HealingWell
Search Close Search
☰

Is it better to take too much Asacol or too little?

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 5/24/2012 5:27 AM (GMT 0)
(yes, I am a moron) Had a really rough day today and had to take more painkillers than usual to make it through work. *As a result*, I can't remember if I took tonight's dose of Asacol yet -- I take 3 800 mg pills twice a day for the maximum daily dose of 4800 mg. I tried counting the pills left in my bottle but I also can't remember if I started the bottle in the AM or PM on the day when I started, so I can't nail down whether I took tonight's dose or not. Would it be better to take too much or too little? I'm in the middle of an active flare, but for what it's worth I've been taking 4800 mg daily for a few weeks and it hasn't seemed to help at all, so I am leaning toward not taking any more tonight, since I doubt missing a dose will cause me to get worse. Thoughts?
Posted 5/24/2012 6:44 AM (GMT 0)
I don't think it's a big problem for one night, take your tomorrow morning a bit earlier.

Purchase pill dispensers that have an AM and PM..or buy two of the weekly ones and write AM and PM. That way, you will know if you took them or not.

I've forgotten on occasion.

Are you on rectal meds as well?

q
Posted 5/24/2012 2:39 PM (GMT 0)
It's not going to make a difference if you miss one dose or if you double up on one dose. When I prep for a colonscopy I have to not take any pills the day before; my GI doctor told me it wouldn't affect me missing one day. I've done the same thing before -- sometimes it's hard to remember.
Posted 5/24/2012 4:29 PM (GMT 0)
Thanks for the advice everyone. I think I let my stress get the better of me and made a mountain out of a molehill :)

Heather, I'm using Rowasa at night and Cortifoam in the morning in addition to the oral meds. I've been on the Asacol for about 2.5 weeks now, rectal meds for one. No improvements yet so my doctor is going to push for pred starting next week :(
Posted 5/24/2012 4:38 PM (GMT 0)
I watched an interview on TV a few yrs ago now, they were talking with a GI in relation to IBD and this one particular GI in the interview said, most GI's are not perscribing high enough doses of Imuran to their IBD patients, and it would be more effective for the disease if they did...so I think doubling up when in doubt should be safe.
Posted 5/25/2012 7:55 AM (GMT 0)
Pluot..seems waaaaaay too early for your doc to threaten pred.

How bad are your symptoms at this point and have they improved at all? and where in the colon is your UC?

q
Posted 5/25/2012 2:58 PM (GMT 0)
Hi Heather,

My UC goes from the rectum up to the end of the transverse colon -- about 70 cm of inflammation. At this point I am having 6-8 BMs per day, all urgent, virtually all with blood and mucus, and about 80% totally unformed (the other 20% very slightly formed, e.g. small mushy pieces). I also take codeine to get through the night and Immodium before work, so I think without those it would be more like 10-15 BMs. I also have pretty bad pains before BMs, which is a new symptom since my colonoscopy, and symptoms in my eyes (blurry vision and redness that comes and goes). I haven't seen any improvement since I started on meds... if anything I think I am getting worse.

My doctor actually wanted me to start pred a week ago but I asked to try rectal meds first and she said I could try Rowasa and cortifoam for a couple of weeks, but if they didnt help I would have to start pred. I have to check in with her on Tuesday. Could the 5ASAs and cortifoam actually start helping after not doing anything so far? For what it's worth, I haven't had any trouble retaining the Rowasa through the night. What else should I be asking to try before going on pred? I've been on methylprednisolone before (unrelated illness) so I know what the side effects are and I'm very, very scared of ending up steroid dependent.
Posted 5/25/2012 5:43 PM (GMT 0)
Maybe you are having an issue with the mesalamine? Some people don't tolerate it well. After two weeks, I would think you would at the very least see a bit of improvement and if you think its worse than you just may not handle it well.
Posted 5/25/2012 5:47 PM (GMT 0)
I wonder if I'm not absorbing the Asacol HD? I haven't seen pill fragments in my stool like some people do, but it's almost like it's just having no effect... I would think if I didn't tolerate it well I would have more of an acute reaction
Posted 5/25/2012 6:01 PM (GMT 0)
Hi..are you on any probiotics and fibre supplements?

Have you been checked for c.difficile?

Have you had any stool samples at all?

Maybe consider another 5ASA before you go on pred?

How about taking an antispasmodic rather than the t-3?

q
Posted 5/25/2012 6:19 PM (GMT 0)
I'm taking Align right now. I started it about 6 months before I started flaring though. I have VSL#3 as well but haven't been able to start (currently traveling without access to refrigeration). No fibre sups.

I had a stool sample that tested negative for everything including C. diff (but tested positive for increased fat in stool), also had a course of Flagyl when my PCP was absolutely convinced that I had C. diff and decided to start treatment before the stool test results came back. No improvement whatsoever from the Flagyl.

Another oral 5ASA? like Pentasa or lialda? I'm also curious about sulfasalazine instead of 5ASA... I know I've seen some people on the board here who take it. My mother also has IBD and used sulfasalazine to get into remission. I know that's because 5ASAs weren't available when she was diagnosed but I wonder if the fact that they worked for her means they're more likely to work for me?
Posted 5/25/2012 6:31 PM (GMT 0)
sulfazalazine is a 5ASA, but with sulfa in the mix to carry it to the colon.

Yes, I think you should try to exhaust the 5ASA options before prednisone.

Definitely ask for an antispasmodic...I really like dicyclomine, been using it for 23 years.

You can add another probiotic to the align..I don't think it's near enough for you. Culturelle could be one suggestion, I don't believe it needs refrigeration.

Before you go on pred, there's also entocort...even though it 's released in the ileum, it still can go through the colon...but that in conjunction with whatever 5ASA possiblly.

While my UC wasn't throughout, I was going 15 - 20 times a day of bloody razor-like diarrhea. It took a while for it all to slow down, improve, etc...but the treatment of both oral/rectal took months to have extreme improvement.
I don't think it's a 5ASA issue at this point, I think it's all not had time to work long enough.

How is your diet in general? ARe you consuming any foods that could be exacerbating the action of your digestive tract?

Of course, it's your butt...your decition to do the pred. If you're not in a home base, travelling, etc..it might be the easiest option. But you'll still have the pred symptoms and trying to deal with tapering, etc.

But, what about asking the doc for a 14 day taper from 60 - 0?

q
Posted 5/25/2012 6:32 PM (GMT 0)

Pluot said...
Thanks for the advice everyone. I think I let my stress get the better of me and made a mountain out of a molehill :)

It's ok -- we've all been there! :)

I agree, you need to give the enemas more time to work. At least a month before trying pred if you can wait that long.
✚ New Topic ✚ Reply