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


 
04-20-2013, 06:28 PM   #61
kh216
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HD stands for High Density.
04-22-2013, 10:58 AM   #62
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I wanted to give a little update on me. I've been taking Asacol HD for something like 5 days now, and I'm not really liking it. As I suspected, I sometimes pass the tablets undigested. I used to pass my regular Asacol undigested too - but when I was taking 6 tablets daily of regular Asacol, even if I passed 1 or 2 tablets daily, I was still getting more medication than I was passing, so I felt like it was still doing me some good. But now that I'm only taking 2 tablets daily of Asacol HD, if I pass even 1 tablet daily that sucks and I'm missing out on getting 50% of my medicine, and that's significant. I have noticed looser stools/more diarrhea, and I've been feeling a little bit worse the past few days - I can only assume that's due to me not absorbing the Asacol HD because I pass some of it undigested.

Fortunately I have a GI appointment this afternoon, so I'm going to ask him about all of this. I'm hoping to maybe try the Delzicol - even if it is just Asacol tablets stuck inside a capsule, I'd rather take 6 pills a day than 2 for the reasons listed above. I might also ask to try something like Apriso or Pentasa instead. Wish me luck!
04-22-2013, 03:43 PM   #63
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Just got back from the GI. He did switch me to Delzicol. This is going to sound weird but as I explained in my post above, I'm happy that I get to take 6 pills a day again. More pills just increases the odds that I'll actually absorb some of my medication, so it's all good. I did take one of the capsules out of the bottle - like someone else in this thread said, it sounds & feels like there's a tablet inside of the capsule. I didn't open it up but it's probably totally just an Asacol tablet inside. Oh well, I did okay with Asacol tablets. If I don't do well with tablets inside of capsules then I'll just open up the capsules and take the tablets by themselves.
04-22-2013, 11:02 PM   #64
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I also got switched to Delzicol. I take 3 400mg Asacol pills twice a day. I went to the pharmacy to pick it up and they said it was unavailable. I had to call the GI who told me they were switching me to Delzicol. I pick it up tomorrow. It would have been nice to have heard it from the GI or the pharmacy or something first. Just seems sudden. I just hope it still works. I am concerned about the "take an hour before eating or two hours after eating." I don't do well with this for two reasons, 1) I don't do well remembering this rule, and 2) I get sick taking meds on an empty stomach. Wonder why the difference and if it really matters. I am going to ask the pharmacist tomorrow.
04-23-2013, 06:05 AM   #65
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I hope that you are satisfied with Delzicol. If not, there is always Lialda and Apriso.
04-23-2013, 08:44 PM   #66
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From the Asacol website:
Two Asacol 400 mg tablets have not been shown to be bioequivalent to one Asacol® HD (mesalamine) delayed-release 800 mg tablet.

From the Delzicol website:
DELZICOL™ (mesalamine) delayed-release capsules have been shown to be equivalent to ASACOL® (mesalamine) delayed-release tablets.
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04-26-2013, 12:01 AM   #67
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Well I picked up my Delzicol today. I did open up the capsule and it is an Asacol tablet inside. I asked the pharmacist if I had to take it on an empty stomach. She said I could take it with a cracker or bread. I said how about a small bowl of cereal and she said that was okay too. I don't like capsules because they get stuck in my esophagus. Then my espohagitis acts up. I have just taken my three for the evening and my esophagus is hurting. grrrr. I am going to do some research and see if I can just take the tablet out of the capsule. I hate to be a Debbie Downer, but....this is ridiculous that there is a pill inside a capsule. More stuff for our iffy intestines to digest.
04-26-2013, 08:26 AM   #68
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Someone correct me if im wrong, but I thought the whole purpose of the capsule is to keep the pill intact until it reaches the area where you need the medication. If you take just the pill w/o the capsule then it will release the med too high up in your gastro tract and do nothing for your colon or wherever it is that your disease it located.
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04-26-2013, 09:30 AM   #69
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I had the same thought as prplkow, that if I can't break it down properly then I'll just remove the capsule. I'm only on day 4 of Delzicol, but so far so good - I haven't seen it pass undigested in my stool yet, so maybe something about the capsule is allowing me to break it down better. I don't know why that is, since I had a hard time breaking down regular Asacol tablets, but so far so good for me with the capsules. For others thinking the same thing, I'd say give the capsules a fair shot first before removing them.
04-26-2013, 04:10 PM   #70
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I called my doctor's office, told them about Asacol being discontinued and doc sent in a prescription for Balsalazide - another drug for UC and I have Crohn's!!! What is wrong with him???? GRRRRRR!!!!!

