Are All 5-ASAs as LARGE as Lialda??

I'm not a huge fan of the big pills either but Lialda go down pretty easily. I used to take the bigger pills with milk as it seemed to coat things a bit and made them easier to swallow.

Generic Balsalazide disodium (or brandname colazal) comes in capsules you can open and sprinkle over yogurt.

Delzicol comes in big capsules you can open, with much smaller pills inside.

Sulfasalazine can be crushed.

Salofalk do granules which you put on your tongue then drink a glass of water.

Thanks for the replies everyone!

From what I can find on the internet, Salofalk and Pentasa granules are not available in the US. Can anyone confirm this??

I did notice that on the official site for Pentasa, at the top of the page it says "Pentasa is the only oral mesalamine approved to be opened and sprinkled". I'm not sure how that works since I know all these meds are supposed to be delayed release but I'm assuming if the maker of the drug says it, it must be true. If anyone has any experience with this, please let me know.

I 'm going to bite the bullet and try the the Lialda (need to get used to pills now that I'm cursed with UC) but it's giving me major anxiety.

Thank you!

I've never heard of pentasa or salofalk granules being prescribed within the usa. Best you could do is mail order from canada but that'd be a hundred percent out-of-pocket cost to you (as your health insurance policy doesn't apply to international pharmacy orders).

The delayed release coating on the pentasa granules is the same concept as the pills and some probiotics, just applied at a much smaller scale. Take VSL satchel as an example, their individual granules are coated to protect them past the stomach. Same concept as a coating on a big pill but on a much smaller scale. These coatings are PH activated, and dissolve only once they encounter specific PH.

I'd give the lialda a try. If it is unbearable then speak to your doctor or pharmacist about other options. Specifically about pills that are smaller, crushable, or don't need a pill casing.

Anything containing pure mesalamine needs a delayed-release PH-based coating to reach your large intestine (lialda, apriso, delzicol, asacol, etc) when taken orally. As such, you cannot crush or cut those pills and expect them to work.

Precursor molecules that are much, much more complex are exceptions (examples are Colazal®/balsalaside disodium, sulfasalazine, and Dipentum®/olsalazine), which you can certainly ask a doctor or pharmacist about. Essentially, gut bacteria cleave those more complex molecules into mesalamine and a byproduct, so there's no chemical sprayed, delayed-release coating on them. Rather the complex molecule itself is the delayed release mechanism. So, in theory these can be cut, crushed or removed from a capsule without adverse affect. I'm no doctor or pharmacist, so definitely check with yours before doing these.

Good luck, I hope you can find a solution!