What medication to use?

I have had ulcerative colitis for years, but was only officially diagnosed last year. My doctor is unreliable, unresponsive, and uninformed, and my insurance is a.... well, insurance company, so I'm looking to the wonderful internet to give me some advice on prescriptions.

My info:
I'm a 25 yr old female with UC. I have never had an 'accident' but I have severe bleeding, cramps, malnutrition, anemia, etc. when I'm off my meds. Symptoms are exacerbated by cold, lack of sleep, stress, eating too much. Meds keep me stable, but occasional triggers can cause minor cramps or constipation.

I originally took sulfasalazine and hated it. Then a new GI switched me to 400mg Asacol, which I loved, two years ago. Of course, Asacol is now unavailable and I'm scrambling to find a replacement.

My Amerigroup insurance covers: Asacol HD, Canasa, Rowasa, Pentasa

Whenever I bring up certain meds to my insurance, they hedge and say it's really something the Dr should be looking into, then when I bring it up with him, he shakes his head and says it's really hard to know the exact differences/get the insurance to approve it/etc. Basically neither party is allowing me to get the meds I need, and I know that whatever med I choose is going to be an uphill battle to get from them, so I want to make sure I pick the right one.

My question:
Which one of these is easiest to acquire from the insurance companies? Which one has fewer side effects or you guys have found to work better for you?

I'm leaning toward Asacol HD, but I'm afraid my insurance or doctor will give me more of an issue with it, thanks to the many varieties and the discontinued former version (my insurance won't cover delzicol and won't approve me for lialda), so I may try something new if it's easier to get.

Help!

What dose were you taking? lialda is covered for me and with their copay assist card it's only $10. I haven't had much luck with mesalamine lately though, not sure whether it's doing anything good for me. Have you tried using rectal meds and oral in conjunction? I think that's necessary depending on the active area and your symptoms. It's usually a good idea for all of us regardless. Canasa + Asacol HD may give you an idea whether you're going to be able to get into remission with these drugs, if not, you have to think about what the next options are. If your GI is terrible, you should also look for someone new.

Is your doctor a GI? If so, you might consider a second opinion or a different GI, as yours does sound either clueless or careless.

The meds you mentioned all treat different areas of the colon. Asacol HD is formulated to treat the entire length of the colon, although it is often used in conjunction with rectal drugs such as Canasa (treats the rectum only) or Rowasa (treats the rectum and sigmoid.) Pentasa isn't often used for UC because it releases just at the beginning of the colon and doesn't treat other areas.

So in addition to thinking about what works and what the insurance company will cover, consider what parts of your colon are affected by the UC. (I also strongly suspect most other established medications would be covered, but might be more trouble for the doctor to help you get approved.)

Judy2, yes he is a GI. I need to look into getting a new one. Thank you for your information about the different areas they affect! I will check my medical paperwork out to see which one is best...

I did ask my insurance about delzicol, lialda, apriso, salofalk, and sulfasalazine and none of them are covered. I didn't ask about mesalamine as a generic.

I don't know of any others that I should be asking about.

400mg twice a day is almost as good as taking nothing. Sad that your GI would put you on such a minimal dose.

You definitely need to find a better GI.

I know what types of food bother me and which ones to stay away from. (Taco Bell, alcohol, late night snacks, large meals, heavy breads, etc.)

I also know I have cravings and certain foods make me *feel* better as a person, but I'm not sure what role their really playing and I don't have laboratory settings in my kitchen to know what, exactly, helps me and what doesn't. Basically, if any food does help me it's hard to pinpoint and it doesn't help enough or as consistently as a pill.