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Crohn's Disease Forum » Treatment » 5-ASA/Mesalamine » Going onto a 5-ASA treatment


 
09-05-2008, 10:22 PM   #31
Isla
 
Well if you are pre-6th week mark then yes you could be feeling worse before you start feeling better. If you are like 100 times worse, something is wrong and you need urgent care but if you can stick it out to a full 8 weeks on Asacol, then do so it very well may work for you. After 8 weeks if you are the same or still getting worse then it is definitely back to the drawing board for you.
09-10-2008, 08:13 AM   #32
AbstractDonut
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What is Pentasa?
Doctors have been using the drug, Azulfidine, for over 50 years to treat inflammatory bowel disease. In some ways the Azulfidine molecule is half aspirin-like and half like the antibiotic sulfa. Some patients have an adverse reaction to Azulfidine, mostly due to its similarity to sulfa compounds. Scientists were able to remove the sulfa-like portion of Azulfidine, while maintaining the full beneficial effect. The result was meslamine, an aspirin-like antiinflammatory drug. Approved by the FDA in 1987, mesalamine comes in different formulations and delivery systems - one of which is named Pentasa.

Pentasa is a man-made compound that is taken by mouth to treat inflammatory disorders of the colon such as Crohn's disease, and other inflammatory conditions. It is sometimes given in conjunction with other medications such as the steroid, prednisone. Another common name for mesalamine is 5-aminosalicylic acid, or 5-ASA. Each capsule of Pentasa contains about 250 mg of mesalamine. The shelf life is 3 years.

Targeted Delivery
One of the unique features of Pentasa is the fact that the pill does not release its medication until it reaches the diseased area. Each tablet has a special plastic coating which delays release of mesalamine until the tablets reach the end of the 20 feet of small intestine, or the ileum. This allows delivery of most of the medicine right where the problem lies - the ileum and right colon. How mesalamine works is unknown, but it appears to be topical rather than systemic. Once released in the colon, mesalamine is minimally absorbed. Most of it works directly on the lining of the ileum and colon - like putting a salve on a rash. Eventually most of it is excreted with the stool. Studies have shown that Pentasa can help bring a case of Crohn's under control and help maintain a remission over time. Realize that inflammatory bowel disease rarely goes into permanent remission, but the risk of flare-ups can be substantially reduced by continued use of Pentasa at the maintenance dose as directed by your doctor.

What Pentasa is not.
Pentasa is not a steroid like prednisone. It is not habit forming; it does not cause drowsiness. Since it lacks the sulfa-like properties of Azulfidine, most patients intolerant or allergic to Azulfidine and other sulfa drugs can be safely treated with Pentasa. In addition, Pentasa does not reduce a man's sperm count as does Azulfidine. There are no known interactions with other medications. As yet, there is no generic substitution available.

How does Pentasa differ from Asacol
Both Pentasa and Asacol are prescription forms of mesalamine. The difference between Asacol and Pentasa is in the outer chemical coating. Oral Pentasa has a unique formulation. The active ingredient is contained in coated microgranules, which enables a prolonged release of the active substance throughout the intestinal tract, from duodenum to the rectum. Therefore the Pentasa preparation is more useful for Crohn's patients who often have inflammation of the small intestine. The average small bowel transit time is approximately 3-4 hours in healthy volunteers.

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09-10-2008, 08:15 AM   #33
AbstractDonut
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Not to make Isla angry by contradicting her, but this seems to suggest that you should get some benefit from the drug right away since its somewhat topical. I would talk to my doctor if you saw no improvement.
09-10-2008, 02:53 PM   #34
GoJohnnyGo
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Update:

I just got back an hour ago from seeing the doctor. I had planned to see him Monday, but I needed a form filled out for work, so we discussed it anyway. He's just being cautious. Since I was only finding minimal relief so far, he's doubled the dosage.
09-10-2008, 03:14 PM   #35
GoJohnnyGo
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My Asacol pills are a reddish brown. They've got the brand name on 'em, so I know they aren't a generic.

He wants me to increase incrementally the dosage over a few days and not all at once.
09-10-2008, 03:52 PM   #36
Agent X20
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Mine are reddish brown too, and actually called "Asacol" on the packet. I hope they work.. they sorted me out for a long time, and with no noticable side effects. I think I only flared up again 18 months ago because I was stupid and trying to do too much
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09-11-2008, 02:02 AM   #37
BWS1982
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I was told there's no generic asacol, hence it's raping expenses.

Also, Asacol doesn't always have all the benefits and nothing wrong compared to Sulfasalazine (what I'm on now, but not as my primary treatment)...Asacol was highly suspect at making me worse, not better, because it can make the small bowel secrete MORE fluid, and with severe Crohns in the colon, it can't reabsorb the fluid like it's supposed to, hence, worsened diarrhea. That's the theory anyways, on why I was not a good candidate for it, but hey, if it works.

I think that even though it's topical, it may be the type that takes weeks/months to work...like acne medicated creams/oinments...the dermatologists will tell you you won't see a difference the first week...same thing I imagine.
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09-24-2008, 09:46 PM   #38
Colt
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How much do the various 5-ASA drugs cost? I'm considering it.
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Certified Medication Aide, Certified Nurse Aide, Phlebotomist, and Resident Cynic

Meds: Prednisone, Pentasa, Vitamin D & Calcium, Atenalol, Darvocet

Current Issues: Crohn's inflammation primarily of the upper GI (duodenum and up), Tachycardia, Osteoporosis

Current Stage of Grief: Anger
11-12-2008, 03:48 PM   #39
KaraLynn
 
Has anyone ever been treated with 5-ASA enemas?
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