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Why no antacids with Apriso, but not with Asacol?

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Ulcerative Colitis
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Posted 11/7/2018 10:09 AM (GMT -5)
Hi all, I take generic mesalamine (Asacol) 400 mg from Canada. Have for years. I am currently on a PPI for acid reflux (Prevacid) and haven't had a problem taking this together with the Asacol, but maybe that's in part because I don't think it's actually doing a great job of reducing my stomach acid.

Now I am trying out Carafate (sucralfate) for the reflux. This drug coats the stomach and esophagus, much like slippery elm. I am slightly concerned it may cause the Asacol to be absorbed in my stomach rather than my colon. Trying to figure out how far apart to take the meds to avoid this.

Does anyone know why one kind of mesalamine, Apriso, says you can't take any antacids at ALL with it, but others like Asacol don't? Both are time-released. I would love any info on this that anyone may have-- thanks!!
Posted 11/7/2018 10:17 AM (GMT -5)
more than likely it's the difference in the release mechanics - the drug is the same in both, but the coating (and i'm sure a few other things) determines when, where, and how the drug is released - I believe apriso is a once per day vs asacol being multiple times -
and that's all i think i know ;-)
Posted 11/7/2018 10:23 AM (GMT -5)
What makes you think you cannot take antacids with mesalamine?

They're pretty much all PH-coated, delayed release mechanisms (exception is pentasa). Those meds are designed to bypass the stomach, and not begin releasing any medication until the large intestine is reached. They are PH-sensitive, expect to reach certain PH values while sitting within the various holding areas where our food is digested and bathed within acids and enzymes. There are many holding areas beyond the stomach, and most mesalamines expect to hit multiple areas at different PH and sit long enough for the dissolve to start and soften the coating. The exact target PH(es), and dissolve times all vary by brand.
Posted 11/7/2018 10:26 AM (GMT -5)
just out of curiousness, have you tried all the non-med treatments for your AR ?
Posted 11/7/2018 10:26 AM (GMT -5)
If you look online (eg Google "Apriso antacids"), multiple sites of the drugs.com variety assert in no uncertain terms that Apriso CANNOT be taken with any antacids AT ALL, even Tums and stuff like that as well as PPIs.
Posted 11/7/2018 10:35 AM (GMT -5)
TT (love that name!), I have tried: D-Limonene (seemed to work at first but then stopped), DGL (gave me heart palpitations), slippery elm (gave me D and skinny stools, which is too bad bc it really helped!)... gosh what else... gluten-free, dairy free, low acid... Have experimented a bit with Fast Tract Diet but it is tricky for me. I have cholesterol issues so have to be careful about fats; high fat also gives me reflux which Norm Robillard refuses to believe is possible, but many experience it; w/o high fat I am starving on no-carb diets, and empty stomach causes more reflux for me; also there is all kinds of conflicting information on the FTD site which I wrote a post about to which he refuses to reply (eg their app says sweet potatoes basically fine, book says they are the devil, etc., and claims about squash are all over the map-- lots of things like that that, along with the fat claims, make me have some distrust of the whole endeavor).

Someone on this site said marshmallow root caused less D than slippery elm while working similarly. But then my dr. prescribed the Carafate which is same idea, and since things have been so bad I thought I'd give that a try first.

Any other ideas?? Would love to hear 'em! But I cannot have anything mess with my Asacol. I have only ever had 2 flares in 23 years thanks to that Asacol. It's a miracle drug for me. That's why I get the old kind from Canada-- I did not want to change a thing!
Posted 11/7/2018 11:09 AM (GMT -5)
Okay 1st time I have heard of that.

https://www.aprisorx.com/apriso said...
You should not take APRISO while taking antacids because the dissolving of APRISO granules depends on the acidity in your stomach.



I'd say don;t take apriso but rather another form of mesalamine, like asacol, that allows it.
Posted 11/8/2018 12:36 PM (GMT -5)
Probably because the capsule is dissolved in the stomach at a certain acid ph to release the coated spheres....ready to be passed and start dispursing the med (time release) into the small intestine and downward .

q
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