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Asacol discontinued

nogutsnoglory

Moderator
If you take Asacol, please note it has been discontinued. Whatever drugs you have left are the last you will have.

Asacol HD (800mg) is still available and a new drug (same as regular Asacol at 400mg except in capsule form) will replace the existing.

See my post on the news forum about the new drug Delzicol: http://www.crohnsforum.com/showthread.php?t=49761

If you take this drug please call your doctor even if you have refills. From what I understand its off the shelves at pharmacies.

Edit: Here is a direct link: http://www.ashp.org/DrugShortages/No...n.aspx?id=1017

This is right off the Asacol website - http://www.asacol.com/index.jsp

You should not substitute one Asacol HD 800mg tablet for two Asacol 400mg tablets unless directed by your doctor
http://www.asacolhd.com/pdfs/AsacolHDPrescribingInfo.pdf
 
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nogutsnoglory

Moderator
The FDA approved the new drug on Friday. I can't imagine they pulled Asacol off the shelves before the alternative was available. From what I understand a prescription called in now will be denied but maybe they will honor the refill for a few days.

The main thing is anyone on it needs to get their doctors to prescribe Asacol HD as a half dose or get the new drug.
 
If you take Asacol, please note it has been discontinued. Whatever drugs you have left are the last you will have.

Asacol HD (800mg) is still available and a new drug (same as regular Asacol at 400mg except in capsule form) will replace the existing.

See my post on the news forum about the new drug Delzicol: http://www.crohnsforum.com/showthread.php?t=49761

If you take this drug please call your doctor even if you have refills. From what I understand its off the shelves at pharmacies.
Noguts, do you have a link to any article that states Asacol is now off of the market??

But if Asacol HD is still available, that means I take 1 pill, 3 times a day instead of 2 pills, 3 times a day.
 

nogutsnoglory

Moderator
I don't I'm sorry. This was said by one of the experts at an IBD conference I attended. It's possible some GI's won't be aware of the change until pharmacies no longer fill the prescription.
 
Ohhhh no. Something else to worry about. Thanks for the info. At least I have to time to think about what to do.
 

rygon

Moderator
Im assuming it is being discontinued as the patency is running out this year (so Ive read) thus cheaper generic drugs will be coming onto the market
 
I take Asacol HD so I am okay for now. I hope that there will be a cheaper, generic form of Asacol on the market for everyone who needs it. However, I am very suspicious. This new drug, Delzicol, is made by the same company that made Asacol and they are both 5 ASA meslesemane (sp?) drugs.
 
Does anyone know if there is a difference between the Asacol 400 and the Asacol HD besides the 400 mg vs 800 mg? Since it seems to be working for me, I'd rather not change and just get the HD - which means I would take 1 pill three times a day instead of 2 pills three times a day... right?

Thanks. :)
 

Cat-a-Tonic

Super Moderator
!!! I take the Asacol 400 mg and I hadn't heard this! I see my GI in a couple weeks so I will definitely be asking him to switch me to either the HD or that new drug. In the meantime, I guess I will have to do some research on both, because like Sarah50 said, I'm not aware if there are big differences between the 400 and the HD. And I know nothing about this new med, this is the first I'm hearing about it. This seems so sudden, you would think my pharmacist would have said something when I refilled my Asacol a little while ago? I do need to go to the pharmacy today anyway so I think I'll be asking some questions.

Thanks NGNG for the info! I printed that link and will be showing it to the pharmacist and my GI.
 

nogutsnoglory

Moderator
I think it is terrible that there was no prior warning. The new one being a capsule might affect the delivery mechanism. I don't know enough about it or HD since I never took this drug.
 

CrohnsChicago

Super Moderator
Thanks NGNG. I also take Asacol and was not aware. Supposed to call my GI tomorrow for a follow-up. I will make sure he knows too!
 

Cross-stitch gal

Moderator
Staff member
Location
Vancouver,
Took this info into my pharmacy yesterday. They said that they knew that they no longer were stocking the asacol 400 but, didn't know much more. My guess is that this is a sudden change on everybody.
 

