Ulcerative Colitis Meds Compared: Lialda vs Apriso vs Asacol + More
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An ulcerative colitis diagnosis can be both helpful and frightening.
On the one hand, being able to put a name to the symptoms you’ve been experiencing and having a path forward can make you feel more balanced than you’ve been in years. Knowing that you’re not alone, and that 600,000-900,000 people in the United States alone also have ulcerative colitis, can be steadying.
On the other, realizing that you could experience these symptoms for years to come (if not for the rest of your life) can be scary.
Fortunately, there are treatments available that can help you manage ulcerative colitis very effectively—giving you back your freedom and the sense of feeling in control of your day.
The right medication can help you calm otherwise debilitating flare-ups and help you achieve a sustainable day-to-day experience with ulcerative colitis.
But which medication is best for you?
Here, we’ll go through your options—from Lialda and Apriso to Asacol and others. If you have a good understanding of the benefits, side effects, and costs associated with these medications, you’ll be better poised to make an informed decision about your treatment.
Foundational Information: What Is Ulcerative Colitis?
Ulcerative colitis can look very different for each person, but the condition generally boils down to inflammation.
When a person’s colon—an integral and lower part of the digestive tract—is chronically inflamed, that can cause a range of symptoms for the person in question.
The symptoms of ulcerative colitis can include:
- Abdominal pain
- Diarrhea
- Rectal bleeding
- Fatigue
It’s important to note that UC is very different from just having a “sensitive gut.”
Dr. Brynna Connor, M.D., a board-certified family medicine physician who specializes in regenerative medicine, notes that “While everyone experiences stomach or intestinal problems occasionally, some people's digestive systems are more sensitive to certain foods or habits, leading to pain, discomfort, or other symptoms on a regular basis.”
Without treatment, people with UC experience symptoms that can quickly wreak havoc on their ability to navigate normal life.
Ulcerative colitis—or UC—treatment can help mitigate these symptoms quite effectively by reducing the underlying inflammation. Some patients may require a combination of effective medications to achieve remission, maintain remission, and keep their symptoms at bay.
What Medications Are There For Ulcerative Colitis?
There are a few different types or classes of medications that doctors may recommend for people with ulcerative colitis.
Each of these medications will attack your UC from a different angle, attempting to manage different aspects of the way the disease operates.
There are three different groups of medications that people use to treat ulcerative colitis. They include anti-inflammatory drugs, corticosteroids, and immunomodulators.
5-ASA (Aminosalicylates) Drugs – Anti-Inflammatories for US
5-ASA drugs are usually one of the first lines of treatment for people who have either mild or moderate ulcerative colitis. These drugs reduce inflammation in the colon’s lining.
Some of the more common 5-ASA drugs that you’ll hear about include the following.
Lialda for Ulcerative Colitis
Lialda (mesalamine delayed release), is an extended-release drug formulation that should target and treat colon inflammation specifically. One of its unique value adds is its once-daily dosing, which is both convenient and a helpful strategy for ensuring treatment adherence.
Lialda does come with a few potential side effects, which can include diarrhea, abdominal pain, and headaches—though these should go away with time.
You can buy brand-name Lialda through NorthWestPharmacy.com for about $5.00 per pill.
Asacol for Ulcerative Colitis
Asacol (mesalamine enteric coated) leverages the same general active ingredient as Lialda—mesalamine—but comes with a coated formulation that should release a little further along in the colon than Lialda.
This can make it a good choice for treating a form of colitis called “distal colitis,” which simply refers to where along the colon the troublesome inflammation is.
Asacol can come with a range of side effects including nausea, cramps, and, in some cases, kidney issues.
You can buy brand-name Asacol through NorthWestPharmacy.com for about $3.60 per tablet and the generic for much less!
Apriso ER for Ulcerative Colitis
Apriso ER (mesalamine) is another 5-aminosalicylic acid medication, this time in extended release form. It only needs to be taken once a day.
Patients who take Apriso ER should notice reduced rectal bleeding, constipation, diarrhea with mucus, and stomach pains. Over time, when taken regularly under a doctor’s supervision, Apriso ER should help you get your UC into remission.
You can buy brand-name Apriso ER through NorthWestPharmacy.com for about $6.60 per pill.
Lialda vs. Apriso vs. Asacol: Which is Best for You?
If you’re wondering which of these (or other) medications you should pick, you might feel overwhelmed.
There’s a lot to go through—and we haven’t even detailed all of your options, yet!
As you consider the medications you can pick, remember this, first: Your doctor is the best possible resource to help you make a reasoned, strategic decision for your care. We’re here to get you objective information so you can be an educated patient, but your doctor knows your unique symptoms and goals. Make sure you talk to them as you’re making your decision.
Once you and your doctor are on the same page, some further questions to consider may include:
- Whether you’re interested in a delayed- or extended-release medication or not
- What types of side effects work best for you and your lifestyle
- The strength of the medication you need
- What type of dosing strategy and schedule works best for you
- Any interactions you need to avoid with other medications you may be taking.
Then, as you start taking your chosen medications, make sure to keep a log of your experiences.
This may not seem very substantial as you’re doing it but looking back on a written record of the way that your body responded to a medication can be very powerful.
(It can also help your doctor understand what you may need in an updated medication selection or new dosage strategy).
Further Meds to Treat Ulcerative Colitis
Although the three medications we outlined above are some of the most common UC meds, there are certainly others. If you and your doctor have determined that you need an alternative option, these are some of the medications that you may want to consider.
Pentasa (5-Aminosalicylic Acid)
Pentasa (5-aminosalicylic acid) is a slightly more heavy-duty 5-ASA medication that is designed to treat extensive colon disease.
