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Crohn's Disease Forum » Treatment » 5-ASA/Mesalamine » Asacol discontinued


 
04-10-2013, 10:21 AM   #31
Cat-a-Tonic
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My GI emailed me back last night and said he can write me a prescription for Asacol HD 800 mg - 2 pills a day. It sounds like it's stronger stuff than regular Asacol, so that makes sense that I'd be taking less of it to maintain remission. (I was taking 6 pills of regular Asacol 400 a day, so 2.4 grams total - I'll be taking 1.6 grams of Asacol HD.) Taking less pills is always a good thing, and since it's got the Asacol name I guess I feel a little better about this than the new medication. I know it's still a somewhat different med though so I'm still a bit anxious about taking it, I hope I don't get any side effects and that it works as well as regular old Asacol. I guess if it doesn't work or if I do get side effects, I can always try the new med. So yeah, I've got a plan and a backup plan I guess. Nervous but not as anxious & upset as I was.

Has anyone else figured out yet what you're going to do? Chicago, how about you? Did you get to talk to your GI?
04-10-2013, 10:40 AM   #32
CrohnsChicago
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Yes, I called the pharmacy yesterday and they have already taken the Asacol off of the shelf. I also spoke to my GI yesterday; he is going to prescribe me Asacol HD once I finish up the remainder of this bottle of regular Asacol I have in about a week. The dosage is TBD since I'm doing a pred taper right now too and the goal is to eventually get me off of Asacol entirely. Should be fewer pills for me too which would be nice.

I currently take 12 Asacol pills (4pills, 3x/day). I always have trouble remembering to take my afternoon pills since I'm always busy or distracted during that time period. Would be nice to only have to take them morning and evening if possible.

I'm mildly nervous about it too, I've done a few more medication switches and add-ons this year than I care to experience in such a short period of time. I looked it up online too and discussed it with my GI and it seems the only real difference is the strength of the medication. I know afidz said she had some bad reaction to Asacol HD last fall but hopefully this works for me while I continue to get things under control.
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04-10-2013, 10:53 AM   #33
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Does anyone know if this discontinuation applies to Britain,also if it also applies to Asacol suppositories ? thankyou.
04-10-2013, 10:57 AM   #34
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Yeah, she got pancreatitis from it, didn't she? I seem to recall something like that. When I started on regular Asacol quite awhile ago, my GI mentioned that in rare cases, pancreatitis or kidney failure can occur. He tests my blood every so often to make sure my kidneys are okay (and they're fine), and he said "You'll know it if you get pancreatitis." I know it's really painful from reading threads like Afidz's, but so far so good (knock on wood). I haven't had any side effects whatsoever from Asacol 400, so hopefully Asacol HD will work well for me too.

Wow, you take a lot of Asacol! 12 pills a day, that sucks. I thought 6 Asacol a day was a lot! I'm sure it'll be much easier on you taking fewer pills a day.

My one qualm about taking fewer pills is, I sometimes pass Asacol undigested. I have severe GERD, and if I take too much antacids or other reflux meds then it messes with my pH too much, and then I just can't break down Asacol - whole tablets will pass through me undigested (it's not just the shell, I've checked, it's a whole tablet full of medication). Depending on how bad my GERD is and how much meds I'm taking for it, I will pass undigested Asacols anywhere from once a week to multiple times per day. But overall Asacol still works because I'm still absorbing more than I'm passing - even if I pass 2 Asacol tablets every day, I'm still absorbing 4. With only 2 tablets a day though, the odds might not be tipped in my favor anymore. I'm going to have to keep a very sharp eye on my stools for awhile until I know whether Asacol HD is similar to Asacol in terms of my ability to break it down.
04-10-2013, 10:58 AM   #35
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Scottsma, I would check with your doctor or pharmacist for sure. I would think the Asacol 400 tablets have been discontinued everywhere, but the suppositories should be a different thing, so those might still be available. I really have no idea for sure though so check with your pharmacy and/or doc.
04-10-2013, 11:00 AM   #36
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Yes, check with your doctor and local pharmacy. I wish there was better explanation as to why it is discontinued. It bothers me when pharmaceutical companies are so vague and sudden like this. And they wonder why people get nervous about meds sometimes.

