Switched from Pentasa to Lialda

[JDTM]

Howdy folks.

Not feeling super great! Not terrible, by any stretch, but I'm curious about others' experiences with this.

My prescription provider changed at work, and I had to go with a less expensive/covered alternative to Pentasa. I went with Lialda, and thus far I don't feel like I'm "flaring," per se, but I've been going to the bathroom more frequently and I've been dealing with gas and burning sensations.

Compounding the problem, I had a pretty gnarly case of acute bronchitis over the holiday, and as a result, I was prescribed a 5-day course of antibiotics and 12 days of a prednisone taper. Naturally, both of those things could have affected my gut as well. (I also stopped taking LDN during that time, as pred and LDN don't play well together from what I've read.)

Has anyone else here made the switch to Lialda and had any problems adjusting?

 

[ronroush7]

Hi, Jessie. My doctor switched me to Lialda. I don't feel like I had any problems. Have you told your doctor what is going on?

 

[JDTM]

Not yet, but I certainly will! Hoping that things settle down as I get back on LDN. Honestly, I was leaning towards the antibiotics/pred one-two punch messing with my guts, so we'll see how I'm feeling once that's all out of my system. I'm glad to hear you didn't have any issues with the switch though.

 

[ronroush7]

If you do antibiotics and you are on probiotics, I have been told to double up on probiotics.

 

[Scipio]

Where in your gut is your disease located? Pentasa and Lialda are both mesalamine but they have different points where the are released and become active (based on pH). Penatasa becomes active in the small bowel and Lialda becomes active at the ileum - the end of the small bowel and in the colon.

So if you have extensive small bowel disease Pentasa was probably better for you. But if you have ileal, ileal-colonic, or colonic disease then Lialda is probably the better choice.

 

[JDTM]

Based on MRI and colonoscopy diagnoses, my disease is primarily (all?) in the TI, but my gastroenterologist definitely had Pentasa in mind originally because it releases higher up in the GI tract, exactly like you said. I was glad to hear that Lialda released in the TI and wasn't solely for the colon (and thus 100% aimed at UC or colonic IBD).

 

[Cat-a-Tonic]

I didn't do particularly well on Pentasa, so my GI switched me to Lialda, and I'm doing better on that. I was on Asacol to start with, but they stopped making regular Asacol in the US, and my body seems unable to break down the giant Asacol HD tablets. I also couldn't break down Delzicol very well - whoever decided to put a tablet inside of a capsule, I would like to have some stern words with that genius. So yeah, I've been on almost all of the 5ASAs at this point - I went from Asacol to Asacol HD to Delzicol to Pentasa and now Lialda. I think Apriso is the only one I haven't been on.

Of course, for me, since I'm not yet fully diagnosed (I have some type of IBD and I seem to have it mainly in the colon, but we don't know which type of IBD), it tends to be a bit of a guessing game with meds. I apparently don't have small bowel involvement since Pentasa didn't do much for me. Long story short, I've done well with Lialda. I haven't been doing super well lately due to frequent recurrent hemorrhoids which bleed like crazy and take forever to heal, but aside from that, I think my IBD might be in remission. If I could just get my hemmie issues under control then I'd be doing really well.

Jesse, you mentioned being on antibiotics, and I know that for me most antibiotics really mess with my guts. So that alone could account for why you are feeling worse. You might want to try a good-quality probiotic for a bit to restore your "good" bacteria that may have been wiped out by the antibiotics. Stopping the LDN probably also contributed to you feeling worse, although I haven't been on LDN myself so I couldn't say for sure. Are you back on it now? And as for the gas and using the bathroom more, it could be holiday food and/or holiday stress also contributing. If it were me, I'd eat safe bland foods for a bit and take some probiotics, and de-stress as much as possible - are you feeling well enough to exercise right now? Even something simple like walking can relieve stress, and can also help with gassiness. I hope that helps. Feel better soon!

 

[Cali01]

I was on asacol & had an allergic reaction to it. I tried lialda instead & it is working well for me. I like that I can take 2 if in remission & more when my Crohn's is acting up. I've found, for me, 2 is not enough to keep me in remission so I take 3 per day unless I'm having more bowel movements or pain, then I take 4.

My main issue with it is that I often get headaches at the end of the day, and/or feel like I'm getting sick with a fuzzy head and/or a sore throat. It all goes away by the next morning, though.

 

[Eridon2002]

I took Lialda when first diagnosed. I don't think it was strong enough for how bad my Crohn's was. Plus sometimes it just shot right through me and ended up in the toilet.