Crohn's Disease Forum » General IBD Discussion » Have I Been Prescribed Wrong Meds?


02-26-2018, 05:22 PM   #1
jamieariss
 
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Have I Been Prescribed Wrong Meds?

I know I need to direct this question to the doctor (and I will). I just wanted to hear from you

I've been prescribed Pentasa (mesalamine). However, I dont have UC, I have crohns. Not ileocolitis but ileitis... The affected area of my intestines is my ileum only, my large intestine has never showed any inflammation.
My understanding is that pentasa is for the large bowel?

Can anyone shed light on this?
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02-26-2018, 05:31 PM   #2
ronroush7
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I have Crohn's disease and use mesalasine in another form called Lialda.
02-26-2018, 05:33 PM   #3
Womble
 
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Yep I was on it too for ileal
02-26-2018, 06:57 PM   #4
Scipio
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I know I need to direct this question to the doctor (and I will). I just wanted to hear from you

I've been prescribed Pentasa (mesalamine). However, I dont have UC, I have crohns. Not ileocolitis but ileitis... The affected area of my intestines is my ileum only, my large intestine has never showed any inflammation.
My understanding is that pentasa is for the large bowel?

Can anyone shed light on this?
You are absolutely right that mesalamine is primarily for UC and often not much good for Crohn's, but some docs still frequently try it out first since it's a mild drug. So wouldn't necessarily say that you have been given "wrong" drug so much as you have been given a weak drug that has a low probability of success.

Your doc may well be following the traditional "step up" approach of (after an induction round of corticosteroids) starting with the mildest maintenance drugs first and working up to the harder stuff if and when the weaker drugs fail. The usual steps are 1. Mesalamine --> 2. Immunosuppressants (6-MP, azathioprine, or methotrexate) --> 3. Biologics (Remicade, Humira, Stelara, etc.).

"Step up" may be the correct approach if your disease is quite mild. But the more modern approach, especially for moderate or severe disease, is the "top down" approach of hitting it with the biologic heavy artillery very early on to limit the permanent damage and thus reduce the likelihood of later surgery.

The main thing that often works against the use of the "top down" approach is insurance companies (in your case the NHS). They often will not approve the use of the expensive biologics until after the weaker, milder drugs have failed.
02-26-2018, 11:36 PM   #5
KenK
 
Join Date: Mar 2008
One of my former co-workers has UC and takes Lialda, says it works great for him.
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