The only thing I can think of off of the top of my head is that it may relate to the US patent expiration date that is nearing. So its likely that there may not be an issue in other parts of the world but here we have to deal with it however definitely double check on your end.
04-10-2013, 11:51 AM   #37
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Does anyone know if this discontinuation applies to Britain,also if it also applies to Asacol suppositories ? thankyou.
I know the FDA approved Delzicol as a replacement. I don't know about the UK if they discontinued Asacol or if a replacement has been arranged.
04-11-2013, 03:00 PM   #38
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I talked to GI yesterday. He told me about Apriso. www.rxlist.com/apriso-drug.htm.
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04-11-2013, 04:06 PM   #39
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Well if one wanted to try something new as a replacement for Asacol there are a few variations of mesalamine.
04-12-2013, 02:03 PM   #40
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@scottsma i was at GP today and they know nothing about it being discontinued over here,even went into the chemist,spoke to the pharmasist and she didnt know anything about it either,she even phoned the supplier to place an order just to see what they would say,they took said order so she just asked outright and they said they knew nothing...

so it looks like were ok over here...for now anyway.hope this info is of use to you.
04-17-2013, 09:53 PM   #41
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Hi,
I am new. I actually just signed up so that I can let you know what I have found out about Asacol. It is discontinued. Was manufactured by Proctor and gamble, sold to Warner chilcott. phone number 1-800-521-8813. I did call, they told me Asacol 800 is not bio equivalent to Asacol 400. The replacement is "Delzicol" My Gi just okay-ed a prescription for me. I've been counting the days till Asacol's patent expiores(August of this year) They did tell me at Warren, even though the product changed names that does not mean the med will not go generic.
04-17-2013, 10:38 PM   #42
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You're right that it's expensive, kh216! With insurance I pay $75 a month for Asacol. Without insurance, I believe it'd be over $500 (going by memory, don't have the info in front of me). I just looked it up, and with my insurance I'd also be paying $75 per month if I switched to Delzicol. It looks like it'd be the same cost for Asacol HD too. So at least I won't be paying any more, but I sure would like to pay less as $75 each month is not cheap. (I also take Nexium, Ranitidine, and Amitriptyline - and generic Zofran as needed - so with those added in I pay over $100 each month just for prescriptions).
I have had to buy small qtys w/o insurance during processing gaps.

The average cost worked out to be $5/pill, or, $20 / day for me (1600mg)
04-17-2013, 11:05 PM   #43
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It's only in the US. There is an ingredient in Asacol called dibutyl phthalate that the FDA has decided is unhealthy and needs to be removed from all drugs, not just Asacol. I just grabbed this from a post on Facebook, so not super reliable. Apparently it's an inactive ingredient in the coating of Asacol.

I don't know much else...
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04-17-2013, 11:34 PM   #44
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The regular Asacol is going to be for people who have minor flare or under remission. The Asacol HD is for people who have moderate to severe flares. Well that is what the Asacol website said. But it isn't a big deal. My pharmacy just gave me the new ones not the HD. It isn't a narcotic or anything so they didn't need approval from the doctor.

I was all scared for a minute lol but not a biggie. :]
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04-18-2013, 05:56 AM   #45
kh216
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I take Asacol HD and I looked it up on the web and it also contains dibutyl phthalate. I have an appointment with my gastro doctor tonight so this will be another thing I will want to discuss with him.
04-18-2013, 08:37 AM   #46
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Kat, keep in mind the patent expires in August. If there are any law suit's, it could extend the Patton, but my fingers are crossed for August. I pay $79 out of pocket for this drug
04-18-2013, 09:23 AM   #47
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Figured this out a few days ago when my mail order insurance filled only 1 month of my 3 month prescription and said the Asacol was being discontinued. They won't fill another 2 months because they don't have it anymore.

