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Ulcerative Colitis
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Posted 3/27/2014 4:05 PM (GMT 0)
I wanted to check what medication people take and what combination works for them who have a similar condition to mine (see signature).
This flare up I am currently having seems to be more persistent than previous ones. It is not especially severe: about 2-3 bowel movements with a bit of blood and sometimes some mucous, but given that I am taking all the meds, I usually come out of a flare up completely after a few weeks or at least see an improvement but this time it seems slow and it's been over a month.
Can one become resistant to meds?
Also what is the maximum dosage for mesalazine before it's toxic? I worry that i already take a high dosage of mesalazine as tablets (4.8g) plus asacol enemas on occasion so i am worried on overdosing.
thanks for the help also some links would be appreciated to point me in the right direction.

PS: oops my signature doesnt seem to show up:
Ulcerative Colitis (proctosigmoiditis) since 1999. Flare-ups about every 2-3 years on average.
Taking 800mg mesalazine tablets daily when in remission.
During flare-ups: mezavant (mesalazine) between 3.6g and 4.8g tablets, Entocort enema (budesonide 2.3g), Asacol (mesalazine) foam 1g, Mutaflor (probiotic), occasionally.

Post Edited (nightlife) : 3/27/2014 10:08:06 AM (GMT-6)

Posted 3/27/2014 4:34 PM (GMT 0)
You can definitely become resistant to steroids, which includes the budesonide enema. Sorry to hear you are having trouble getting out of this flare.

I think it's pretty hard to overdose on mesalamines, but you are supposed to be getting regular check-ups with your GI to make sure everything is alright. It is common to take the max oral dose plus a 4g enema.
Posted 3/27/2014 5:02 PM (GMT 0)
If you are only taking 800mgs oral mesalamine total while in remission and then flaring you really should be taking 2.4 grams per day to stay in remission. 2.4 is the normal dosage while in remission, going up to 4.8 while flaring. I'm not really sure why 4.8 is considered the max dose because, for the most part, these meds are more topical and not systemic, basically meaning it would be very hard to actually overdose on them and many take this max dose plus rectals too.
Posted 3/27/2014 5:10 PM (GMT 0)
Yes, 800mg oral was way too little... I am not sure why I did it, maybe I didn't pay attention :(
Also the other mistake I made was that when I started Entocort, I wasn't using it consistently (using it for a few days, then stopping it), as I wasn't sure whether I was actually having a flare-up as symptoms were mild (only slight urgency a mild cramps).
In any case many thanks for the advice.

Just to check with regards to mesalazine enemas/foams:
is there a make that's better than another or are they all the same? (I am in the UK, so we have Asacol, Salofalk, don't think we have Rowasa that people here seem to like). Also is foam better than liquid enemas? I always felt that the gasses (propane etc?) from foam can't be good for colon somehow (toxic?) or is it pure fantasy? Many thanks again.

edit: I notice enemas come usually in 4g while foams only 1g. Does it make a difference?

Post Edited (nightlife) : 3/27/2014 12:12:50 PM (GMT-6)

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