So I called back and requested Delzicol instead - until I can see him to discuss this, which is a month away!!! UGH!!! Feeling very confused about my doctor and why he does what he does!!!
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I seem to be in remission: I believe from the Asacol / Low Residue Diet / Probiotics and NO STRESS!
04-26-2013, 04:37 PM   #71
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Thankfully there is no cost difference in the Asacol HD. Started it today. We will see how well it works with fewer, larger pills....
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04-26-2013, 04:52 PM   #72
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Good luck, Chicago!

Sarah50, do you have Crohn's colitis or Crohn's in the terminal ileum? My GI still isn't sure which type of IBD I have, but he suspects Microscopic colitis. My suspicion is Crohn's because I tend to have pain in the terminal ileum area. My GI told me that Asacol/Delzicol works on both the TI and the colon, so it works on both areas in question for me. I think technically Asacol/Delzicol is prescribed more often for UC than for Crohn's, but it should work for any type of IBD in the colon/TI area.
04-26-2013, 05:04 PM   #73
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Good luck, Chicago!

Sarah50, do you have Crohn's colitis or Crohn's in the terminal ileum? My GI still isn't sure which type of IBD I have, but he suspects Microscopic colitis. My suspicion is Crohn's because I tend to have pain in the terminal ileum area. My GI told me that Asacol/Delzicol works on both the TI and the colon, so it works on both areas in question for me. I think technically Asacol/Delzicol is prescribed more often for UC than for Crohn's, but it should work for any type of IBD in the colon/TI area.
Cat, I have Crohn's in the terminal ileum area. I haven't had any symptoms since on Asacol (except a few lately) - but why I'm concerned it's not working is because I had my primary care doctor order a Calprotectin test recently which showed very high inflammation (900)! Normal is 0 to 50. So I honestly don't know what to think.
04-26-2013, 06:27 PM   #74
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Sarah,
Most of us who have Crohn's Disease find that Asacol alone does not keep us in remission. You may want to consider adding another Crohn's medication. I am personally on 6mp, which is an immunosuppressant, besides Asacol. It is good that you take vitamins and follow a low fiber/residue diet.
04-26-2013, 06:35 PM   #75
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yes it sounds like it may be time to add on a medication. Asacol works by itself for many, but depending on the severity of your inflammation and any other complications you may have, it may need to be used in conjunction with a steroid or immunosuppressor.

I currently take asacol and 6MP after realizing that asacol is helpful but alone isn't enough to hold me over after a flare and a round of prednisone. The goal is to eventually get me off of asacol entirely and just take 6MP.

I hope you and your doctor are able to get things under control soon
04-26-2013, 07:11 PM   #76
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Sarah,
Most of us who have Crohn's Disease find that Asacol alone does not keep us in remission. You may want to consider adding another Crohn's medication. I am personally on 6mp, which is an immunosuppressant, besides Asacol. It is good that you take vitamins and follow a low fiber/residue diet.
KH and Chicago - thank you and I believe I might need an immunosuppressant since the Calprotectin test said high inflammation in the intestines. But why wouldn't you switch to the stronger meds and get off of Asacol? I don't understand why take both but maybe they work differently... I don't know.

I called my doctor and requested Delzicol instead of the UC meds of Balsalazide - since this med doesn't dissolve until in the colon. My doctor STILL didn't give me what I want. I'm beginning to think either I'm nuts and don't understand what I'm reading or my doctor doesn't know what the hell he's recommending. I called my primary care doctor to get a referral to the other GI. I'm frustrated!
04-26-2013, 07:49 PM   #77
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The thing about asacol is it is topical medicinal ointment (hence the delayed release capsule) and coats the lining of your intestine giving it a chance to heal. I always think of it as a "buffer" from irritants.

so while I am weaning off of prednisone currently and waiting for the 6MP to kick in fully, the asacol is the topical aspect of my treatment plan offering medicine and at the same time acting as a buffer from any food or other things that may irritate as they pass the lining of my terminal ileum and colon which is covered in ulcers and it is allowing my bleeding ulcers a chance to heal themselves without much interference....that's just how I think about it in a nutshell lol.

Sorry to hear your current GI is being uncooperative but Im glad you are taking matters into your own hands and trying to get another opinion.
04-26-2013, 09:24 PM   #78
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The thing about asacol is it is topical medicinal ointment (hence the delayed release capsule) and coats the lining of your intestine giving it a chance to heal. I always think of it as a "buffer" from irritants.

so while I am weaning off of prednisone currently and waiting for the 6MP to kick in fully, the asacol is the topical aspect of my treatment plan offering medicine and at the same time acting as a buffer from any food or other things that may irritate as they pass the lining of my terminal ileum and colon which is covered in ulcers and it is allowing my bleeding ulcers a chance to heal themselves without much interference....that's just how I think about it in a nutshell lol.

Sorry to hear your current GI is being uncooperative but Im glad you are taking matters into your own hands and trying to get another opinion.
That's a great explanation Chicago, and makes sense. Thank you!

