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Asacol vs. Asacol HD

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Ulcerative Colitis
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Posted 7/18/2011 8:25 PM (GMT 0)
My doc wants me to switch to Asacol HD because it's fewer pills, but I noticed on the Asacol website, that Asacol 400 mg. is used to treat mild flares while HD is used to treat moderate flares.

I just that that HD was a larger pill, and the same as regular Asacol.

Any explanation? Should I stick with the 400 mg. if they've been working for me or move to the HD for convenience. I feel I have mild UC with occasional flare up in the rectum.
Posted 7/18/2011 8:59 PM (GMT 0)
It seems OK for those who use it...one good thing, it's a smaller dosage than the Lialda, so increasing and decreasing is easier without an extreme dosage change.

I would still split the dosage twice a day, however.

q
Posted 7/18/2011 9:24 PM (GMT 0)
I didn't like the HD because they were horse pills and I couldn't swallow them! A whole bottle wasted....
Posted 7/18/2011 11:18 PM (GMT 0)
I guess I can go pick up samples at my doc.

But why would HD be used for "moderate" flaring and regular be used for mild... Is there something stronger in HD

This is also on the website?

Prescribing Information

You should not substitute one Asacol HD 800 mg tablet for two Asacol 400 mg tablets unless directed by your doctor.
Posted 7/18/2011 11:43 PM (GMT 0)
Who knows....but I would think that the lowest dosage for Asacol would mean a higher lowest dosage for the HD (I think that the HD means high dosage...both are "time released"...so maybe the fact that more med is dissolved by one coating instead of more, it means more med gets dispursed.

Ha, I'm just guessing. I see no problem to continue taking what works.

q
Posted 7/19/2011 12:55 AM (GMT 0)
My general philosophy is, "if it ain't broke, don't fix it." If I were doing absolutely fine on regular Asacol I think I'd leave it be. My son is doing fine, and his GI has been very hesitant to change him to Lialda or Asacol HD because some of her other patients have flared with the change.

I've stayed on Asacol a long time but have flared at least twice a year anyway, so I think I may ask to try something different.
Posted 7/19/2011 1:05 AM (GMT 0)
If you read the insert on the Asacol 800HD... it clearly states that it is NOT bioequivalent to Asacol 400mg... meaning that two regular Asacol 400mg do not equal an Asacol 800mgHD.  I learned this hard and fast.  My insurance would not cover the A800HD for my son,  they would cover the A400mg (for the first month, then they denied it).    So we ran out of samples of the A800HD and the Dr switched us to the A400mg.   My son had a severe flare within one month.   If the A800HD is working and your insurance will cover it.. take it.   We were taking the same amount of pills per day for either one (2 tabs X 3 times a day).   Like Songlady says... if it ain't broke, dont fix it".   if it is working for you, take it.  

Just my opinion cool

 

Posted 7/19/2011 2:32 AM (GMT 0)
Hi Ellen,

Just FYI, my friend has always taken reg Asacol and did very well with it.  (She does however go unmedicated between flares)  For her last flare up her Dr. gave her Asacol HD and it did not help her at all.  She went to reg. Asacol...back out of the flare.  So...I think there must be a difference.  I would say also...if it ain't broke don't fix it!  Good luck,

B

Posted 7/19/2011 4:14 PM (GMT 0)
OK, I'm sticking to regular Asacol for pancolitis. It would be nice if it helped the rectum though. It doesn't.
Posted 7/19/2011 6:28 PM (GMT 0)
With the patent on Asacol running out in 2013, I'd say that Warner Chilcott is offering a higher kickback to doctors for prescribing Asacol HD. Get the addicts moved to the new crack and maintain the profit stream.

A similar thing happened with Astra Zeneca when the patent ran out on Prilosec. They introduced Nexium, and that became magic.

Me, my older sister, and younger brother, all three have UC. Each of us has experience and learned the maxim: if it ain't broke, don't fix it.
Posted 7/19/2011 7:09 PM (GMT 0)
It is in the best financial interest of the company to convince the FDA that asacol is not the bioequivalent of asacol HD. The coating are not exactly the same but the PH required to dissolve them is almost. If it was found to be bioequivalent, they would not get a fresh patent for Asacol HD. Proctor and gamble sold asacol and asacol hd because of doubts about patent and/or profitability once asacol goes generic. Most countries did not give them a new patent or allow them to charge more for HD

Also Asacol HD is not approved as a maintenance medication.It is approved for high dose induction of remission for mild-moderate flares. Your insurance company might refuse to cover it long term.

I would only switch to save money and then it still might be a chancy thing.
Posted 7/19/2011 7:22 PM (GMT 0)
AZYooper and Noah_Bodie, your information makes a lot of sense. My doc says it's bioequivalent. Already ordered Asacol garden variety.

Thanks all!
Posted 7/20/2011 7:28 AM (GMT 0)

journey2health said...
My doc says it's bioequivalent.


Point your doc to this.

www.asacol.com/pdf/asacolhd-info.pdf

One Asacol HD 800 mg tablet has not been shown to be bioequivalent to two Asacol® (mesalamine) delayed-release 400 mg tablets (2)
Posted 7/20/2011 4:52 PM (GMT 0)
When I ran out of Asacol HD (I take 2 pills 3X a day) I went to Asacol 400 mg and just doubled the dosage. Had the same effect, as far as I could tell.

That's all I can tell you as far as the efficacy. And the pills are larger, but I'd hardly call them "horse pills." They are not difficult to swallow.
Posted 7/20/2011 6:29 PM (GMT 0)
Noah....it doesn't explain why, however. Can you expand on why it's not equivalant...is it better or worse?

The treatment dosage seems to be the same...top dosage of 4800 mg daily. Same as Asacol. Which doesn't seem to be necessary for many patients regardless.

Any other info you can share?

q
Posted 7/20/2011 7:40 PM (GMT 0)
Let me nose around and see what I find.
Posted 7/20/2011 9:47 PM (GMT 0)
thanks
q
Posted 2/17/2015 12:45 AM (GMT 0)
DON'T switch to asacol hd. It stinks, it doesn't work. I've had 4 flares since being forced to switch (400mg no longer available)... I'm giving up on asacol all together. I am having good success with Fu Zi Li Zhong Wan. A traditional Chinese med I first tried in 2000/01 when I was first diagnosed. I even tried to reintroduce Asacol HD after it was finally approved by my insurance. ... but began getting symptoms again.

HD is BAD medicine... STAY AWAY unless you like Prednisone cycles every few months.
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