Asacol HD - Might need to Switch - Help please!

Sometimes switching between mesalamines is uneventful and other times it causes issues. No knowing which is you in advance. Most doctors or pharmacists will say there's little difference among the various formulations. Anecdotally here, some have said one works better for them than another.

You can try an appeal, sometimes they work and other times not. Worth a try.

Same goes on savinv money, I'd give it a try. I'd choose Balsalazide over sulfasalazine as it is less prone to side effects. Sufasalazine does help with joint aches if you have any (it's an Rheumatoid arthritis drug and uc drug).

DBwithUC said...
appeals vary company to company

i would try lialda. i do well on it, and there a copay assist card

Thanks for your feedback! I looked - they seem to have discontinued the copay assist last month...honestly the lialda would cost me as much as the Asacol HD would but would be approved easier by my insurance. It would still end up costing me about $3,000 a year extra. I'll definitely talk to my doctor about it though if my insurance gives me a runaround on my medication. thanks!

All of the medications you mention deliver anti-inflammatory mesalamine to the large intestine but how it's delivered varies.

Generic Balsalazide Disodium (brand name Colazal) and generic Sulfasalazine (brand name Azulfidine) are an older class of UC medications, therefore are true generics at a reasonable cost. Unlike Lialda/Asacol hd, there is no red/orange chemical coating with PH-delayed-release delivery. Rather, they are more complex molecules that gut bacterium breaks down into mesalamine and a byproduct. It's the same result but achieved through different means. In the case of sulfasalazine, that unused byproduct is sulfa which is an allergen to some and can cause headaches and number of other side effects, but it is the cheapest by far of all UC meds (about $75 a month if you pay entirely out of pocket). The majority don't experience side effects of sulfasalazine, you cold always try it and if you get headaches then switch. Overall Balsalazide is a safer bet as the byproduct does not appear to have the same adverse reactions, it's a little more expensive ($200-400 a month if paid entirely out of pocket). Both are tablets taken multiple times a day. There's a lot more interest in these lately due to prescription med pricing. A number of posters use Balsalazide, and some use sulfasalazine.

Balsalazide Disodium is generic of Colazal, comes in 750mg pills, a typical dose is 6,750mgs or 9 pills daily.

Sulfasalazine is a generic, comes in 500mg pills, a typical dose is 4,000mgs or 8 pills daily.

Lialda is similar to asacol hd, but larger pills: 1,200mg instead of 800mgs. Lialda is taken all at once in the morning, which is it's biggest difference. Lialda has a generic that's new to market but at $1,200 a month it's a rather expensive generic.

iPoop said...
All of the medications you mention deliver anti-inflammatory mesalamine to the large intestine but how it's delivered varies.

Generic Balsalazide Disodium (brand name Colazal) and generic Sulfasalazine (brand name Azulfidine) are an older class of UC medications, therefore are true generics at a reasonable cost. Unlike Lialda/Asacol hd, there is no red/orange chemical coating with PH-delayed-release delivery. Rather, they are more complex molecules that gut bacterium breaks down into mesalamine and a byproduct. It's the same result but achieved through different means. In the case of sulfasalazine, that unused byproduct is sulfa which is an allergen to some and can cause headaches and number of other side effects, but it is the cheapest by far of all UC meds (about $75 a month if you pay entirely out of pocket). The majority don't experience side effects of sulfasalazine, you cold always try it and if you get headaches then switch. Overall Balsalazide is a safer bet as the byproduct does not appear to have the same adverse reactions, it's a little more expensive ($200-400 a month if paid entirely out of pocket). Both are tablets taken multiple times a day. There's a lot more interest in these lately due to prescription med pricing. A number of posters use Balsalazide, and some use sulfasalazine.

Balsalazide Disodium is generic of Colazal, comes in 750mg pills, a typical dose is 6,750mgs or 9 pills daily.

Sulfasalazine is a generic, comes in 500mg pills, a typical dose is 4,000mgs or 8 pills daily.

Lialda is similar to asacol hd, but larger pills: 1,200mg instead of 800mgs. Lialda is taken all at once in the morning, which is it's biggest difference. Lialda has a generic that's new to market but at $1,200 a month it's a rather expensive generic.

thank you for this very thorough breakdown. this helps me a lot, I feel when I see my doctor I will know more of what to talk about now, so thank you!!!!!!! hopefully one of these will work for me. if not I'm afraid the asacol hd generic I take now won't work anymore if I go back on it. I hate that a company can try and tell me whats best for my UC based on their costs. I already spend 2k a year getting medication so its scary I might have to spend another 2k next year and forever. hopefully a cheaper option will work. thanks again!!

I switched from Asacol HD to balsalaside without any obvious effect. But I am also taking Entyvio, 6-MP, hydrocortisone so it's not clear how much good mesalamine was doing.

UCinGV said...
My insurer also stopped covering Asacol HD, and so I got pushed into Lialda. I have felt much better since around that time but I can't say for certian it is because of the Lialda.

I have recently switched to generic Lialda (Zydus Mesalamine DR) and I have noticed no negative effects.

I'm so confused about the generic lialda. I take the generic asacol hd right now and it's also called melamine dr and by zydus. but it sounds like there is another one? my new plan won't even cover that generic I am on by zydus - and I cannot find the lialda generic. lialda sounds like it could be a good option for me to switch to, but cost wise it'll be a lot more expensive than if I can take the others. however I guess at this point I just want to be healthy so I'd rather spend an extra 3k a year I guess. I feel like it should be illegal for insurance companies to do this if they know something works for someone