Crohn's Disease Forum » Ulcerative Colitis Forum » Asacol versus Sulfasalazine for Ulcerative Colitis

09-28-2012, 10:06 PM   #1
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Join Date: May 2012
Asacol versus Sulfasalazine for Ulcerative Colitis

I am diagnosed with Ulcerative Colitis. My doctor wants to try a new medication as the old one (Lialda) was not working well. He said he is going to put me either on Asacol or Sulfasalazine but isn't sure which yet. He plans to do some research and talk to other doctors first. That's fine but I figured I'd do some research as well. Can anyone tell me which is better for Ulcerative Colitis?
09-29-2012, 12:51 AM   #2
Jennifer's Avatar
They could both potentially work really. It depends on the person. I have Crohn's and have taken both. The sulfa drug made me pretty sick (more pain, diarrhea, some vomiting etc) and has made many others sick as well but there are plenty of people who haven't had a problem with it so its your call. Asacol is newer and did work better for me and didn't make me sick. Really what's probably going to happen is they'll try one and if it doesn't work then they'll switch to the other. I know insurance companies always like to try the cheaper one first (which is why I took the sulfa drug at all in the first place) but cheaper doesn't always mean better.
Diagnosis: Crohn's in 1991 at age 9
Surgeries: 1 Small Bowel Resection in 1999; Central IV in 1991-92
Meds for CD: 6MP 75mg
Things I take: Tenormin 25mg (PVCs and Tachycardia), Junel (endometriosis), Tylenol 3 (Osteoarthritis), Zantac 150mg 2/day (acid reflux), Klonopin 1mg (Panic Disorder), Imitrex 25mg (migraines), Zofran 8mg (nausea)
Currently in: REMISSION Thought it was a flare but it's just scar tissue from my resection. Dealing with a stricture. Remission from my resection, 19 years and counting.
09-29-2012, 09:23 AM   #3
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Join Date: Jan 2012
Location: Tynemouth, United Kingdom

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I have U.C and have used asacol for 6yrs without probs. but everyone is different.I use it as maintenance now.If you use the tablets you will have to have your bloods done every 3mths.But we're all different,so it's trial and error.Good luck.
12-08-2012, 01:47 PM   #4
Join Date: Dec 2012
Sulfasalazine has one major negative. It causes intolerance reactions in 30% of people that take it and the higher the dosage the more people that have problems. It is inexpensive and is probably the most effective oral 5asa type drugs for maintaining remission. It also helps some people with arthritis symptoms. It was developed to treat RA.

Asacol was developed as an alternative and has fewer side effects and can be used at higher dosages that induce remission.

I wouldn't necessarily rule out sulfasalazine for maintenance. I had to stop using it because of head aches and fever after one month.
12-18-2012, 05:16 PM   #5
Cross-stitch gal
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Location: Vancouver, Washington

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I have used both. When I was first diagnosed with UC I was put on Sulfasalazine. Was on it for years until I was told it wasn't working anymore for me and then I was put on Asacol. From what I remember being told: Asacol is a little stronger than Sulfasalazine.

Didn't have any trouble with either drug. Although, after awhile of being on the Asacol I started passing pills with my BM's.
Ulcerative Colitis/IBD 1996, Iritis 2001, Ulcerative Proctitis 2013, Indeterminate Colitis 2016, Remission 2017, Hand Eczema

Current Meds:
Pentasa 1000mg 2xday or Mesalamine DR 1.2gm 2xday, Canasa Suppositories (when needed) 1000mg 1xday, Tylenol 3 with codeine 300-30mg (when needed)

600+D Calcium 2xday, Multivitamin, 65mg Iron 1xday, Fish Oil 1000mg, Vitamin D3 5,000 I.U., Eye Drops 2xday

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09-20-2014, 07:01 PM   #6
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Join Date: Sep 2014
Location: Manitoba
my son who is almost 22 months old is on Sulfasalazine for a few weeks now, and it was working till the last few days, he started to get blood in diaper again. He is on iron supplement, which makes his stool very dark, so sometime it is hard to see.
Sulfasalazine 1/2 tbs twice daily
Iron supplement for toddlers (2.5mg) twice daily
Folic Acide (1mg) once per day
Pure Aleo Vera juice 2 Tbsp (twice daily)
Pro-biotic 1 tbs twice daily

Last edited by djf863000; 09-20-2014 at 10:33 PM.
09-21-2014, 02:39 PM   #7
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7vNH's Avatar
Join Date: Apr 2014
Location: Charlotte, North Carolina
All of these drugs break down into the same thing (5-ASA). You can add balsalizide to the list too.

Sulfasalazine has been around the longest. It worked for me for a long while, but it tends to make me feel slightly nauseated. It is by far the cheapest, if that's a factor.

There isn't much difference between Asacol and Lialda, I don't think; they're both time-released mesalamine.

If the top-down mesalamine doesn't work, you can try bottom-up (mesalamine enema). It's not as easy, but if it means staying away from the immunosuppressants, you might consider it.
04-04-2015, 10:53 PM   #8
Ann Morgan
Senior Member
I was finally diagnosed with UC in 2006 after having diarrhea since 1997.
I was prescribed Asacol, and then after that Lialda.
I am still taking the Lialda and I also take Questran Powder twice a day.
I have had no problem tolerating the Asacol or the Lialda or the Questran.
I had no health insurance in 2012 and my Gastroenterologist told me about a program that offered free prescriptions for Lialda to poor people.
It is called "Shire Cares".
I got Lialda for free for one year, they mailed me a 90 day supply every three months for a year. After 2012 I had health insurance.

The cash cost for Lialda is $432.00 per month where I live !
My current insurance plan has that stupid "donut hole" or "coverage gap" and last year I found myself having to pay 47 percent of the cash price for my Lialda for almost six months out of the year......SAY WHAT.

I don't understand why I have health insurance prescription coverage if they are going to have a "coverage gap" that makes me pay 47 percent of the cost for name brand drugs after a certain period of time, and then I have to pay 77 percent of the cost of generic brand drugs after a certain period of time each year.

Basically, every year now, after six months of having all of my prescription drugs covered at a very reasonable price, I then have to go broke paying for them for the last six months of the year because of the "coverage gap"

Thanks for listening.

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