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worth trying colazal if asacol doesn't work?

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Ulcerative Colitis
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Posted 6/30/2009 5:57 PM (GMT 0)
Asacol isn't doing anything for my symptoms at all. My dr said that he wanted me to try colazal and that if that didnt work then Remicade would be the next option. I went to the pharmacy to fill the rx and they will not cover it. With all the other medications I am on I can not afford to pay full price for the colazal. My dr. is fighting for me to be able to have it since this is one of my last options in pills to try. I really do not want to do remicade because I have heard its your last option before surgery....and im def not ready for surgery.

anyone have experiences where colazal worked good when asacol failed?

Posted 6/30/2009 6:23 PM (GMT 0)
I switched from Asacol to Azulfadine (Sulfasalazine) with much success. If Asacol's not working for you, it's definitely worth trying another ASA.
Posted 6/30/2009 8:24 PM (GMT 0)
I did well when I first switched over from asacol to colazal. Depending on your income level, you may be able to get colazal for free. I know I did while I was in school.
Posted 6/30/2009 8:46 PM (GMT 0)
I made a switch from Asacol to sulfasalazine, and it was a huge improvement.  (And the stuff is comparatively dirt cheap.)
Posted 6/30/2009 8:57 PM (GMT 0)
I cant take sulfasalazine because im allergic to sulfa drugs. I think the colazal was around 100 a month (if insurance covered it...the cost would be $15)but when I already pay over 100 a month in meds I can't afford to pay another 100 a month. I guess I will just wait it out and see if the dr can argue with the pharmacy to get it covered. The only reason why the pharmacy won't cover it for me is because They state........Since mesalamines (pentasa and asacol) did not work for you there is no sense in trying colazal because it does the same thing. They use studies to determine whether or not they think it will work for me.....and I am NOT a study!

*sigh*

I tried to tell them I was a study and I was a person but it didn't seem to work.

Posted 7/1/2009 12:04 AM (GMT 0)
Wow, I would switch pharmacies. That is complete bs. If they had any clue they would no that that type of logic does not work for this disease.
Posted 7/1/2009 12:58 AM (GMT 0)
Yeah I know its BS but I can't go to another pharmacy. The plan I have is an HMO and the funny part is I work for them for the last 7 years!! You have to use there pharmacies for copays or they are not covered under copay. I take some prescriptions outside because walmart has good deals but this one is way more expensive on the outside.

I just got the papers in the mail today to do an appeal on the drug since they denied it...they also sent a denial paper to my GI so im guessing that he is going to try to appeal it also but can take 14-30 days to get an answer back.  In the paperwork they listed all the other mesalamines that can work for UC that would be covered under copay....except ive tried all of them and none of them worked.

Posted 7/1/2009 2:21 AM (GMT 0)
I highly recommend you continue fighting!! Asacol did NOTHING for me.  I switched Colazal and I can't believe the difference.  It took some time to really kick in but it's working now.  It is currently the only thing I am taking now.  about once a day I get urgency, usually first thing in the morning.  Other than that..I'm good.  Don't give up!!

Posted 7/1/2009 3:25 AM (GMT 0)
Original Colazal has helped me more than any other oral 5-ASA to-date, so i'd say it's definitely worthwhile for you to try. My insurance won't cover it fully since last yr when the generic came to market; I tried the generic for a few months but it made me sick, ugh! Now I have a $240 co-pay for every bottle of original Colazal (280 capsules). The blasted pharmas get us coming & going!!!!!!! (Scrap Girl put me on to a Colazal discount card offered by Salix; then Salix discontinued their discount a couple months later because they are currently pushing Apriso.) There IS evidence that Colazal works better than Asacol etc. for patients with left-sided UC-- so your doctor should explain in his appeal that you need Colazal for that reason. You might also get some relief from Xifaxin (Rifaxamin)-- a fairly new non-systemic antibiotic that originated in Europe, but has been used successfully against some UC flares by U.S. patients in recent yrs. Best wishes for you to get the help you need-- keep us posted as your time/energy permits. / Old Hat (30 yrs with left-sided UC ... [etc.])
Posted 7/1/2009 7:46 PM (GMT 0)
I did a quick PubMed search, and found the abstract for this article...I can't get the whole thing, but maybe your GI can.  It shows that balsalazide (Colazal) is more effective at getting people into remission than mesalamine.  You should submit this as evidence of why they should cover it for you!

1: Dig Dis Sci. 2009 Apr;54(4):712-21.

