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Asacol is a brand name drug which is known in the generic world as mesalamine. This medication is often prescribed to ulcerative colitis patients early on during the treatment phases.  Some people use this drug as their maintenance drug for many months or even years.

Asacol is unique in that unlike some other medications, it is made with a special outer capsule that enables it to travel through much of the gastro intestinal tract intact before it starts to release itself.  Basically, the outside of the pill doesn’t break down early on, it is supposed to make its way near your colon before it releases its medicine inside. When I was prescribed this medication, I was told that the pill only releases itself once it hits a certain Ph level that exists only in the colon…

There are several different mesalamine medications on the market, and Asacol might very well be one of the most expensive.  If medications costs/health insurance are a factor, you might want to talk with your doctor to see if there are alternatives that your doctor might recommend.  As asacol is taken orally, there are also other medications which are similar and mesalamine based which are prescribed as enemas and suppositories.

asacol medication

asacol pills

Asacol is a medication which is considered an anti-inflammatory medication.  One of its main goals is to try and stop our bodies from creating other substances which produce inflammation and or pain.

One thing to note is that before you start taking Asacol, be sure to tell your doctor if you have any type of known allergic reactions to Aspirin.  Asacol is very similar to Aspirin and you should definitely let your doctor know if you can’t tollerate it before starting on Asacol.

As for people who have had success from Asacol alone for treating their ulcerative colitis, it surely does happen.  It wasn’t the case for me, but I am just one particular case.

If you have had used or are using asacol and want to share a comment below on how its going/went for you, feel free.

35 thoughts on “Asacol”

  1. Catherine

    I’ve been on mesalamine (under the brand name salofalk) in various forms since being diagnosed in November 2009. I started on enemas as my UC was lagely isolated in the colon and lower left side. I thought I had cramps before, but wow. Apparently it’s not all that common and can be a reaction to either the drug, or the enema. It’s also one of the least invasive and least systematic way of dealing with isloated lower left UC. I persevered for a couple of weeks, but then couldn’t take it anymore. My dr was away so I went untreated for a couple of weeks (please don’t do this, ever. See a GP, turn up at your specialists office and cry until they find someone else to see you, anything), ended up on massive doses of pred from an after hours GP.

    Then I tried salofalk granules (like little vanilla flavours hundreds and thousands), which didn’t seem to do much either and I crashed again as I weaned off the pred. So then upped the dose of the granules and added azathioprine. Again, everything fell to pieces when I weaned off the pred. Then as it seemed like I was going to be on steroids for a while, I went from pred to entocort, which didn’t seem to help either and I ended up in hospital for a week, tried the entocort again and back in hospital again. Then I was back on to pred and salofalk foam (basically enemas but foam instead of liquid – meant to be easier to handle, also started remicade at the same time (and still on the granules and azathioprine). This cocktail got everything under control and I successfully weane off the pred during my 3 doses of remicade. I also started SCD at the same time.

    Everything was going pretty well for a few months, at least I thought so. I had some loose BMs, but thought that was prety normal given how much fruit and veg I was eating. To cut a long story short, I had a flare a couple of weeks ago, and went back on the SCD intro diet. I’ve added spinach, yoghurt and applesauce and am adding pork for dinner tonight (mmm, solid food) and all seems to be going well.

    1. Wow Catherine,
      You have done an incredible amount of mesalamine! It seems like you just might have done every possible combination. Thanks so much for sharing your story about this. I hope things go well for you with your current attempt with the intro diet, and espcially with some pork tonight! best of luck and keep us posted!!

  2. I was diagnosed with severe UC back in 2004 and put on Asacol by my doctor. It made my symptoms worse at first but when I lowered the dose then it was livable. Asacol is an anti-inflammatory drug so all it does is reduce inflammation. It did nothing for the pain of colitis nor did it do anything to actually heal my intestines or cure the problem that was causing my symptoms (yeast and fungal overgrowth). It wasn’t until I discovered the Specific Carbohydrate Diet and understood what was causing the imbalance in my intestines and worked to bring my gut back into balance that my ulcerative colitis was healed – without meds. I’ve been symptom free and med free ever since. I’m glad to hear the the SCD worked for you also. Keep spreading the word and saving people’s colons!

