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Lialda vs Asacol
Introduction
For patients with inflammatory bowel diseases such as ulcerative colitis, certain drugs that control inflammation within the colon can help in managing symptoms and inducing remission. Lialda and Asacol are two such drugs that are prescribed for this condition. They each impact different aspects of the disease but both have anti-inflammatory effects on patients with ulcerative colitis. Lialda is a delayed-release medication designed to deliver the active ingredient mesalamine directly to the colon, which helps manage inflammation at its source. On the other hand, Asacol also contains mesalamine, but it's delivered via an enteric-coated tablet designed to breakdown and release medication specifically in areas of the digestive tract affected by inflammation.
Lialda vs Asacol Side By Side
| Attribute | Lialda | Asacol |
|---|---|---|
| Brand Name | Lialda | Asacol |
| Contraindications | Should not be used by patients with kidney disease unless directed by a healthcare provider. May worsen symptoms in some individuals. | Should not be used by patients with kidney disease unless directed by a healthcare provider. May worsen symptoms in some individuals. |
| Cost | For 120 tablets of Lialda (1.2 g) averages around $1,200, approximately $30–60/day depending on dose. Generic mesalamine ER can range from approximately $0.50 to $3 per day. | For 100 capsules of Asacol HD (800 mg) averages about $600, meaning each daily dosage would cost roughly between $12-$24. Generic mesalamine ER can range from approximately $0.50 to $3 per day. |
| Generic Name | Mesalamine | Mesalamine |
| Most Serious Side Effect | Signs of kidney problems, decrease in white blood cell count, severe stomach and abdominal pain with bloody diarrhea, chest pain, shortness of breath, unusual tiredness, allergic reactions. | Allergic reactions, unusual bleeding or bruising, severe nausea, blood in stools, chest pain, increased thirst and urination, rapid heartbeats. |
| Severe Drug Interactions | Drugs like azathioprine or mercaptopurine can potentially interact. | Drugs like azathioprine or mercaptopurine can potentially interact. |
| Typical Dose | Oral dosages typically range from 1.2–4.8 g/day, with 2.4 g/day being sufficient for most patients. | Generally begins with a dosage of 800 mg to 1600 mg orally three times per day, up to a maximum of 4800 mg/day. |
What is Lialda?
Mesalamine (the generic name for Lialda) was a significant development in the treatment of ulcerative colitis, an inflammatory bowel disease. Mesalamine works by inhibiting the production of certain chemicals that cause inflammation in the colon and rectum, thereby reducing symptoms like diarrhea, bleeding and stomach pain. It was first approved by the FDA in 2007 as Lialda. Unlike other treatments which need to be taken multiple times a day, Lialda's once-daily dosing provides convenience for patients.
On the other hand, Asacol is another form of mesalamine which requires more frequent dosing during the day. Both drugs have few side effects since they work locally within your gut rather than systemically throughout your body. However, though rare, both can potentially affect kidney function so regular monitoring may be required.
What conditions is Lialda approved to treat?
Lialda is approved for the treatment of different forms of ulcerative colitis:
- Active mild to moderate ulcerative colitis, which involves inflammation and ulcers in the lining of the colon and rectum
- Maintenance of remission in patients with ulcerative colitis, helping them manage their symptoms over a longer period.
How does Lialda help with these illnesses?
Lialda aids in the management of inflammatory bowel diseases, such as ulcerative colitis, by increasing the amount of mesalamine available in the intestinal tract. It does this by releasing it slowly over time so levels can be maintained higher for longer periods. Mesalamine is a type of anti-inflammatory drug that works directly on the lining of the gut to reduce inflammation and prevent further damage caused by these conditions. Inflammation in these cases is thought to be due to an overactive immune response causing harm to one's own cells. Therefore, by increasing mesalamine, Lialda can limit negative effects like discomfort and help patients manage their condition more effectively.
What is Asacol?
Asacol, the brand name for mesalamine, is an anti-inflammatory drug used to treat ulcerative colitis and to maintain remission in patients with this condition. This medication works by reducing inflammation in the colon, allowing damaged tissue to heal and preventing symptoms such as diarrhea, abdominal pain, and rectal bleeding. Asacol was first approved by the FDA in 1987. It doesn't suppress the immune system like some other drugs for inflammatory bowel disease (IBD). Instead it targets a substance in your body called prostaglandins which are part of the inflammatory process. Its side-effect profile is also different from immunosuppressants; it's less likely to cause severe infections or lymphoma (a type of cancer), common risks associated with stronger IBD medications. The effects on prostaglandins can be beneficial for treating IBD symptoms particularly for those who don't respond well or want alternatives beyond "typical" immunosuppressive drugs.
What conditions is Asacol approved to treat?
Asacol is an FDA-approved medication used in the treatment of:
- Ulcerative colitis, a chronic disease that affects the large intestine
- Proctosigmoiditis, inflammation of the rectum and sigmoid colon
- Proctitis, inflammation of the lining of the rectum
How does Asacol help with these illnesses?
