medicine not breaking down

I have noticed that my asacol is not breaking down and is being passed in my stool! Is their a reason for this? What can/should I do?

[Jennifer R, RPh]

In general, uncoated tablets are absorbed extensively in the proximal ( beginning )portion of the GI tract; therefore, delayed-release tablets are used to achieve a local effect in the colon. Following oral administration, 20—30% of a dose is absorbed, with peak plasma concentrations achieved in 3—12 hours.  It is specially formulated to release the medicine after it has passed through your stomach into your intestines. If you are finding only the shell that is very common. However, if you are finding full  undissolved tablets in your stool I would then suggest you contact your prescriber.
Best of luck to you.

Jennifer R RPh www.drugstore.com

[daystrom]

Hi there,

I was diagnosed with sigmoidal colitis in 2005, but I reckon that it went unchecked for about 4 years prior to that.  I was initially treated with mesalamine (Asacol) but it had no effect.  My GI guy then hit me with prednisone and that knocked it down.  I have been on Asacol in a prophylactic capacity since (800mg tid).  Does it keep me in remission.  Maybe, but maybe it is the tremendous quantities of fentanyl, diacetylmorphine and morphine I abused as well for all I know :P.

From my somewhat limited research into Asacol, it is tolerated very differently by different people; some sing its praises, others curse it as worsening their condition.  If the tablets are consistently not breaking down in your GI tract, then you might want to discuss other medication options with your gastroenterologist.  Salofalk is one of them, another is Colazal.  There is also a new time-release, once per day formulation of mesalamine on the market called Lialda.  The matrix of that formulation may be better tolerated in your GI tract.  Bottom line is that you have options.

I wish you well, IBD is a total drag.

Ray

[izzay]

I apologize for answering this on anyones behalf. I have no experience with pharmaceuticals but do have professional experience with the controlled-release systems they are combined with. If the drug is extended-release, it is possible it will never entirely digest. Resin-coated tablets, and capsules using capillary diffusion models such as that of ALZA Pharm, can pass without any digestion of the capsule, and minimial digestion of an active compound-impregnated tablet. Other technologies involve a hydrogel surrounding the "payload", which is water-permeable and allows outward diffussion of the payload without any change in the capsule. If the drug is a tablet and is excreted the same size it was ingested in, then you might have a problem. This is all in general, the formulation of your Asacol may differ. I'm sure a pharmacist will have more experience with cases like this.

[daystrom]

Great stuff izzay.  Asacol uses a resin-coated controlled-release mechanism for the record.  I must say that my knowledge of this sort of thing is rather limited, my only experience was some hacking I did with the controlled-release matrix in OxyContin, which is glucose-based and was easily defeated by carmelizing the sugar.  Whatever Endo Pharma has done with their new Opana (oxymorphone) controlled-release tablets has me totally stumped however.  Any insight?  hehe, j/k.

Great info, thanks.

Ray