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generic vs. brand name or switching meds?

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Ulcerative Colitis
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Posted 11/14/2020 8:23 PM (GMT 0)
Hi all,

I've been on low dose balsalaside for a while and it helps with remission along with intermittent mesalmine enemas. Unfortunately, I have widespread numbness that developed a few weeks back and given that this is the only medication i'm on and nothing is coming up on blood work and MRI (all normal so far), I was thinking with experimenting going off the balsalaside to see if numbness reverses even though it would risk a flare...ugh!

I was initially thinking of switching from balsalaside (generic) to the brand name colazal. Do you think there is a decent possibility that my side effect will reduce just from switching from generic to brand name? Have others had different side effects from generics. I'm worried about trying something new and can only seem to tolerate low doses.

If not, what other options for meds do I have that act similarly to balsalaside? I have not looked at recent meds in the 5-ASA class and whether there is something new.
Posted 11/15/2020 6:17 AM (GMT 0)
Don't give up UC medication and risk a flare! The doctor who RXed your Balsalazide should be advising you on this. Do you have pancolitis or was your inflammation limited to left-side of colon or proctitis? Balsalazide and its brandname, Colazal, are designed to treat left-sided UC, whereas other oral mesalamines like Asacol and Pentasa work on pancolitis. Apriso is a newer oral mesalamine that was intended for use in maintaining remission. Be aware also that your health insurance may require you to use Rx generic meds instead of the brandnames. Oral generic meds may contain different "fillers" than the brandnames, such as chemical dyes, which can cause side effects. In the past forum members have posted here about problems with the Balsalazide made by Roxanne Labs. The one made by Mylan seemed to be more reliable. / Old Hat (40 yrs with left-sided UC; in remission taking Colazal)
Posted 11/16/2020 1:49 AM (GMT 0)
Hi Old hat,

I just found out that my insurance will cover brandname, Colazal so i will try that first before switching to another medication. I don't know if I am reacting to the inactive ingredients in balsalazide, but I do notice that I get different side effects based on manufacturer. The current one is apotex. When I was first diagnosed about 20 years ago, I believe it was left sided UC, although I am not 100% sure and have to find the original colonoscopy.
Posted 11/16/2020 7:04 AM (GMT 0)
Great if your insurance will cover it! Definitely go for that. It bugs me no end that insurers foist off oral generics on patients with chronic conditions though they really are not equivalent to the brandname med. We did some threads on that about 8 yrs back and a forum member in AZ posted that some generics even have ammonia in them, yuck. / Old Hat
Posted 11/18/2020 2:34 AM (GMT 0)
It's possible it's a neuropathy which might be unrelated to your meds.

It's also a type ii diabetic thing as well, and long term and cumulative effects of prednisone makes us higher risk. Might be good to get your blood sugar checked.

You can skip generic colazol for a couple days max, to see if your symptoms improve. Don't just quit all meds indefinitely.

There's sulfasalazine, Apriso, lialda, delzicol, pentasa, and others you can try.
Posted 11/19/2020 10:56 PM (GMT 0)
Thanks for the suggestions ipoop and old hat.

I'm trying to switch to colazal from the generic to see if that has impact on my symptoms. However, cvs said that they can't get any colazal (brand name) and I can't even order it. My GI doc thinks its unavailable in the US. Is it true that Colazal (brand name, not the generic) is not available in the US?
Posted 11/20/2020 12:54 AM (GMT 0)
Not true as far as I know. I got an Rx refill a month ago. There was a crisis over it in 2012 when Salix suspended production without prior warning, even to physicians. Then they resumed it within 3 months due to protests. However, Salix was sold to a Canadian conglomerate ca. 4 yrs ago so anything could happen. The price of Colazal increased a lot since that takeover, though it was always costly. For me it has been a miracle med therefore worth a struggle to obtain. / Old Hat
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