Asacol Dosage

Hello everyone, I hope everything is alright on your end.

I have a question that has been bugging me, since 1600mg of Asacol has been partially effective, I had doubled the dosage to 3200mg during my most recent flare. The impact is not noticeable, but my doctor said to try 4800mg instead. My question is, what is the difference between 3200mg and 4800mg in terms of the latter being more effective? According to my doctor, it seems that people only see improvement when jumping from 1600mg to 4800mg of Asacol.

Furthermore, my specialist has told me to take my medicine in the morning and at night, but it seems that some people are prescribed a different cycle that includes the midday ingestion of a certain dosage. Should I take 1600mg 3x a day or 2400mg 2x a day?

Also, my doctor reckons this won't make a difference, but I had to plead with him for suppositories. It seems odd that medical professionals, who I would assume have a decent grasp on logic, see no point in prescribing suppositories to people with distal proctosigmoiditis. Rectal medicines treat distal regions much more efficiently than oral NSAIDs, thereby making a world of difference for certain patients. Would you opt for trying suppositories before increasing the oral dosage first?

I would skip the suppositories and go straight to the 4g enemas. And I would take the 4800 mg of Asacol. You can't overdose on mesalamine. Essentially the oral meds and the enemas act topically in the colon.

As for timing the meds, I was originally on a 3x/day schedule but i would always forget the midday dose. My DR agreed that splitting it into morning/night would be fine, and it was. but you can try the 3x/day thing, if you think you will actually remember to take your pills.