HealingWell
Search Close Search
☰

mesalamine

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 7/30/2015 1:56 PM (GMT 0)
Can someone help me?
i have tried oral mesalamine tablets such as apriso, asacol and lialda. all have caused a terrible reaction such as bloating, cramping and diarrhea within taking 1 or 2 pills. so i stopped immediately. right away, the symptons subsided. so i guess i am mesalamine intolerant. i do not want to go the the next level of maintenance treatment, which is 6mp, because afraid of all the side effects.
so my question is..has anyone been able to tolerate rowasa enemas (which i realize are mesalamine based) that cd not tolerate it in oral form? i am wondering if taken topically through an enema, as opposed to orally, perhaps i wd be able to tolerate the mesalamine better.
can anyone provide any insight? thank you so much.
Posted 7/30/2015 2:13 PM (GMT 0)
In my previous flare, I was extremely nauseated from asacol and colazol. I used rowasa and had no side effects. Maybe you could give them a try?
Posted 7/30/2015 4:25 PM (GMT 0)
There's no reason to be scared of 6mp. I've been on it 2.5 years without a single side effect. It's all about risks versus benefits. Immunosuppressive medications have statistically small odds of serious side effects (less than 1 percent). While the odds of 6mp helping you are around 70 percent. The most concerning side effect of these medications is lymphoma which has odds of 4 in 10,000 (or 0.04 percent) compared to 2 in 10,000 ( or 0.02 percent) for the general population. The Crohn's and Colitis Foundation of America is the source for these statistics:
Webcast: programs.rmei.com/CCFA139VL/presentation/player.html
Transcript: www.ccfa.org/assets/pdfs/risk-and-benefits-transcript.pdf
Posted 7/30/2015 4:34 PM (GMT 0)
I agree with iPoop. I understand that it's scary starting something new, especially something like 6mp that has a long list of possible side effects. You have to remember that the dose we take is very low and puts us at at a low risk for these types of side effects compared to people who take these medications for other purposes like anti-rejection. I took 6mp for a while without any side effects. You could try rowasa but depending on the extent of your inflammation, it may or may not be useful. Rowasa is great but it will not reach your entire colon... You could also try steroid enemas but they have the same problem. if you're dealing with pancolitis, healing the sigmoid and rectum isn't going to get you to 100%.
Posted 7/30/2015 5:43 PM (GMT 0)
I have a question on this though. Most people on 6MP or AZA, Imuran, or whatever get regular blood tests to make sure you are at a "therapeutic level" or are not having liver problems. Are you saying that our therapeutic level is much lower than, let's say transplant patients, and are you saying that transplant patients take dosages much higher than the "therapeutic level"?
Posted 7/30/2015 6:49 PM (GMT 0)

garylouisville said...
I have a question on this though. Most people on 6MP or AZA, Imuran, or whatever get regular blood tests to make sure you are at a "therapeutic level" or are not having liver problems. Are you saying that our therapeutic level is much lower than, let's say transplant patients, and are you saying that transplant patients take dosages much higher than the "therapeutic level"?

Therapudic level means, the medication is at a level in which it is helping the patient. Some patients can tolerate higher or lower dosages. The max is 1.5mgs per kilogram for 6mp; 2.5mgs per kilogram for Imuran/aza.

While on 6mp, imuran, or aza two blood tests must be done on at least a trimonthly basis. First, is the Complete Bloodcell Count (CBC) which checks to make sure the white blood cell count doesn't get too low (these medications desired affect is lowered WBC, but too low and risk of infection becomes dangerous). Second, is liver panel test, which looks for proteins indicating a toxicity response and the medication is lowered in dose or discontinued before damage to the liver can occur (not everyone can safely reach 6mp@ 1.5mgs per kilogram or imuran/[email protected] per kilogram). Allopurinol can be added in toxicity cases, to reach therapeutic levels at much lower dosages of 6mp/aza/Imuran.

Liver transplant patients are often on multiple strong immunosuppressive medications simultaneously. Something that's not done with uc.
✚ New Topic ✚ Reply