Is Salofalk better than Mezavant for left-sided Crohn's Colitis?

[nitty]

Hi everyone!

With my consultant's agreement I stopped taking Mezavant tablets about 6 months ago due to feeling generally run down and achey, and this did seem to help me feel better. I am continuing to take 125mg Azathioprine daily.

Unfortunately I started getting rectal symptoms again about a month ago and now need to get them under control. I will follow my nurse's advice to use suppositories for a few weeks first, but I'd rather not use them long-term and would prefer an oral treatment if possible. She has suggested trying Salofalk as she says this is good for disease in the left colon, as returning to Mezavant may just make me feel fatigued again and we should at least try something else first.

I just wondered if anyone had any knowledge about this or if there are any other suggestions out there? This may be a question that those on the forum with UC could also help with.

Cheers!

Nitty

 

[FrozenGirl]

I don't have any real knowledge on Salofalk but I believe Mezavant is good for the left colon as well. I would say try it. Maybe they target the same area but everyone responds differently. There is very little risk so I would say its worth a try.

 

[DustyKat]

Whilst Salofalk will treat the large bowel it is generally recognised as having the most benefit in the terminal ileum (small bowel) and the ascending colon (right colon).

Again, Salofalk may be of benefit to you and certainly worth a try but I would think looking at it formula wise that the Mezavant would have been a better fit.

Dusty. xxx

 

[Lady Organic]

what is the difference between salofalk and mezavant? they look like they are the same ingredient with only 5-asa inside? do they have different location liberation?

on 5-asa suppositaries:
http://www.crohnsforum.com/showthread.php?t=71121

 

[DustyKat]

Do they have different location liberation?

Yes they do. They are developed to be released in different areas of the bowel:

• Pentasa is designed to be released throughout the small and large bowel.
  
• Salofalk in the terminal ileum and ascending colon
  
• Asacol in the large bowel only.

Dusty. xxx

 

[nitty]

Thanks for the replies.

I'm thinking that if Salofalk and Mezavant are both forms of mesalamine then I may have the same side effects with both anyway, and at least I only had to take the Mezavant once a day.

I'm also wondering whether balsalazide might be worth a try as that is meant to be good for left-sided disease and it may differ in how it affects me fatigue-wise. It was suggested to me (by a friend who is a GI specialist and who also has CD himself) as an option a couple of years ago when I first started meds, along with the Mezavant option, preferring the latter due to the dosing schedule.

At the moment I am trying a 6 week course of Pentasa suppositories to see if it is just a localised flare of proctitis that might settle down, but I am assuming that my previous history will mean that I will need an oral treatment eventually, and so I want to have done my homework by the time I see my consultant again.

 

[DustyKat]

Studies seem to indicate that Balsalazide is superior to Mesalamine in inducing remission in UC and is better tolerated than the 5ASA’s. Given that I would think it is well worth a try.

Dusty. xxx

 

[Lady Organic]

Yes they do. They are developed to be released in different areas of the bowel:

• Pentasa is designed to be released throughout the small and large bowel.
  
• Salofalk in the terminal ileum and ascending colon
  
• Asacol in the large bowel only.

Dusty. xxx

thx but what about mezavant? Where is it liberated? is it new on the market?
In 2001 I tried salofalk (1000mg x 4 times/day ) without much luck a few times and I was only rectum and left-sided colitis. I got initial response but lost it very rapidly. After we moved on to sulfasalazine (4 times/day), not much more luck and only partial response again. I tried several times these 2 drugs in 2 years along with prednisone bouts, but no other capsules where tried, like if there were nothing else within these categories...??? After these failed trials, I moved on to purinethol (like Aza). I just wished i had tried the combination with mesalamine enemas (go further up than suppositaries).

Ive just read quickly on Balsalazine which is a form of sulfasalazine right? If this is the case, it is true sulfasalazine would have greater efficacy than mesalamine according to my GI.

 

[nitty]

Thanks Dustycat,

I think that is the line I will take if I have to go back on a 5-ASA again. You don't know if you don't try it!

 

[DustyKat]

Mezavant is large bowel only. I did make a mistake in my previous post, I meant to say that Colazide is released in the large bowel only, not Asacol.

The 5ASA’s are a derivative of Sulfasalazine. Sulfasalazine is made up of two molecules, 5-aminosalicylate (5-ASA) and sulfapyridine and this was the drug that was available first. Unfortunately it did have side effects for many people and studies found that the most of the unwanted side effects were linked to the sulfapyridine molecule. As a result they removed this molecule and thus the 5ASA class of drugs was born.

Dusty. xxx