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What is the best 5ASA med out there?

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Ulcerative Colitis
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Posted 3/4/2014 4:47 PM (GMT 0)
Currently on Lialda, doesn't work unless I'm on 10mg prednisone. I asked my Dr if I could try Colazal, but he told me to stick to the Lialda. I used Asacol 400 for many years before it was discontinued.
Posted 3/4/2014 4:58 PM (GMT 0)
All of the 5ASA (aka meslamine-based) medications are essentially the same. Slight difference in coating and release-rate, but the dosage is the same for all (with apriso having a slightly lower max dose).

You don't mention using a combination of oral and rectal meds. Try either a enema (aka rowasa) or canasa.

If that doesn't work it's time to try hardcore stuff like immunosuppressive meds. Pred is dangerous longterm, so you shouldn't be using it as a maintenance med.
Posted 3/4/2014 5:14 PM (GMT 0)
Is there a reason you can't take the new version of Asacol, Asacol HD? I know I could not take it for awhile because of the cost. I believe there are ways to find discounts on the drug online though.

Sometimes I have to be firm with my doctor about trying a new medicine and he usually comes around. It's your disease and your body and you should be a partner in deciding your treatment.

I agree with ipoop, about using the enemas if you are not already. I kept reading about them on this board and when I finally tried them I quickly realized why they are so often recommended. They work wonders even when you can only keep them in for 15 minutes.
Posted 3/4/2014 5:17 PM (GMT 0)
Sorry didn't include my signature. Been using Canasa when needed, Dr never prescribed enemas. I really want to try those. Right now prednisone dosage is actually between 7.5 and 10 mg. Don't want to hit the big meds yet until I find the right combination that works for me. Considering FMT.
Posted 3/4/2014 5:33 PM (GMT 0)
JUST found an old Rowasa enema box in my closet, looked at the expiration date, June 2014. Figured I'd give it a try. Couldn't hold it for longer than 10 minutes, but it was a start. I am now lying down and feel slightly better. I was lying on my left side when I administered it. I'm going to call my GI, and if he doesn't prescribe these, time for a different GI. I'm going to try to use as many benign treatments as possible. Wish I never took that prednisone in the first place. I get terrible withdrawal when I try to taper more.
Posted 3/4/2014 5:38 PM (GMT 0)
Some people are extremely sensitive to prednisone. Taper very slowly, by 2.5mgs at a time, or even 1mg at a time if you have to. And don't rush it either, take a few weeks or even a month before you drop to the next lower dose. I'm sorry you're having trouble. I myself have just started canasa and I'm hoping it will help. I hope you find the relief you need!

Stef
Posted 3/4/2014 5:46 PM (GMT 0)
Let me be quite clear here prednisone is much worse than either immunosuppressive meds or biologics (both have a good chace of helping you with only statistically rare side effects). You are much better off to be on those meds rather then pred longterm. It sounds like you are prednisone-dependent (I was for a while too) the only way to kick prednisone is to be on a strong enough maintenance medication combination to discontinue pred. I hope the enemas are enough for you. However if they are not, the don't be afraid of the stronger meds.
Posted 3/4/2014 7:32 PM (GMT 0)

mspoopypants said...
Currently on Lialda, doesn't work unless I'm on 10mg prednisone. I asked my Dr if I could try Colazal, but he told me to stick to the Lialda. I used Asacol 400 for many years before it was discontinued.

My situation is very similar to yours. Asacol 400 worked well for many years, and the Dr. was convinced its replacement, Delzicol would offer identical results. Delzicol didn't work, and made my stomach upset enough so that I was not interested in eating. Next up was Lialda, which had pretty much the same effect.

Colazal (its generic actually) has worked great though. I've been pleased with the results.

I wanted to try Asacol HD, but my Dr.'s nurse told me that my insurance rejected it. However, I called my insurance company just yesterday, and it turns out that they were waiting for the Dr. to return a form indicating why Asacol HD was medically necessary. Seems my Dr.'s nurse lied to me.

Also, my Dr. was reluctant to let me try Colazal because it's an "old" drug and Lialda is newer and therefore better. I'm glad that I learned of Colazal from this forum, and for not letting my Dr.'s advice rule the day.

For full disclosure, I've never had to take pred, and have left-sided UC.
Posted 3/4/2014 8:13 PM (GMT 0)
ipoop, the reason why I am reluctant to try biologics is because I really don't want to go down the same path I'm already on. The Dr. is trying to wean me off the pred, and once I'm done with the hard stuff, I'm done. If I need a colectomy, so be it. I want to take 5 ASA's or nothing at all. I forgot to mention here that I had major robotic abdominal surgery in September '12 to remove a large fibroid. Was fine until surgery, then the poops came immediately afterward. I was pretty steady for a while, taking my Asacol 400 for a while until it was DISCONTINUED. But, prior to that I had morning loose poops but no blood. Blood started after I was put on Dum-zi-col. Asacol HD worked for a bit with a higher dose of pred. Now it's the withdrawal symptoms I'm dealing with coming down from that junk. Also might I add that I quit smoking prior to surgery, too but here's a catch-I took Cipro for a short while and symptoms were GONE. In fact, I was constipated. Took Flagyl, got diarrhea again. More interestingly, on the very first day of my period, symptoms are GONE. I firmly believe that this is a bacterial/hormonal issue. I just want to get it taken care of, change my diet and try another 5ASA because I think Lialda is also loosening my stools.
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