Here's the issue that I'm running into for the future. My Rx insurance (Catamaran) doesn't cover the Delzicol yet. I called them before calling my doctor. They looked up Delzicol and said it isn't on their formulary yet so it wouldn't be covered. The Rx insurance rep said she didn't know what the problem was with the mail order pharmacy and that they should still be stocking Asacol. She suggested I call the physical hospital pharmacies instead of relying on the mail order (my mail order is through my local hospital as my wife works there and I'm on their insurance).

3 phone calls later, one of the hospital pharmacies let me know they wouldn't have a problem filling the remainder of my refill because they still had Asacol. Hopefully this will get me through until the Delzicol gets added to my Rx insurance's formulary. I don't want my doctor to prescribe me a medication that I can't afford because of insurance reasons. Damn you Warner Chilcott!
04-18-2013, 09:31 AM   #48
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Ruthrj,
Hope my insurance will cover it. The pharmacy said if they don't they will ask the doctor to fill out a Preauthorization request. Sometimes that works. The doctor said I can also get a prescription and buy from Canada on line. If they have the drug, cheaper anyway, I think they charge $149 for the same qty of my $500 asacol here in the states. Hmm, wonder if they still have the Asacol 400 there?
04-18-2013, 09:44 AM   #49
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Mehita, do you happen to know what about that ingredient is unhealthy? I hadn't heard that so I'm intrigued. My GI just switched me to Asacol HD - I just took the first pill this morning. I'm assuming that ingredient is in Asacol HD as well? At any rate, I see my GI on Monday anyway, so I will give the Asacol HD a chance between now and then, and I will discuss all of this with him at my appointment. I checked with my insurance and they will cover Delzicol (with my standard $75 copay of course), so if I have to switch to that then at least I can without a big insurance headache.
04-18-2013, 09:44 AM   #50
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Huh, didn't know a doctor could do a preauthorization request. That sounds like a great idea! I'll discuss that the next time I'm in.

I wouldn't be half as concerned as I currently am if my Rx insurance was up to date with current events. The rep didn't have the slightest clue that Asacol was being discontinued at all, said the system said it was active and everything was perfectly fine.

To make matters a little more complicated, I just got offered benefits for my current job so I'm going to be getting off my wife's insurance and onto my own. Need to get this sorted out entirely before or after the switch, not in the middle. This Asacol discontinuation couldn't have come at a worse time, lol!
04-18-2013, 11:29 AM   #51
Mehita
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Cat - here is a link to the basic info on Wiki...

http://en.wikipedia.org/wiki/Dibutyl_phthalate

Quite honestly, I don't know how true it is since I can't find anything on the Internet, though the FDA does list DBP as an ingredient on Asacol. I follow a woman on Facebook who has IBD and she said she just got a letter from her doctor this week telling her she needs to switch to the new drug because of DBP in the shell of Asa.

???????
04-18-2013, 03:00 PM   #52
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I take Lialda (2MG, 2/day) - I thought it is the same as Asacol?? Aren't all Mesalamines the same?
04-18-2013, 03:15 PM   #53
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My basic understanding is that All 5-ASAs aim to deliver the medication to the colon however some may start delivering at various points before they even reach the colon (I saw a visual PowerPoint presentation on this at the University of Chicagos IBD Clinic patients info session once). Bonding agents and pill dosages all vary in each one as well. Certain bonding agents can cause allergic reactions.

