Long Term Maintenance Therapy

Inducing a remission can be a challenge and long-term remission is an important goal for all patients. Both sul-fasalazine and the newer generation of 5-ASA preparations are comparably effective for maintenance of remission. Effective 5-ASA maintenance doses are usually in the range of 2 to 4 g/d of sulfasalazine (Azulfidine), 2 to 4 g/d of Pentasa (available as 500 mg capsules), 2.4 to 4.8 g/d of

^Editors Note: AZA/6-MP dosage variation based on TPMT and later 6-TG/6-MMP levels can also be used. There is a separate chapter on this approach.

Asacol (available as 800 mg tablets), 1 g/d of olsalazine (Dipentum), or 6.75 g/d of balsalazide (Colazal). Another benefit is that recent studies have demonstrated an association between maintenance treatment with an oral 5-ASA drug (over 1.2 g) and a reduction in the risk of colorectal cancer in patients with UC (Eaden et al, 2000). For patients who eventually require immunomodulatory therapy with AZA/6-MP, these drugs should be continued indefinitely. It is usually unnecessary to continue 5-ASA along with AZA or 6-MP. For most patients, a lifelong maintenance treatment program will prove beneficial and should reduce the frequency of flares considerably (Kamm, 2002). Frequent flares despite adequate doses of maintenance medications are an indication for colectomy

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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