Yeah, I'm definitely not the type to just sit back and say or do nothing. I've had to fight (cry) to get my way several times with my primary doctor to push them along into tests, actions that I felt I needed! And I've been right, so far! We definitely have to learn to advocate for ourselves!
04-29-2013, 11:45 AM   #79
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I found this forum (and joined) as I searched for information about Asacol being discontinued. My pharmacist provided Delzicol as a replacement last month and it seems to work as well for me, although I second the complaints about trying to get such big capsules down. And my copay jumped from $60 to $100 because it is not a "preferred" drug to my insurance company.

Maybe with putting the tablet inside a capsule, they were able to get rid of the dibutyl pthalate coating the tablet. Delivery of medication time to the digestive tract might be a consideration for those thinking of pulling the tablets out of the capsules.
05-03-2013, 02:55 PM   #80
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I wanted to give a little update on me. I've been taking Asacol HD for something like 5 days now, and I'm not really liking it. As I suspected, I sometimes pass the tablets undigested. I used to pass my regular Asacol undigested too - but when I was taking 6 tablets daily of regular Asacol, even if I passed 1 or 2 tablets daily, I was still getting more medication than I was passing, so I felt like it was still doing me some good. But now that I'm only taking 2 tablets daily of Asacol HD, if I pass even 1 tablet daily that sucks and I'm missing out on getting 50% of my medicine, and that's significant. I have noticed looser stools/more diarrhea, and I've been feeling a little bit worse the past few days - I can only assume that's due to me not absorbing the Asacol HD because I pass some of it undigested.

Fortunately I have a GI appointment this afternoon, so I'm going to ask him about all of this. I'm hoping to maybe try the Delzicol - even if it is just Asacol tablets stuck inside a capsule, I'd rather take 6 pills a day than 2 for the reasons listed above. I might also ask to try something like Apriso or Pentasa instead. Wish me luck!
Cat, when you were on the Asacol HD - your doctor prescribed 2 a day to replace the Asacol 400 of 6 per day, is that right???

I'm asking because I *finally* got my doctor to give me Asacol 800 since he didn't want to give me the Delzicol (I have NO idea why!!!) but he must not have realized that dosage was twice as strong because it says the same - 2 pills 3 times a day. UGH! I know 1 Asacol HD 800 ml is not supposed to be the equivalent of 2 Asacol 400 ml - which makes NO sense ml wise!! So I asked the pharmacist and she said yes, it is equivalent. So I ASSUME I'm supposed to take one pill, 3 times a day??????
05-03-2013, 03:12 PM   #81
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Sarah50, yes, that is correct. I was taking 6 tablets per day of regular Asacol, and then he had me take 2 Asacol HD daily when I made the switch. I didn't do well on Asacol HD so I'm now on 6 capsules a day of Delzicol and doing much better. My GI said that he tried me on Asacol HD first because he knew my insurance would cover that, and he wasn't sure if it would cover Delzicol. But he was happy to switch me to Delzicol when I complained about the HD not working, and my insurance does cover it (well, with my usual $75 copay anyway).

The reasoning for taking 2 HDs a day instead of 3 is, HD has more bioavailability than regular Asacol did. So by taking 2400 mg daily of regular Asacol, you're absorbing a certain amount of that - apparently you don't really absorb the full 2400 mg. By taking 1600 mg daily of HD, theoretically you're actually absorbing more of that than you would with regular Asacol, so it all evens out and is fairly equal that way. That's my understanding anyway based on what my GI told me. My pharmacist, like yours, seemed to think that 800 mg of Asacol is equivalent to 800 mg of Asacol HD, but apparently that's not actually true.

If you're not satisfied with taking 2 HDs daily, check with your doc. They may bump you up to 3 a day, or they may switch you to Delzicol (it may have just been an insurance thing like it was with my GI, he said since it's such a new medication that not a lot of people's insurance cover it yet).
05-03-2013, 04:12 PM   #82
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Sarah50, yes, that is correct. I was taking 6 tablets per day of regular Asacol, and then he had me take 2 Asacol HD daily when I made the switch. I didn't do well on Asacol HD so I'm now on 6 capsules a day of Delzicol and doing much better. My GI said that he tried me on Asacol HD first because he knew my insurance would cover that, and he wasn't sure if it would cover Delzicol. But he was happy to switch me to Delzicol when I complained about the HD not working, and my insurance does cover it (well, with my usual $75 copay anyway).

The reasoning for taking 2 HDs a day instead of 3 is, HD has more bioavailability than regular Asacol did. So by taking 2400 mg daily of regular Asacol, you're absorbing a certain amount of that - apparently you don't really absorb the full 2400 mg. By taking 1600 mg daily of HD, theoretically you're actually absorbing more of that than you would with regular Asacol, so it all evens out and is fairly equal that way. That's my understanding anyway based on what my GI told me. My pharmacist, like yours, seemed to think that 800 mg of Asacol is equivalent to 800 mg of Asacol HD, but apparently that's not actually true.