Comparison of mesalazine and balsalazide in induction and maintenance of remission in patients with ulcerative colitis: a meta-analysis.Rahimi R, Nikfar S, Rezaie A, Abdollahi M.

BACKGROUND: 5-Aminosalicylates are the standard treatment for induction and maintenance of remission in mild-to-moderate ulcerative colitis. In recent years, the 5-aminosalicylic acid-containing pro-drug balsalazide has been the focus of attention. AIM: To compare the efficacy and tolerance of balsalazide and mesalazine by meta-analysis. METHODS: Pubmed, Embase, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials were searched for studies comparing the efficacy and/or tolerance of balsalazide with mesalazine in the management of UC. The search terms were: "mesalazine" or "5-aminosalicylic acid" and "balsalazide" and "ulcerative colitis." Data were collected from 1966 to 2007 (up to February). There was no language restriction. "Symptomatic remission," "complete remission," "relapse rate," "total adverse events," and "withdrawals because of adverse events" were the key outcomes of interest. RESULTS: Six randomized placebo-controlled clinical trials met our criteria and were included in the meta-analysis. In these "symptomatic remission," "complete remission," "relapse rate," "total adverse events," and "withdrawals because of adverse events" were evaluated in three, three, two, five, and six of the trials, respectively. They included 653 patients consisting of 55.4% men and 44.6% women randomized to receive either balsalazide or mesalazine. Pooling of three trials for symptomatic remission yielded a significant relative risk (RR) of 1.23 (95% confidence interval of 1.03-1.47, P = 0.02). The summary RR for complete remission in three trials was 1.3 (95% CI of 1.002-1.68, P = 0.048). Pooling of two trials for the outcome of relapse yielded a non-significant RR of 0.77 (95% CI of 0.56-1.07, P = 0.12). Pooling five studies from which data for any adverse events were extracted, yielded a non-significant RR of 0.87 (95% CI of 0.75-1.001, P = 0.53). The summary RR for withdrawals because of adverse events in six trials was 0.69, a non-significant RR (95% CI of 0.37-1.29, P = 0.24). CONCLUSION: Balsalazide is more effective than mesalazine in induction of remission, but balsalazide has no benefit compared with mesalazine in preventing relapse in the population selected. The number of patients with any adverse events and withdrawals because of severe adverse events is similar for mesalazine and balsalazide.

Posted 7/1/2009 10:55 PM (GMT 0)
I had been on asacol since I was first diagnosed in  05, including my three year remission. I saw my GI in April and told him I was having some symptoms and was switched to colazal and I absolutely love it! I thought I was in remission before but this is a million times better!

Keep fighting!!

Posted 7/1/2009 11:44 PM (GMT 0)
     I was switched from Asacol to Colazal about two years after being diagnosed...so that would be in 2000.  I take the generic Balsalazide...not sure of the spelling there.  Actually, I still get flares, so not sure if it works that great.  However, my UC is still confined to the rectum, hasn't traveled further into the colon in all those years , so just maybe, they Balsalazide IS helping by keepin it down there.
Posted 7/1/2009 11:48 PM (GMT 0)
I'm sure it isn't your pharmacy that's denying you the medication, but your insurance. Since you're limited to one pharmacy, I assume you're in an HMO. Typically, they function more like insurance companies than health care providers, and with some you have to fight for everything you get. The only suggestion I can make is to be persistent, annoying and always buzzing in their ears.

Good luck.
Posted 7/2/2009 2:30 AM (GMT 0)
I have been on asacol for many years and have found it to be pretty ineffective - actually I think it makes urgency worse at times... I may ask about colazal..
Posted 7/2/2009 2:47 AM (GMT 0)
Note to Fruitgirl & others: Balsalazide breaks down into mesalamine within the colon. So-- it's not a different drug, but a different delivery of 5-ASA & unlike Asacol, it's not pH-level dependent for dispersion. Asacol is designed to start dissolving in the terminal ileum. / Old Hat (30 yrs with left-sided UC ... [etc.])
Posted 7/2/2009 5:34 AM (GMT 0)
Thanks for the advice. I faxed in my letter to my insurance company so we shall see what happens. I might just bite the bullet and pay for it if they won't. at least maybe try it so that I can file another apeal that shows that it actually works for me and im not another statistic haha. Never know if soemthing will work until you try it. I tried Imuran and the worst side effect I had on it was constant thirst and fatigue. If my body hadn't of freaked out I think it would have been the perfect thing...Ive been on prednisone too long now and I guess I am too teh point where they consider it long term user....I can't get under 10 mg without all symptoms coming back fast with in a week.
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