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Too much mesalamine?

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Ulcerative Colitis
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Posted 1/27/2012 11:41 PM (GMT 0)
Hi all,

Was just browsing through some posts and noticed one where it was mentioned that high doses of mesalamine could cause some significant side effects. I have left sided colitis and was in remission for a while initiated by 4 g of Salofalk oral tablets per day. Then back in November, I took some antibiotics (only for 3 days because they made me feel terrible) to help clear up acne and started to flare. So, as of yesterday, my doc ordered a nightly Salofalk enema (4g) and 4g per day (split into two doses) of Mesagran (which is mesalamine in granule form flavored to taste like "vanilla custard"). Is this too much mesalamine? Do you have any thoughts / suggestions? I'm kinda paranoid...

Thanks everyone.
Posted 1/28/2012 5:48 AM (GMT 0)
OK, you started to flare in November and continued till yesterday on the 4g Salofalk oral?

The doc changed you to the granules and added the 4g rectal?

What's the dosage of each packet of granules?

I'm puzzled why the doc didn't just add the enemas.

q
Posted 1/28/2012 6:05 AM (GMT 0)
I wouldn't worry about it. I was on the max dose of Asacol and mesalamine enemas (tapered for maintenance) for the past 5 years with no side effects. The medicine isn't released until it gets to your colon so it's not absorbed as much systemically as far as I understand it. You want to get your flare under control as soon as possible so I think high doses of mesalamine are a good thing. If you start having side effects, you can talk to your doctor about decreasing...no use worrying until it happens.
Posted 1/28/2012 6:13 AM (GMT 0)
I asked the doctor the same thing - seeing that the Salofalk tablets worked before. She said that this Mesagran stuff is new and should work better (more of it should reach the lower part of the colon where my inflammation is).

Each individual Mesagran packet contains 1g of mesalamine.

I noticed in the stools I've had since starting the granules, there are quite a few in there - making me wonder if they're actually doing some work or just passing through. Also, I haven't been able to hold the enemas in longer than a couple of hours before I have to make a mad dash to the bathroom in the middle of the night.
Posted 1/28/2012 6:17 AM (GMT 0)
Oh, yeah, from the end of Nov I continued (until yesterday/the day before yesterday) on the Salofalk oral. I didn't start out using it consistently though as my first flare symptoms were mild and I hoped just a few pills here and there would help. Not so much. Then I went on a holiday through SE Asia over Christmas/New Year's, pretty sure I picked up some kind of stomach bug there, the colitis continued to get worse, and I scheduled an appt with my GI earlier this week. She ordered a full blood test, plus stool and urine sample along with a test for C.Diff (I had that back in about 2005, but knocking that out didn't do squat for the colitis).
Posted 1/28/2012 11:58 AM (GMT 0)
Well as far as im concerned I read many post here on enemas and their absorbion. And what I picked is that even though you dont retain them all all the time they are still very beneficial.

And as long as you lay on your left side for the first 30 minutes the enemas should at least done some good workthere.

Im used to enemas now but once in a while i wake up during the night, have a big spasm and lose some of it. I know its from them cause its the white liquid and has this vinegar smell and nothing else comes with it.

So hang in there cause even if you retian only half of it they are still more beneficial than the suppositories.

Love your name! (im francophone)
Posted 1/28/2012 11:51 PM (GMT 0)
Okay, well, I at least feel like all isn't lost when I can't hold the enema. I do make sure to stay on my left side for at least 30 minutes. And I suppose it makes sense just to follow Dr.'s orders, rather than panic at the outset.

Thanks for the advice everyone (and the compliment, Tournevice).
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