Asacol, like Lialda, is a type of medication known as an aminosalicylate and is used to treat ulcerative colitis, an inflammatory bowel disease. It works by reducing inflammation in the intestines which helps to lessen symptoms such as diarrhea, rectal bleeding and stomach pain. Asacol has been designed for targeted release in the gut, thereby ensuring that it delivers its anti-inflammatory action directly at the site of inflammation. Its action on various chemicals produced by the body during inflammation plays a key role in its effectiveness as an anti-inflammatory drug. If patients do not respond well to other forms of treatment or have specific requirements due to their condition's severity or location within the colon, Asacol may be recommended over other treatments such as Lialda.
How effective are both Lialda and Asacol?
Both mesalamine (Lialda) and Asacol have well-established histories of success in treating patients with ulcerative colitis, being approved by the FDA just a few years apart. Since they act on similar mechanisms, they may be prescribed interchangeably depending on specific patient needs. The effectiveness of Lialda and Asacol in managing signs and symptoms of ulcerative colitis was directly studied in numerous clinical trials; both drugs demonstrated comparable efficacy in reducing inflammation as well as promising safety profiles.
A 2007 review indicated that mesalamine is effective at inducing remission from the first week of treatment, that its side effect profile is favorable over many other treatments for inflammatory bowel disease and it's generally well-tolerated even among elderly populations or those with kidney issues. Mesalamine has become one of the most widely prescribed medications for managing ulcerative colitis due to its proven history and study into its effectiveness at treating this condition.
In 2016, a meta-analysis showed that Asacol seems to be more effective than placebo in maintaining remission among patients with quiescent ulcerative colitis, exhibiting similar efficacy to other common maintenance therapies. Nonetheless, Asacol is typically considered an essential part of a comprehensive treatment plan which might involve additional therapies such as corticosteroids during flare-ups. Significant research on its use involves co-prescription alongside these supplementary treatments so data confirming its efficacy alone would need further exploration. However, given their distinct delivery systems - Lialda being once daily dosing versus multiple doses per day for Asacol - choosing between them often depends upon patient lifestyle considerations.
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At what dose is Lialda typically prescribed?
Oral dosages of Lialda typically range from 1.2–4.8 g/day, depending on the severity of symptoms and individual patient response; however, studies have shown that a dosage of 2.4 g/day is sufficient for treating mild to moderate ulcerative colitis in most patients. Children should only use this medication under the direct supervision of a healthcare provider who will determine appropriate dosage based on their weight and disease severity. For both adults and children, if there's no significant improvement after several weeks, the doctor may consider increasing the dose or switching treatment strategies altogether. It is crucial not to exceed a maximum daily dose of 4.8 g without medical consultation.
At what dose is Asacol typically prescribed?
Asacol, used to treat ulcerative colitis, generally begins with a dosage of 800 mg to 1600 mg orally three times per day. This dose can be increased up to a maximum of 4800 mg/day divided into three doses if there's no improvement in symptoms after several weeks. In most cases, the therapeutic effect is noticed within 3-21 days of starting therapy at this level. However, remember that you should always follow your doctor's instructions and never exceed the recommended daily dose without medical consultation.
What are the most common side effects for Lialda?
Common side effects of Lialda may include:
- Headache
- Gas, bloating
- Stomach pain or cramps
- Diarrhea, constipation
- Flu-like symptoms (fever, chills)
- Dizziness and fatigue
- Skin rash or itching
- Nausea and vomiting
- Joint pain
While Asacol can cause similar side effects such as headaches, gastrointestinal discomfort (nausea, diarrhea), joint pain and skin rashes. However, it might also lead to unwanted side effects like hair loss and changes in liver function tests. It's important to discuss these potential side effects with your doctor when choosing between the two medications.
Are there any potential serious side effects for Lialda?
While Lialda and Asacol are both used for the treatment of ulcerative colitis, they may have different side effects in rare cases. For Lialda, these could include:
- Signs of kidney problems such as change in the amount of urine
- Symptoms related to a decrease in white blood cell count like fever, sore throat or fungal infection
- Severe stomach and abdominal pain accompanied by bloody diarrhea
- Chest pain, shortness of breath or unusual tiredness which can be signs of heart conditions
- Allergic reactions that manifest as hives; difficulty breathing; swelling around the face, lips or tongue
If you experience any symptoms like these while taking Lialda, it's important to contact your healthcare provider immediately.
On the other hand with Asacol use watch out for:
- Any allergic reaction including itching/swelling (especially on face/tongue/throat), severe dizziness and trouble breathing.
- Unexpected bleeding/bruising or signs pointing towards low blood cell counts such as persistent sore throat and frequent infections
- Kidney issues indicated by changes in amount/color of urine.
You should seek immediate medical help if you encounter any severe side effects after consuming either medication.
What are the most common side effects for Asacol?
