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Oral mesalamine - ever mixed them?

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Ulcerative Colitis
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Posted 7/31/2013 12:16 PM (GMT 0)
Has anyone ever been on multiple oral mesalamines at the same time. I ask this because I know that everyone processes them differently and that for some, the medication doesn't release until sooner/later.

My issue has been that Lialda sometimes releases too late for me, where as Pentasa releases too soon. So why not take some of both?

I have been dealing with a flare since February and just came off of my 2nd Pred taper. Before moving on to the next step, I told my GI that I wanted to give one last go with mesalamine on its own because I know my colon does respond to it provided it gets where it needs to be (evidenced by my recent C-scope which showed only a small patch of mild/moderate inflamation as compared to my initial moderate pancolits DX.)

So this past week I have been going with 4 lialda/day, nightly rowasa(generic), and daily canasa. I feel as good as I have since February, but still am having some symptoms and know that the inflamation is not gone entirely. I was thinking that maybe if I substituted a couple pentasa for a lialda I might get more coverage?

 

Posted 7/31/2013 12:52 PM (GMT 0)
My guess is that your insurance wouldn't cover Pentasa and Lialda at the same time, so that would be the biggest reason to not do it. However, I can't see that it would cause any harm.
Posted 7/31/2013 1:19 PM (GMT 0)
Hadn't thought of that. Of course at this point i have a cabinet filled with bottles of pentasa, lialda, asacol, and apriso... I could open a drug store! lol
Posted 7/31/2013 1:26 PM (GMT 0)
I have mixed Lialda and Colozal w/ Dr's okay...fyi.
B
Posted 7/31/2013 1:50 PM (GMT 0)
I am currently on both Lialda and sulfasalazine.
Posted 7/31/2013 6:12 PM (GMT 0)
I can't help but think that if one releases too early and one too late that maybe neither one is right for you.
Posted 7/31/2013 6:28 PM (GMT 0)
How do you know that one releases too late and the other too soon in your colon?

You just started the Lialda this week? as well as the rectals?

Where exactly is the spot that's still inflamed?

q
Posted 7/31/2013 7:26 PM (GMT 0)
Been on the lialda for 4 years... Have taken the others at time when flares or symptoms arose. I have used the rowasa/canasa here and there over the years in the same manner... when symptoms seemed to arise. One week ago was when I made the full commitment to every night/day regardless of symptoms to see if this flare could be contained and preferably stopped with just the mesalmine (pred seemed to do little).

As for how i can tell too soon/too late is mostly based off of where I feel pain and color/consistency of what comes out.

At the time of my c-scope in May, the patch of inflamation was in the transverse area. However, I was coming off of a pred taper and had been taking lialda as well as using canasa/rowasa. (seems to provide some evidenece that my colon responds to the mesalamine.)

I am pretty certain that inflamation spread in the month following as symptoms got much worse so I did another pred taper starting mid-june and ended in mid july. GI felt that if that didn't work it was time to move on to something else.

I just wanted to give one last go with nothing but the mesalamine before moving on and thought why not mix a bunch of them together? THat way they are releasing at different times... in different places... etc...
Posted 7/31/2013 7:45 PM (GMT 0)
I think insurance will cover it...I switched to Apriso with my new GI, but right before seeing the new GI I asked for the old GI to refill my Asacol HD prescription.

Last time I went to the pharmacy they had both ready for me so I just got them both....I'll keep picking up Asacol if they keep refilling it every month so I can have spare, just in case. :)
Posted 7/31/2013 7:49 PM (GMT 0)
I believe they'll both will go throughout the colon, but it does depend on your own ph or bacterial balance and how fast things move through your digestive tract in order to be released initially.

Have you tried the Pentasa separately before?

Are you taking the Lialda all at once? because you can split the dosage to twice daily.

q
Posted 7/31/2013 8:24 PM (GMT 0)
Yes... i have only taken each of them by themselves never mixed them.

I think the issue with the pentasa for me is that it released too early... the lialda maybe too late. The Apriso didn't seem like it was concentrated enough but probably released most timely.

I do take the lialda all at once. i have thought about splitting up the dose, but was concerned the volume wouldn't be enough..

Like i said... i know the inflamation really responds to the mesalamine, its just a matter of getting enough of it in the right places.

I think it's likely that if this doesn't work out, I'll be trying Uceris... and then 6mp or biologic.
Posted 7/31/2013 8:43 PM (GMT 0)
I mixed colazal up in a enema bottle a few times and squirted it up the rear. Don't ever do that, lol. It burns.
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