Cat-a-Tonic

Super Moderator
I just talked to my pharmacist, and he wasn't too sure of things. He said he thinks that he can just switch me to the 800 HD without my GI writing a new prescription, but he wasn't totally sure. He said he'd research it and will get back to me. I think I'm going to email my GI now and get his thoughts. I see him in a couple weeks but I will be running out of Asacol 400 around that time and don't want to be too last-minute with this stuff.
 

nogutsnoglory

Moderator
Thanks Paso. I definitely think it would be unwise to just start a different formulation without talking to the doctor.

Can I just say how much big pharma sucks! Ok off my needle meds disposal soap box.
 

Cat-a-Tonic

Super Moderator
Huh, interesting. The pharmacist made it sound like Asacol 800 vs 400 are pretty much the same thing. But apparently not quite! I emailed my GI to get his thoughts. I wonder if he's being inundated with calls & emails from other Asacol patients who are freaking out too. Pretty glad I have an appointment in a couple of weeks so I can discuss this in person!
 

CrohnsChicago

Super Moderator
Now that I think about it...I wondered why Asacol didn't have a detailed web site the other day...there was only one for Asacol HD. It all makes sense now. And from the sound of the Asacol HD web site your doc will have to readjust your dosage.
 
You can buy the ASACOL GENERIC from any Canadian Pharmacy.
Been buying it for a year. My daughter who takes it
say's it works better than name brand. and alot cheaper.
It is made by Sun Pharma the same company that will be selling it at Walgreens
 

Cat-a-Tonic

Super Moderator
I just did some googling on Delzicol, that new mesalamine drug that's replacing Asacol. I thought this was particularly relevant info: "Drug interactions: Azathioprine or 6-mercaptopurine: blood disorders have been reported." So if anyone is on Aza/imuran or 6MP, this new mesalamine is apparently not for you.

I got that info here:
http://www.wcrx.com/pdfs/pi/pi_delzicol.pdf

Edited to add: It also says "Dose at least 1 h before or 2 h after a meal." I have always been told to take my Asacol with food, so if I have to switch to this new med, it's going to throw off my whole schedule. I've grown so accustomed to "eating = take Asacol".
 

CrohnsChicago

Super Moderator
Well apparently this isn't for me....lol

Thank you Cat for sharing that info and the link! Looks like me and my GI have some discussing to do....

I just did some googling on Delzicol, that new mesalamine drug that's replacing Asacol. I thought this was particularly relevant info: "Drug interactions: Azathioprine or 6-mercaptopurine: blood disorders have been reported." So if anyone is on Aza/imuran or 6MP, this new mesalamine is apparently not for you.

I got that info here:
http://www.wcrx.com/pdfs/pi/pi_delzicol.pdf

Edited to add: It also says "Dose at least 1 h before or 2 h after a meal." I have always been told to take my Asacol with food, so if I have to switch to this new med, it's going to throw off my whole schedule. I've grown so accustomed to "eating = take Asacol".
 
This doesn't affect me personally but I am angry about it. This pharmaceutical company knew that its patent was runnning out so they basically changed its name to keep the patent going. Asacol was not cheap and I am sure that people were hoping to get the generic version of it. I bet Delzicol will be even more expensive than Asacol.
 

Cat-a-Tonic

Super Moderator
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).
 
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).
Cat - call Walmart and ask how much they will charge with whatever you switch to - Asacol HD or the new one. I pay $30 a month for Asacol at Walmart (after paying a $180 deductible the first of the year).
 

Dexky

To save time...Ask Dusty!
Location
Kentucky
My son's been on the 800mg Asacol for over two years now. We went to pick up our script once and they gave us the 800mgs instead of 400. When asked, our GI said it was no different than two 400s. There's been no trouble with it.

@Cat…if Asacol is working for you now, I'd push to switch to the 800's. If it ain't broke...
 

Cat-a-Tonic

Super Moderator
Thanks Mark. I'm going to check with my GI to be sure and to get his thoughts. I do have slight issues with the Asacol 400s - sometimes I pass them undigested. With my severe GERD, the more reflux meds I take, the more Asacol I pass. It needs a certain pH to break down, and if I mess with my stomach acid too much then I just can't seem to break down Asacol. So I am somewhat intrigued by this new Asacol replacement med because it's a capsule, not a tablet. I've heard others on the forum say that they pass Asacol undigested but can break down Pentasa just fine (Asacol's a tablet and Pentasa is a capsule), so maybe capsules in general are easier to digest. My GI knows I've had some issues with passing Asacol undigested so I want to hear his thoughts on the new capsule drug.
 