Common side effects of Asacol may include:
- Headache, dizziness
- Abdominal pain, cramping and bloating
- Nausea or vomiting, loss of appetite
- Diarrhea or constipation
- Mild skin rash
- Fatigue and sleep problems (insomnia)
- Muscle or joint pain.
It's also worth mentioning that some patients have reported experiencing hair loss during treatment with Asacol. It's important to note that these side effects are not experienced by everyone taking the medication - they can vary greatly from person to person based on various factors. Always consult your healthcare provider for medical advice tailored to your individual circumstances.
Are there any potential serious side effects for Asacol?
A small number of people using Asacol may experience serious side effects. Such symptoms, which warrant immediate medical attention, include:
- Signs of an allergic reaction such as hives, itching or skin rash; difficulty breathing; swelling in the face, lips or throat
- Unusual bleeding or bruising; purple or red pinpoint spots under your skin
- Severe nausea, upper stomach pain that might spread to your back accompanied by a loss of appetite and rapid weight loss
- Blood in stools or change in bowel movements
- Chest pain particularly when you breathe, wheezing and other signs of lung problems
- Increased thirst and urination indicating kidney problems
- Rapid heartbeats
If any of these symptoms occur while taking Asacol reach out to your healthcare provider immediately.
Contraindications for Lialda and Asacol?
Both Lialda and Asacol, along with most other medications for ulcerative colitis, may worsen symptoms in some individuals. If you notice your condition worsening or experience severe side effects such as cramping, bloody diarrhea, fever, headache or rash while taking these drugs, please seek immediate medical attention.
Neither Lialda nor Asacol should be used if you are taking certain types of medications. Always inform your doctor about any medication you are currently using; drugs like azathioprine or mercaptopurine can potentially interact with them. Moreover, both of these medications should never be taken by patients who have kidney disease unless directed by their healthcare provider due to the risk of further renal impairment.
How much do Lialda and Asacol cost?
For the brand name versions of these medications:
- The price for 120 tablets of Lialda (1.2 g) averages around $1,200, which works out to approximately $30–60/day depending on your dose.
- The price for 100 capsules of Asacol HD (800 mg) averages about $600 meaning each daily dosage would cost roughly between $12-$24.
So, if you are taking a higher dosage range for Lialda (i.e., 4.8 g/day), then brand-name Asacol is comparatively less expensive on a per-day treatment basis. However, remember that cost should not be the primary factor in determining which medication is right for you.
In terms of generic alternatives, mesalamine extended-release capsules (generic option similar to Asacol HD and Lialda):
- Mesalamine ER (400 mg tablets) can be found in packs of 30 and above with costs ranging from approximately $0.50 to $3 per day for dosages between 800 mg/day and up to maximum dose recommended as per doctor's prescription.
- For larger quantities like packages containing up to several hundred doses, the cost may reduce slightly due to volume discounts offered by some pharmacies or retailers.
Remember prices will vary based on location and pharmacy chosen along with potential insurance coverage adjustments. Always discuss options with your healthcare provider before making any changes in your medication regimen.
Popularity of Lialda and Asacol
Mesalamine, available under brand names such as Lialda and Asacol, is commonly prescribed for the treatment of ulcerative colitis.
In 2020, mesalamine in the form of Lialda was estimated to have been prescribed to about 1 million people in the United States. Lialda accounted for just over 25% of all mesalamine prescriptions in the US that year.
On the other hand, Asacol (also a formulation of mesalamine), was prescribed to an estimated 600 thousand people in America during that same period. This represents roughly around 15% of total mesalamine prescriptions within the country. The prevalence of both these medications has remained fairly steady over recent years due to their efficacy and tolerability among patients with inflammatory bowel disease.
Conclusion
Both Lialda (mesalamine) and Asacol (also mesalamine) have long-standing records of usage in patients with ulcerative colitis, and are backed by numerous clinical studies indicating that they are more effective than placebo treatments. Due to their similar active ingredient, they work primarily by reducing inflammation in the colon.
Lialda is typically administered once daily while Asacol is usually taken twice or three times a day due to differences in the drug's delivery system within the body. The choice between these two may depend on patient's preference for dose frequency and cost considerations as both drugs are available in generic form which represents significant savings especially for those paying out-of-pocket.
The side effect profiles for both medications are quite similar since they share an active ingredient - common side effects include headache, gas, stomach pain, or diarrhea. Both Lialda and Asacol require careful monitoring particularly when starting treatment; any signs of acute intolerance syndrome such as cramping, abdominal pain, bloody diarrhea should be reported immediately to a healthcare professional.
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Refrences
- Claussen, D. (1992, August). Asacol (Mesalamine). Gastroenterology Nursing. Ovid Technologies (Wolters Kluwer Health).http://doi.org/10.1097/00001610-199208000-00007
- Yang, L. P. H., & McCormack, P. L. (2011, January). MMX® Mesalazine. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11205870-000000000-00000