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Delzicol, Lialda, or asacol ?

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Ulcerative Colitis
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Posted 5/5/2016 8:34 PM (GMT 0)
I have had 3 different GI opinions all three say something different. I am confused and tired of switching medications. I don't know which GI to go with or trust. Ugh.
Posted 5/5/2016 9:11 PM (GMT 0)
it would make it easier for others to help if you would put some information in a signature -

which med or meds have you tried ? and for how long ?
Posted 5/5/2016 10:21 PM (GMT 0)
I was diagnosed during my pregnancy (gave birth 3 weeks ago now) and was put on delzicol which I have now learned is subtherapeutic dose. I was also out on prednisone which I tapered until the csxn bc I wanted to be able to breastfeed off of it. I did fine. But then week after the csxn the symptoms came back (likely bc if the stress of surgery and they gave me NSAIDs which I stupidly took). I saw an IBD specialist last week who said I should switch from delzicol to Lialda which I did but could not see him regularly bc he's or of network , so he referred me to a GI in my network that I saw today and who just said switch (Yet Again) from the Lialda to delzicol but this time on a higher dose. I'm not crazy about taking 12 pills a day w delzicol and plus I have a high copay. Should I switch back to delzicol bc this guy says so ?

Right now on the Lialda and uceris I'm still having symptoms but it's only been a week. I badly want to do a short prednisone course but I'm trying my darndest to tough it out.
Posted 5/5/2016 11:11 PM (GMT 0)
Delzicol, Lialda, or asacol ? Whichever is the most affordable. The first line of treatment for ulcerative colitis is anti-inflammatory mesalamine given in both oral and rectal routes. The brand shouldn't matter but the dose does, and it's got to be affordable. Just make sure you're prescribed the maximum oral dose of 4,800 milligrams a day ( 4 lialda or 12 delzicol) and also are prescribed a rectal route mesalamine (either canasa suppository or rowasa enema) for best effect. Patient copay assistance programs are available to help with cost of lialda/delzicol. Generics are also available if your cost is too much.

I wouldn't keep switching medications. Stay on one for a while to see if it's working. You should see results in 3-4 weeks on a maxed out oral + rectal route regiment. If not, then it's time to add immunomodulators, a much stronger medication (e.g., Imuran, 6mp). Some do fine on the mesalamine and never need anything stronger. However, if you continue to a struggle to control your uc symptoms then it's warranted.
Posted 5/6/2016 10:06 AM (GMT 0)
This flare is getting a little worse while I'm waiting for these meds to kick in. The last GI told me not to take prednisone just stick w the uceris but I can't tolerate this. I have prednisone at home should I not just do a short course to help me through ? I think his active inflammation for days and days may be harmful ? Or should I continue to struggle and tough it out waiting for the uceris and mesalamine to kick in , to avoid prednisone ?
Posted 5/6/2016 10:28 AM (GMT 0)
No don't take the pred
Wait until you're prescribed a course w taper

Uceris did me some good. Add rectal meds, be diligent about oral meds and you could see remission easily.
The nice think is those drugs are generally safe.

Ps stay on uceris for 8 weeks only
Posted 5/6/2016 11:29 AM (GMT 0)
I wouldn't recommend self medicating with prednisone as it needs a proper dose and taper regiment that should be given by a doctor for your safety. You should call your gastroenterologist and tell him/her that things are getting worse. Maybe he/she will recommend prednisone.

Prednisone is a quick rescue medication that improves uc symptoms. It has a time and place to buy us time while other medications work and it's helpful during severe flares when uc symptoms are just unbearable. However, just be prepared for nuisance side effects while on pred, as everyone gets them. As such, many of the long-term uc folks here will take prednisone but only if it's absolutely necessary (not when there's a gray area of should I?).
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