If you're not satisfied with taking 2 HDs daily, check with your doc. They may bump you up to 3 a day, or they may switch you to Delzicol (it may have just been an insurance thing like it was with my GI, he said since it's such a new medication that not a lot of people's insurance cover it yet).
Thanks, Cat!! I'll try the 2 a day. That's fine because of all the supplements I'm taking.... pill city!
05-05-2013, 12:16 PM   #83
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Just pickup my new Rx of Delzicol, that they say replaces Asacol. Says its a time released capsule, for some odd reason I decide to open one of the capsules. Low and behold, there is an Asacol tablet inside!! Check it out, what kind of scam is this!
05-05-2013, 01:10 PM   #84
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My gastro doctor thinks it's a scam too, especially since the patent on Asacol is about to run out and now other pharmaceutical companies would be allowed to produce generic ( and cheaper) versions of it. Warner Chilcott, the maker of Asacol and Asacol HD is in partnership with FDA and they claim that one of the additives in Asacol's coating is bad. However, I was taking Asacol and Asacol HD for years without having any problems. If the additive is so dangerous, why aren't they withdrawing Asacol HD right now too?
05-05-2013, 03:26 PM   #85
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Just another opinion. Perhaps the elimination of that inactive ingredient allowed the Asacol to dissolve too early and not reach the intended area of the colon. So they may have encased it in a capsule to allow the medicine to work further downstream. I do know they made a suppository version of Asacol for help with Crohn's-Colitis that was further down in the colon where the pills may not be as effective, because they released the active part of Asacol too soon. Just a thought.
05-08-2013, 10:52 PM   #86
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With all the absurdly different costs associated with a heart attack in the U.S. being in the news lately, I am wondering..... What do you pay for a 90 day supply of Delzicol 400 MG and how many pills a day does that prescription cover? I take 6 tabs per day but asked the doctor to prescribe 9 a day, which is the same cost for me. This allows me to only pay for three 90 day supplies per year and still get what I need for the full year. I decline the final refill.
05-09-2013, 06:19 PM   #87
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Update on me...I have been taking the Delzicol for the past almost three weeks. First the capsules were getting stuck in my esophagus and secondly, I was not good about the no eating for an hour after taking the capsules especially when they got stuck I had to eat something to get them pushed down. As such, I guess I have self inflicted the ugly Crohn's out of hibernation and have lots of pain again where the TI is. Just called the GI and he has switched me to Asacol 800 HD. I was taking 6 of the 200 Asacol, so 1200mg a day, and I guess I will be taking 1600mg of this HD version. Two pills a day. Thanks Cat-a-Tonic for sharing your knowledge of the dose difference because I was a little worried about taking more Asacol than I was. Hopefully this will work. Fingers and toes crossed.
05-10-2013, 04:07 PM   #88
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Update on me...I have been taking the Delzicol for the past almost three weeks. First the capsules were getting stuck in my esophagus and secondly, I was not good about the no eating for an hour after taking the capsules especially when they got stuck I had to eat something to get them pushed down. As such, I guess I have self inflicted the ugly Crohn's out of hibernation and have lots of pain again where the TI is. Just called the GI and he has switched me to Asacol 800 HD. I was taking 6 of the 200 Asacol, so 1200mg a day, and I guess I will be taking 1600mg of this HD version. Two pills a day. Thanks Cat-a-Tonic for sharing your knowledge of the dose difference because I was a little worried about taking more Asacol than I was. Hopefully this will work. Fingers and toes crossed.
Prplkow - I hope it works for you!! My doctor refused to prescribe the Delzicol for some reason but when I asked about Asacol 800 HD, he prescribed it. I, too, was taking 6 pills a day on Asacol 400 and have been taking 2 pills a day of the Asacol 800. It's been a week and so far so good! Fingers crossed for you!
05-10-2013, 05:19 PM   #89
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Grouchy, I get a 30 day supply of Delzicol at a time, and with my insurance I have a $75 copay. So for 90 days I'd be paying $225 I guess. Ouch! I have a $75 copay for most of the name-brand IBD meds - I paid $75 per month when I was on Entocort and when I was on Asacol, and I blew $75 on a month's supply of Asacol HD that I only used about 5 days' worth of. The other name-brand med I take is Nexium, I pay $25 per month for that one.
05-11-2013, 11:25 AM   #90
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I have been trying to refill my Asacol with the new Delzicol but have been denied because it is not covered. The Asacol 800 isn't covered either. Does anyone have any ideas where my doctor and I should look for a replacement?
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