Switching from Asacol to Lialda?

In what way isn't it working?

It's not metabolised in your "body" per se....it's a topical medication that depends on PH or bacteria to break down the coating and be dispersed into the colon.

Have you not tried mesalamine retention enemas?

q

Those are questions you need to ask your doctor, methinks...because they're good ones.

What were your symptoms that lead you to believe you the meds (both oral/rectal) weren't working?

q

First, as much as GI's know, one thing they don't know is which med or med combination will work on any one particular patient since we're all different. It all boils down to trial and error, even for them. So, they really don't know ANYTHING in those regards.

Second, the answer to your question is yes, many have switched to Lialda from Asacol and gotten better, me for one. By the way, I later switched to Pentasa which I find works better on me than Lialda. There are several reasons why Lialda could work better for you than Asacol. All of these 5ASA's have the same medicine inside (mesalamine) but have different coatings so that they release in slightly different parts of the colon. They are topical, as Quincy said, not systemic. As your condition changed it's possible that the Asacol started releasing in a different part of your colon than when it kept you in remission. Also, Asacol is normally prescribed several times per day while Lialda is usually prescribed only once per day. This is two separate options. You have a choice with Asacol of getting less medication more times per day or with Lialda of getting more medication just once per day. Sometimes that can be a big difference. Personally, I prefer the Pentasa because it seems to spread better throughout the colon because it is composed of several granules of medicine instead of one clump of medicine as in Asacol and Lialda.

I agree with Quincy's questions and would like to add some of my own:

You mentioned that Asacol kept you in remission until it stopped working. What actually put you into remission in the first place? Was it Asacol by itself, or in combination with something else? What dosages of Asacol did you take to achieve remission and what dosages did you take while in remission? It's also possible that something like prednisone actually put you into remisison and the Asacol never did anything from the beginning and the farther you got from being off the pred you slowly got worse because the Asacol was not ever working or you may not have been taking a high enough dose.


Remicade can take several weeks before you see any solid results. One thing I really don't understand with doctors such as yours is that Remicade is partially made from mouse proteins and you often need to take a drug such as Immuran or AZA concurrently to help stop antibodies from forming to the Remicade. Immuran and AZA are also treatments for UC so I don't understand why they don't just start with those first without the Remicade and if that's not good enough then add the Remicade later. Since Immuran and AZA can take longer to work than Remicade if the patient is in bad shape and can't wait sometimes they just jump on the Remicade right away. If Remicade works well then there would probably not be a need for Lialda at that time but it wouldn't hurt to be on it until the Remicade started to work. What were your symptoms before treatment, any during remission, and what are your symptoms now?

The remicade might do the trick for you
My crp went from 140s to about 80 overnight with it
i still was on IV steroids but after that they were able to taper me
I am two weeks out on my 3rd loading dose and I am feeling much better than I could have imagined feeling at that point
Have you considered taking something like imuran
You won't see results right away but it also helps prevent antibodies from developing against the remicade so the remicade can work longer
I hope you feel better soon

Seeing pieces of the pill husk is fine. You don't want to see whole, solid pills with any regularity.