I take Lialda (2MG, 2/day) - I thought it is the same as Asacol?? Aren't all Mesalamines the same?
04-18-2013, 03:25 PM   #54
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Yep, what Chicago said. They all are mesalamine-based, the main difference is where the medication is delivered to, and that's based on the coating. My GI told me that Pentasa works mainly on the small intestine, Asacol works on the TI and colon, and Lialda works on the colon & rectum. Each med has a different coating which is made to break down in a particular pH, so they pass through the stomach and then break down when they get to the proper spot. I was told that's why there are so many different brand-name versions of mesalamine - it's actually the special coating that is under patent, not the medicine inside.
04-19-2013, 07:51 PM   #55
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Yesterday, I had my appointment with my gastro doctor and he basically thinks that Warner Chilcott is scamming us because the patent for Asacol has run out. He showed me one of the new Delzicol capsules. It is red but when you open the capsule, it tooks exactly like an Asacol tablet inside of the capsule. I was taking Asacol HD but now I am going to switch to Lialda. I don't need to support their scam.
04-19-2013, 10:33 PM   #56
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Just got my Asaol HD tablets this evening. Still taking them 3x day, but instead of 12 little pills I now just have to take 6 BIG pills lol. I'll be starting them sometime later next week.

Last edited by CrohnsChicago; 04-19-2013 at 10:49 PM.
04-20-2013, 12:14 AM   #57
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Yes, I called the pharmacy yesterday and they have already taken the Asacol off of the shelf. I also spoke to my GI yesterday; he is going to prescribe me Asacol HD once I finish up the remainder of this bottle of regular Asacol I have in about a week. The dosage is TBD since I'm doing a pred taper right now too and the goal is to eventually get me off of Asacol entirely. Should be fewer pills for me too which would be nice.

I currently take 12 Asacol pills (4pills, 3x/day). I always have trouble remembering to take my afternoon pills since I'm always busy or distracted during that time period. Would be nice to only have to take them morning and evening if possible.

I'm mildly nervous about it too, I've done a few more medication switches and add-ons this year than I care to experience in such a short period of time. I looked it up online too and discussed it with my GI and it seems the only real difference is the strength of the medication. I know afidz said she had some bad reaction to Asacol HD last fall but hopefully this works for me while I continue to get things under control.
CrohnsChicago:
My daughters GI just changed her Asacol to two times a day because she kept forgetting the middle dose too. now it is 4 in am and 4 in pm.

Our phamacist is on a committee that changes the name of drugs as needed. he said that Asacol was changed because it kept getting mixed up with another drug... other than that, he said it is the same.
not sure about the Asacol HD. I'll ask next month.
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04-20-2013, 04:24 PM   #58
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I have a letter from my pharmacy that says the discontinuation of Asacol 400 mg comes about because the U.S. FDA recommended that dibutyl phthalate (DBP), an inactive ingredient in Asacol products, be removed from all drug products. In order to accommodate the FDA guidance, Warner Chilcott developed Delzicol 400 mg delayed release capsules that do not contain DBP.
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04-20-2013, 05:03 PM   #59
CrohnsChicago
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So...I went to the CCFA educational symposium in my state today.....

Warner Chilcott, the manufacturer for these meds, had a booth specifically promoting Asacol HD and Dielzicol...I took pamphelets on both.

I asked him about everything we discussed here and he seemed to not know what I was talking about (but said I was asking good questions)...hmmm....

I asked what he believed the reason was for the change in medication. He said Dielzcol was exactly the same as regular Asacol (dosage and medication), but the big and only change was the capsule it is placed in.

I asked him if it was the same, they why did I read about the blood disorders risk for those taking 6-MP I read about for Dielzcol....he was completely unaware of such a complication (but of course, to cover his butt, he stated "but as we all know not everyone responds the same and we can't guarantee a perfect drug"). He said whatever I read may have more to do with testing done in rats than that done in humans.

I'm just sayin'....if you are going to go to a big educational event and promote a medication that has recently been changed....you'd better be prepared to answer as much as possible in depth...just sayin'.......and OF COURSE consider the possible motivation for not answering my questions even if you did know what I was talking about.....


****may I add....I pulled out the information they gave me in the packet...it specifically mentions "mesalamine and azathioprine or 6-mercaptopurine may increase the risk of blood disorders"....
04-20-2013, 05:12 PM   #60
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My pharmacist still gave me the old ones. I guess they didn't get the new ones in stock yet. What does the HD stand for in the new Asacols? High Deff? lol
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