 10/15/2013 7:20 PM (GMT 0)
Do make a list of questions/concerns to keep your appointment focussed and efficient.

q
Posted 10/17/2013 4:02 PM (GMT 0)
Hi Cayco,

I am UK based but I think the UK and Us will all follow the same procedures for treating the condition.

I think the consultants often start off recommending what they personally think but when a patient isn't happy with a line of treatment, they have to offer alternatives because it is our choice at the end of the day.

I hope you are feeling better than you did.

J
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