Mesalamine - How much is too much?

It's really, really hard to OD on mesalamine. I think you're at the max dose of asacol, though.

With tapers, go slow. I tried to taper my lialda too soon and am now flaring again.

When I was on Asacol, I was taking 12 400mg tablets a day, so you're far from the maximum doseage there. Also, Asacol and the other mesalamines (oral and rectal) aren't that well absorbed by the colon, so not much is going systemically in your body. I was also using a 4g enema every night for a lot of that time. There's also someone on here (songlady?, sorry if I'm wrong) who takes 16 400mg Asacol/day.

jkingfrt...you should up the Asacol to at least 6 daily.

The 4g enemas would be best, but if you have lots of supps, you can do the enema at night and the supps twice during the day.

OR, do the enemas one in the morning and one at night.

But, the 4g enema makes more sense and possibly one supp during the day.

You're not at a max dosage.

How long have you been at your current nightly dosage of the 2g?

quincy

Quincy, I've been on the 2g enema nightly for about a month and a half (basically when I started antibiotics in early Jan) but I had been using it about 3 times a week before for maintenance. The proctitis feels like it is confined to the last inch of my rectum and started just over a week ago when I stopped having diarrhea (likely caused by the antibiotics). I second that this area is hard to treat, having been in this spot a few times over the last 8 years. The suppositories, enemas, proctofoams sometimes help and sometimes don't. Right now the 2g enemas and the suppositories (1g once a day) are helping a little but not providing any dramatic relief.

I am going to try the 4g enema at night and 2x 1g suppositories during the day and see if that works out. Otherwise it's back to proctofoam or maybe even cortifoam although I find those things burn more than they help (even pred has the same effect).

Hard to sit down for a few hours after a BM!

j.

It doesn't sound like you're anywhere close to overdosing on 5-ASAs. The one way you can tell if your colon is overmedicated: your urinary system starts producing a lot more output than you generally have. 5-ASAs are not totally benign, though; they affect the kidneys at excessive dosages. RE Proctofoam vs. Cortifoam: Proctofoam mainly treats hemmies; Cortifoam usually speeds healing of the rectum as it contains 10% steroid, a higher dose than Proctofoam. / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)

Too much is when you have to pee around the clock-- including waking up to go multiple times at night. Nearly as annoying as multiple bms ... / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)

I say give it a week or two more and see where you are.