Cat-a-Tonic

Super Moderator
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?
 

CrohnsChicago

Super Moderator
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.
 

Cat-a-Tonic

Super Moderator
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.
 

Cat-a-Tonic

Super Moderator
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.
 

CrohnsChicago

Super Moderator
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.
 

nogutsnoglory

Moderator
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.
 
@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.
 
The new Asacol...Delzicol

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.
 
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)
 
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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Artisan105

Yondaime
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. :]
 
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.
 
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
 
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!
 
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?:ybatty:
 

Cat-a-Tonic

Super Moderator
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.
 
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! :ybatty:
 
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.

???????
 

CrohnsChicago

Super Moderator
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?
 

Cat-a-Tonic

Super Moderator
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.
 
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.
 

CrohnsChicago

Super Moderator
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 :yrolleyes: lol. I'll be starting them sometime later next week.
 
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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.
 
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.
 

CrohnsChicago

Super Moderator
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"....
 

Artisan105

Yondaime
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 :)
 

Cat-a-Tonic

Super Moderator
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-a-Tonic

Super Moderator
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. :p 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.
 
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.
 
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.
 
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. :yrolleyes:
 
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.
 

Cat-a-Tonic

Super Moderator
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.
 
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!!! :(
 

CrohnsChicago

Super Moderator
Thankfully there is no cost difference in the Asacol HD. Started it today. We will see how well it works with fewer, larger pills....
 

Cat-a-Tonic

Super Moderator
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.
 
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.
 
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.
 

CrohnsChicago

Super Moderator
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 :hug:
 
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!
 

CrohnsChicago

Super Moderator
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.
 
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!
 
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.
 
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?????? :ybatty:
 

Cat-a-Tonic

Super Moderator
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).
 
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! ;)
 
:hallo3:
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!:eek2:
 
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?
 
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.
 
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.
 
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. :smile:
 
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. :smile:
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!
 

Cat-a-Tonic

Super Moderator
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.
 
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?
 
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?
I think you may be stuck having to switch to a different brand of mesalamine such as Lialda or Pentasa. Call your insurance company and find out which brands they do cover and go from there. That really sucks!!
 
I think you may be stuck having to switch to a different brand of mesalamine such as Lialda or Pentasa. Call your insurance company and find out which brands they do cover and go from there. That really sucks!!
Thanks, wow both of those are covered. I will have to contact him to see if I can use them. Thanks! I will have to stretch out the few remaining tabs I have to cover however long it takes. What really annoys me is that Medco recommended the Dezicol as a replacement for me so my doctor wrote that script. Then they denied it a week later.
 
I live in New Hampshire and have bee taking Asacol for 15 plus yrs. for ulcerative Colitis. I was told last month that Asacol was being taken off the market because it was found to have cause birth defects! I am 55 yrs. old I don't think I will be having any more children. So I was given Lialda which is less expensive for me than Asacol was. But Asacol kept me from having flare ups so I really didn't want to change. But my Dr. prescribed Lialda since Asacol wasn't available here in New Hampshire. I have a friend who lives in Maine that just picked up her 3 month supply of Asacol!! So what the heck is that all about?
 
She didn't get it from a mail order! But from her local pharmacy! And that was a good 3 weeks after I was told it was taken off the market!
 
It *is* discontinued, but whatever quantity was manufactured hasn't all been used up, so many pharmacies still have some on hand, but will not be getting any more once it is gone.
 
Lallx4: Similar to you I have taken Asacol for 10+ years and it seems to keep my Crohn's-Colitis in remission. When I went to my doctor to give me a new prescription for Delzicol - he did not know it existed and did not know Asacol was discontinued. I knew because I got a letter from my pharmacy. I showed him the letter. The Delzicol was so new it was not even in his computer list of drugs yet. So he manually wrote a prescription for Delzicol based on the letter I had from the pharmacy. I've been taking it for about two weeks now and so far so good.

Whichever prescription you end up with I hope it continues to work for you and your able to stay in remission. I wish you well.
 
Find it a little interesting that this occured a few months before the patent would run up. In july and the new drug Delzicol will attain a brandy new patent. Seems a bit suspicious
 
i read that the "problem" was it could cause some fertility issues. however that was at 190 times the normal dose that would be given to humans.
 
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