Switching from Lialda to Asocal?

Hi everyone,

Earlier this year I was flaring and having a lot of UC issues and feeling horrible. My doctor wanted me to take Simponi, but I didn't feel ready to give up on Lialda. After some time, I've been able to taper off everything except Lialda (4/day still) and I feel great.

I had to switch insurance and just found out my new plan doesn't cover Lialda (it would cost over $800/mo!!) and the only thing they cover is Asacol.

I'm wondering if anyone has made this switch before? I'm scared it will somehow trigger a flare, and wondering if it has any side effects different than Lialda? I worked so hard to get healthy, the thought that I could be sick again for month and months over insurance politics is really upsetting.

Any advice would be greatly appreciated!

The various meslamine-based, oral medications are all extremely similar. The dosing will be the same (as far as active ingredient meslamine goes). Both medications include a delayed-release coating that is based on PH. The formulation of that coating and medication release-rate are slightly different. Lol I think the only difference you'll actually notice is more pills to take (lialda pills are higher dose per pill, meaning less pills to swallow).

Do you mean Asacol HD? I think that is the only one still sold. Most insurance is preferring Delzicol.

Anyway, you will need to take more pills, usually spaced out a bit. Oral mesalamine bothers my sleep, so I am glad I can take Lialda all in the morning.

Some people report problems switching, and buffers or release mechanisms can make trouble for some, but I am always surprised at how many here report trouble switching. I wonder if AZYooper doesn't have a good point about stress and expectations.

good luck

The main difference, and dealbreaker, for me was the fact that Asacol HD or regular contains dibutyl phthalates, which basically destroy male genitals and cause hormone damage over time. Lialda's inactive ingredients are much safer.

There really aren't two kinds anymore. There used to be Asacol 400mgs and Asacol HD 800mgs but they discontinued the 400 mgs and repackaged it into the drug they now call Delzicol, which is a 400mg Asacol pill stuffed inside of a capsule. If your body didn't like taking splt dose Lialda then that could cause you trouble with the Asacol.

There is a Lialda card that can get you $125 off the cost but you would still be paying hundreds. Since the medicine inside both is the very same I really don't understand why you couldn't take the Asacol all at once, other than you would be swallowing a good number of pills (6) at the same time. As far as I know Asacol has never been prescribed that way. You might want to ask the doctor about that though because I really don't see the difference in taking 4.8 grams of Lialda all at once with 4 pills or taking 4.8 grams of Asacol all at once with 6 pills. Seems like the same thing to me. I did notice with the Asacol I was having occasional whole pills slip all the way through unused whereas that never happened to me with the Lialda. And before anyone says anything, they were not the casings, they were whole unused pills. Another option might be to transition taking 2 Lialda in the mornings and three Asacols in the evenings and see how your body reacts to it all. It might give you a heads up as to what you can expect.