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Crohn's Disease Forum » Treatment » 5-ASA/Mesalamine » Pentasa has failed what is next?


08-23-2010, 04:16 AM   #1
meardonna
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pentasa has failed what is next?

Hi pentasa not working to control flare-up. got hospital appointment tomorrow. was wondering is there a kind of progresion of treatments doctors tend to stick to? if there is it would be handy to know what sort he would sugest next, that way I could look them up first and make an informed decision. At the moment i'm going in blind and have no clue where next
08-23-2010, 10:33 AM   #2
Rebecca85
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Well, Pentasa hasn't entirely failed for me, it is keeping my symptoms at a low level but not getting any better (if you see what I mean). But my docs said the next step for me is azathioprine. I don't know if that is a standard progression or anything though.
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08-23-2010, 10:36 AM   #3
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I have been on Pentasa many times, never works ...but imuran or Entocort was what my next step was. Entocort is very mild and hardly any side effects but costly!
08-23-2010, 10:38 AM   #4
Rebecca85
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Is Imuran basically the same as aza?

Edit: meardonna I have been reading some of your other posts and see that pentasa is the only thing you've tried. I would think there is a strong possibility of you going on some sort of steroid to get the flare under control, then trying the pentasa for maintenance.

Last edited by Rebecca85; 08-23-2010 at 10:44 AM.
08-23-2010, 10:54 AM   #5
scifi-enthusiast
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Azathioprine is the generic name for Imuran.
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Diagnosis: March 2008 (7 days after resection)
Surgery: 1 emergency blind resection because of hemorrhage & massive blood loss (March 2008), Reconnection of Colon (June 2008), Removal of billiard ball size abscess (Dec. 2010)
Meds: Lialda-2.4gm (every other day), Imuran-0mg, Pred-0mg, Calcium+d, Humira-40mg, Sulfasalazine-500mg
Previous Meds: Pentasa (didn't work)
Currently on SSD & SSI
08-23-2010, 10:55 AM   #6
Rebecca85
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Thanks, so I guess the docs do like to try stuff in the same order then.
08-23-2010, 01:17 PM   #7
meardonna
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I've been on pred loads! with my first severe attack whilst pregnant, which was when I was diagnosed I was on pred both IV and orrally for 4 months. slowly weaned of then found breastfeeding kept it under control so didn't need my pentasa for 2 years. stopped feeing at easter fell ill again restarted pentasa and was on oral pred for 7 weeks, settled down continued to take pentasa and have salofalk enema for when I have flare ups. all of a sudden after being off pred for about 3-4 months all of a sudden I'm stuck with another big flare. i don't want to be on continuous steroids
08-23-2010, 01:18 PM   #8
meardonna
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Is Imuran basically the same as aza?

Edit: meardonna I have been reading some of your other posts and see that pentasa is the only thing you've tried. I would think there is a strong possibility of you going on some sort of steroid to get the flare under control, then trying the pentasa for maintenance.
I've been on pred loads! with my first severe attack whilst pregnant, which was when I was diagnosed I was on pred both IV and orrally for 4 months. slowly weaned of then found breastfeeding kept it under control so didn't need my pentasa for 2 years. stopped feeing at easter fell ill again restarted pentasa and was on oral pred for 7 weeks, settled down continued to take pentasa and have salofalk enema for when I have flare ups. all of a sudden after being off pred for about 3-4 months all of a sudden I'm stuck with another big flare. i don't want to be on continuous steroids
08-23-2010, 04:06 PM   #9
Rebecca85
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Oh sorry I must have missed that. My money's on aza then. Good luck tomorrow!
08-23-2010, 04:20 PM   #10
JoeUK
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I've been ok on Azathioprine for years now. Make sure you talk to your Dr about dosage. My "ideal" dose made me very I'll and I had to insist on reducing it slowly until I could tolerate it. Good luck tomorrow!
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08-24-2010, 04:10 PM   #11
meardonna
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Complete waste of time! Back on pred!! I'm like a yoyo!! apart from the spell of remission due to breastfeeding I've been on pentasa, had flare-up, put on pred then weaned off, fine for about 2 months then another flare up!! I just seem to be on, off,on,off! obviously it should be starting to sink in that pentasa alone is not strong enough for me. my doctor wont even discuss anyt other meds! I've had 4 sigmoidoscopy's both during flare-up and normality, doctor says he might consider doing a colonoscopy once I'm off the sterroids which will be more than 10 weeks! isn't it best to look when there is a flare-up? fed up
08-25-2010, 01:26 AM   #12
Rebecca85
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I have heard that docs don't like to do scopes on Pred because it masks any problems. So I presume he wants to look when you come off to see if the inflammation is gone.

Does your gastro work in a big team like mine does? If so, you could try and get an appointment with another doc and explain things to them, they might have a different opinion and be able to prescribe something stronger.
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