Lialda or generic Colazal?

Colazal/balsalazide is a more complex molecule than mesalamine. Once Colazal reaches the large intestine, bacteria cleave that molecule into mesalamine and a byproduct. So, you're already taking mesalamine. It's just delivered differently to your large intestine.

Asacol is straight-mesalamine but uses a PH-delayed release coating for large intestinal release. A fancier way to achieve the same goal (delivery of mesalamine to the large intestine but without relying on gut bacteria to process it into mesalamine).

If you've been denied colazal then there's a few complex molecules that are broken down to mesalamine by gut bacteria. There's sulfasalazine is similar but has more side effects due to the sulfa component (also an allergen to some). Olsalazine (Dipentum®) is similar to colazal, again cleaved by bacteria.

The mesalamines should be fine, asacol, lialda, apriso, pentasa, delzicol, etc. I guess it comes down to what's on your insurance formulary list and your out-of-pocket cost. Some mesalamines do have manufacturers patient copay assistance cards( e.g., lialda and delzicol).

I'd try to make one change at-a-time, to minimize impact. No one can predict whether there will or will not be a reaction. Switching meds might briefly upset your system. I'd either stick with daily enema as a precaution or at least have enough on hand just in case you see a reaction you can then do daily.

Luckily Colazal doesn't seem to make my hair loss worse, but I hate to go back to another med and have it cause issues. My copay has been ridiculous the past few years since my insurance turned it into a '4th tier drug'. Mine was more than $1200 for 90 days - I think it was about 1200 a month! But I'd hit that out of pocket max on drug and medical costs at $4600 (combined) and then pay nothing. Well UHC got wise to that and now they won't even let it count against the out of pocket max. I hope whatever I change to lets me stay in remission.

Hi seasons,

I've been doing pretty well UC-wise. I never ended up staying on Imuran as it was affecting my pancreas. I was able to get off the Prednisone about 6 months after that, 2 1/2 years ago now, and have been good ever since. I'm currently trying to reduce my mesalamine enemas to a few times a week as some others on here have said they do. I probably suffer more from the extra intestinal symptoms - I have some bad hair loss now (no idea why, but my testosterone levels are strangely high even with being on birth control).

How have you been? Hope you have been doing better as well!

I wish I could fight it. I actually sent in an appeal to the insurance company and they rejected it (of course). They only think of what is a short term gain for them - banking on you never getting sick. The 'doctors' they claim to have at the insurance companies that determine what meds are and are not needed I'm convinced are just people basing their decisions on immediate costs with no knowledge of diseases or illnesses at all. I've been having issues with other medications at my insurance as well lately (not for UC). Even for meds that are $60 - they are questioning now. The substitutions they give for medications often are not the same at all and have much harsher side effects. But if they are cheaper, that is that is all they are concerned about. It's a shame we give them so much money (my annual out of pocket is about $4600, plus my monthly premiums) yet they do not want to cover our meds.

I think my GI gave me a dose of Lialda 3 times a day still? But was only 6 pills a day compared to the 9 I take now of Colazal. I plan to get another month refill this week, then cram in a 3 month refill right at the end of June - before they stop covering July 1. That way at least I can stick them for 4 more months of the Colazal!

Luckily I've met my out of pocket max for the year, so now all my drugs cost nothing until next year. I do love how my insurance company waited until I met that maximum to then tell me they were going to no longer cover the Colazal! Make me pay 100% for the majority of the refills, then stop covering it. Real nice!

and this is why i will do everything at my disposal to avoid big pharma & just as big insurance !

people have to eat -

making informed decisions about the food choices one makes has nothing to do with UC -

does your wife have UC ?

it's called a choice - tell me what choices you have when it comes to your drugs - can you get them at a local pharmas market ?

We're gardeners ourselves and eat healthy, try to be low impact, etc. Didn't cure my uc though. Only strongest uc medications make a difference for me, personally. My kudos for you being able to be med free, I wish we all could. But not possible for many.