Asacol and Lialdia, which we touched on above, primarily target the colon for treatment. Pentasa treats both colonic and small bowel UC. If your UC or related inflammation extends beyond your colon, Pentasa may be worth talking about with your doctor.
When compared to heavier-duty medications like corticosteroids, Pentasa comes with pretty minimal side effects.
However, there are some possible side effects to be aware of, which may include diarrhea and bloating while your body gets used to the medication.
You can buy Pentasa for less through NorthWestPharmacy.com!
Imuran (Azathioprine) and Purinethol (Mercaptopurine)
These two medications—Imuran and Purinethol—are part of a class of medications termed “immunosuppressants.” These medications work by slowing or suppressing some parts of the body’s immune system to help reduce inflammation—which is very effective for diseases that are caused in whole or in part by out-of-control inflammation.
With great efficacy does come a greater risk for side effects, though. In some cases, immunosuppressants like Imuran and Purinethol can cause:
- Increased infection risk (after all, you are suppressing the immune system)
- Liver toxicity
- Bone marrow suppression
To make sure that these medications are helping you more than they may be harming you, your doctor will likely want you to commit to regular blood tests.
This can feel complicated, but it’s a good way to have a clear, continued insight into your health and how these medications are contributing to your symptom relief.
You can buy Imuran for about $0.70 per pill and Purinethol for about $4.50 per pill through NorthWestPharmacy.com or their generics for much less.
Entocort (Budesonide)
Entocort (budesonide) is a corticosteroid. It’s a very quick-acting option for reducing inflammation with minimal systemic absorption. This medication works by targeting inflammation located along the digestive tract.
One of Entocort’s benefits is its minimal side effects. Chronic use of systemic corticosteroids traditionally comes with a wide range of side effects, from high blood pressure to weight gain. These are not common—or at least not par for the course—for most patients who take Entocort.
However, even though Entocort is a good option for managing acute UC flare-ups, it’s not necessarily a good idea for longer-term use.
When taken over the long term, Entocort can cause patients to risk adrenal suppression.
You can buy brand-name Entocort through NorthWestPharmacy.com for about $2.50 per pill. Purchase the generic through for a bigger savings still.
Canasa Suppositories (Mesalamine – Salofalk in Canada)
Suppositories may come with a less-than-stellar reputation, but the fact of the matter is simple: If you’re interested in avoiding systemic side effects, it makes sense to treat a condition with a topical agent, right where the condition is.
That’s what a suppository does. Canasa Suppositories (mesalamine) are designed to treat rectal inflammation. If a patient has mild distal colitis or proctitis, Canasa Suppositories may be an effective choice. They will provide a high concentration of the medication directly to a patient’s affected area, which can reduce inflammation and help promote healing.
Usually, if a patient does experience side effects with Canasa, those side effects are both localized and minimal (e.g., mild rectal irritation). These effects should go away as the body gets used to the drug.
You can buy brand-name Canasa Suppositories through NorthWestPharmacy.com for about $2.60 per tablet.
FAQs: Comparing Colitis Meds (And Choosing the Right One for You)
Want to learn more about your options?
Here are some of the top questions we field about the most common UC medications.
What is the Difference Between Lialda and Mesalamine?
Lialda is the brand name; mesalamine is a drug that can reduce inflammation in the colon lining, and is not necessarily branded on its own.
While several drugs may leverage mesalamine as an active ingredient, Lialda’s unique in that it has a once-daily extended-release formulation, which can make taking it very convenient.
If Lialda doesn’t work for you, you may be able to take Asacol, Apriso, or one of the drug’s other formulations.
What are the Side Effects of Lialda?
The side effects of Lialda can include:
- Headaches
- Abdominal pain
- Diarrhea
- (in rare cases) Kidney problems
Your doctor can help you determine strategies to mitigate these symptoms. If you find that a mesalamine-related symptom is not going away or is becoming severe, do not hesitate to contact your healthcare provider.
Lialda vs. Apriso: What’s the Difference?
Lialda and Apriso are both mesalamine-based drugs that doctors prescribe to treat ulcerative colitis. That’s what they have in common—their difference lies primarily in their release mechanisms.
Lialda is designed for once-a-day doses. It releases the drug relatively quickly after dosing, requiring another dose about 24 hours later.
Apriso uses a delayed-release formulation. After dosing, the drug will slowly dispense medication in the colon until the next drug is required.
This can help keep the desired amount of medication in the bloodstream consistent.
How Does Asacol Compare to Lialda and Apriso?
Asacol is a different brand of medication that leverages mesalamine as an active ingredient—as do both Lialda and Apriso. Asacol’s difference is in its coating. Asacol’s enteric outer layer protects it and allows it to dissolve in a very specific time and place—e.g., a little lower in the colon.
This makes it an effective choice for treating distal colitis.
Are Pentasa and Colazal Stronger Options for Ulcerative Colitis?
Pentasa is a medication that treats UC in both the small intestine and in the colon. This makes it a good option for patients who have forms of colitis outside of just the large intestine.
Colazal is another type of 5-ASA drug that can treat mild to moderate UC. It can have different side effects, though it may work otherwise quite similarly.
While these drugs—in particular, Pentasa—may be a bit stronger than other more first-line treatments, they’re not necessarily automatically suited to moderate or severe UC. Instead, each of these medications may be a good fit (or not) depending on your unique symptoms and health goals.
Your doctor can help you determine which of these medications is the best possible option for you!
In Need of a Way to Buy Cost-Effective Colitis Meds?
When you’re ready to purchase your UC medications, whether you’re in need of Lialda or Asacol or Apriso, we’re here to make that easy for you. Our team of customer service representatives is ready to answer any questions you may have about our Canada pharmacy and international drugs offering.
When you’re ready, you can place an order online or over the phone—it’s that simple!
The team at NorthWestPharmacy.com looks forward to serving you!
