Sulfasalazine?
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Sulfasalazine?
My doctor wants to wean me from Entocort to Sulfasalazine. Feedback please!
Hi Susie,
Sulfasalazine is a prodrug, that is to say, it does not become active in the digestive system until it is broken down by bacteria in the colon, into 5-aminosalicylic acid, (5-ASA), and sulfapyridine. While sulfapyradine has a therapeutic effect for rheumatoid arthritis, no beneficial effect from sulfapyradine has been observed for treating inflammatory bowel disease. Since many people tend to react adversely to sulfa drugs, sulfasalazine has mostly been replaced with mesalamine, (sometimes referred to as mesalazine, to further confuse the matter), in the treatment of IBDs.
Mesalamine contains the active moiety of sulfasalazine, known as 5-aminosalicyclic acid, while eliminating the sylfapyradine. Mesalamine is a derivative of salicylic acid, which means that it is related to NSAIDs. For many people who have an inflammatory bowel disease, NSAIDs have been shown to stimulate leukotriene production, which can cause inflammation and D. Therefore, virtually anyone subject to an IBD flare because of NSAIDs, will also react adversely to mesalamine and/or sulfasalazine.
Unless you have rheumatoid arthritis, mesalamine is a much safer drug to use, with regard to side effect risks, because many people with MC cannot tolerate sulfa drugs. However, sulfasalazine has been around for a long time, and is cheap to manufacture, so it's priced much lower than mesalamine.
IMO, (and this is strictly my unprofessional opinion), Entocort is far more effective, and generally safer, (especially after the dosage is tapered down to a low maintenance dose), than either sulfasalazine or mesalamine. Mesalamine is known to cause pancreatitis in a few cases, especially with long-term use, and the pancreas is not a good organ to inflame, because of it's vital digestive system functions.
Many GI docs are afraid of Entocort, because it is classed as a corticosteroid, but unlike the other corticosteroids, only up to 19% of the active ingredient, (budesonide), is ever absorbed into the bloodstream, so it is nowhere near as likely to cause the side effect risks of the other corticosteroids. Also, most GI docs are unaware of the risks of mesalamine causing pancreatitis, because that risk only becomes apparent if one does a lot of research on the internet, something that most GI docs seem loathe to do, for some unknown reason.
I hope this helps.
Tex
Sulfasalazine is a prodrug, that is to say, it does not become active in the digestive system until it is broken down by bacteria in the colon, into 5-aminosalicylic acid, (5-ASA), and sulfapyridine. While sulfapyradine has a therapeutic effect for rheumatoid arthritis, no beneficial effect from sulfapyradine has been observed for treating inflammatory bowel disease. Since many people tend to react adversely to sulfa drugs, sulfasalazine has mostly been replaced with mesalamine, (sometimes referred to as mesalazine, to further confuse the matter), in the treatment of IBDs.
Mesalamine contains the active moiety of sulfasalazine, known as 5-aminosalicyclic acid, while eliminating the sylfapyradine. Mesalamine is a derivative of salicylic acid, which means that it is related to NSAIDs. For many people who have an inflammatory bowel disease, NSAIDs have been shown to stimulate leukotriene production, which can cause inflammation and D. Therefore, virtually anyone subject to an IBD flare because of NSAIDs, will also react adversely to mesalamine and/or sulfasalazine.
Unless you have rheumatoid arthritis, mesalamine is a much safer drug to use, with regard to side effect risks, because many people with MC cannot tolerate sulfa drugs. However, sulfasalazine has been around for a long time, and is cheap to manufacture, so it's priced much lower than mesalamine.
IMO, (and this is strictly my unprofessional opinion), Entocort is far more effective, and generally safer, (especially after the dosage is tapered down to a low maintenance dose), than either sulfasalazine or mesalamine. Mesalamine is known to cause pancreatitis in a few cases, especially with long-term use, and the pancreas is not a good organ to inflame, because of it's vital digestive system functions.
Many GI docs are afraid of Entocort, because it is classed as a corticosteroid, but unlike the other corticosteroids, only up to 19% of the active ingredient, (budesonide), is ever absorbed into the bloodstream, so it is nowhere near as likely to cause the side effect risks of the other corticosteroids. Also, most GI docs are unaware of the risks of mesalamine causing pancreatitis, because that risk only becomes apparent if one does a lot of research on the internet, something that most GI docs seem loathe to do, for some unknown reason.
I hope this helps.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thank you Tex, that was the info I was looking for. I had a feeling it was not something I wanted to do. She was worried about me having diabetes. I called in today about my symptoms returning when I went down from 9mg of Entocort to 6. I think she was concerned about increasing back to 9, but I am not sure I want to switch drugs! Susie
If you have diabetes, (or you have a high risk of developing diabetes), you can take chromium picolinate to help protect the pancreas, and prevent the sharp rises in blood glucose frequently seen in people with diabetes who take a corticosteroid.
Tex
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I was put on Sulfasalazine when I was diagnosed with mc in 2007 and it worked really well, but it also caused my white blood count to go down to 700 so they took me off it and put me on Asacol which never worked as well. I didn't know about the diet/mc connection back then. I asked if I had to be careful of what I eat and my doc told me not to eat fried chicken, that was it.
MC diagnosed 2007