  3. Asacol has been like a miracle drug for me. I’ve got total moderate UC, and was in a horrible state having been misdiagnosed with having ‘food poisoning’ for 2 weeks. Finally saw another doctor, practically thrown at the specialist within hours, colonoscopy for diagnosis, and bam: six daily Asacol 800mg tablets have REALLY helped. I have reduced my diet really dramatically to help it all heal, and gradually adding back in various foods. What’s really shocking is that if I ever forget to take the pills, there’s an immediate effect, so they are doing a great job.
    I do have some horrible secondary symptoms like sleeplessness and dizziness where it’s hard to say if it’s the condition or the Mesalazine causing it.
    But it really is astonishing how quickly and successfully it worked. I feel very lucky.

    1. Gaby:

      Your story is basically identical to mine. I ate some chinese food and figured I had food poisoning. Two weeks turned into a month, and finally I got a referral to a gastro doc and got a colonoscopy. He put me on Asacol and prednisone, eventually tapering the prednisone down to none and Asacol to 2 400mg tablets 3X daily. I can tell if I miss a dose, too (it’s easy to forget the midday dose at work) because my stomach aches a little and starts gurgling. I’ve been symptom free for around a 6 months now after a very light flare this past June

      It’s cool to read someone’s story and have it be just like your own. Good luck!

  4. Punky Demure

    Hey Adam, nice to read some of your information and that of your readers .. Good job!
    I was diagnosed about 7 years ago with mild Colitis .. and I had not a flair up for 5 years …. this was all new info for me .. since my health for over 60 years has been near perfect. I paid no attention and had no flair ups until about ONE YEAR ago .. a little of this and that … to point me to another colonoscopy about one month ago .. Yup, it came back … worse than before .. but with the Asacol .. I am well into my first month of taking it .. and I am seeing a great result … I do read up on WHAT NOT to entice the BAD bacteria, so I am eating very carefully , and back to dancing with Xbox, (thanks for my son’s electronic geekness) and folks the dancing around REALLY has kept me healthier … So my combo is morning exercise, Asatol, and keeping it all silent from down there …. lower left and right colon. Recently, I read the IBD can be a precursor to cancer.. Does anyone know about that? Here’s to Salmon Salad today! Best regards,

    1. Hey Punky,

      Great to hear you are having some nice results with the Asacol. I don’t know the specifics and the exact data, but unfortunately I do think there is a correlation between IBD patients and higher instances of things like colon cancer… but, you might want to talk more with your GI doc to get some better info on that.
      It’s something that definitely crosses my mind from time to time, but I try not to wory about it, since worrying for me, hasn’t been very productive in terms of changing much in my future.

      Either way, maybe you can send over some of that salmon salad my way… you got me hungry!!!


  5. Hey Adam,

    I’m on 3200mg of Asacol in the mornings for my UC. I was diagnosed in October but had a rather severe flare for two years. It took me 18 months to admit something was wrong to my GP and then another 6 months to get my diagnosis. I’m working on regulating my diet and my Gastroenterologist recommended a low residue diet for the first 6 months. I have celiac disease too so eating is a tricky thing. The bleeding has finally stopped, mucus is less but I feel like I’m starving to death.

    I lost just over 100lbs in the last year and though it’s obvious that my inflammation is less (YAY for less diarrhea) I still feel like I need to eat constantly but I feel sick most mornings and can’t eat until noon or so.

    Did you have any of the nausea with the Asacol?
    Glad your UC is in control and YAY for no flares!


    1. Hey Andrea,

      Whats happening! Great to hear from you.
      Wow, lost 100 pounds, that’s alot, I hope that it didn’t make you horribly underweight, cause I know that some people definitely get that way when they are in nasty flares.

      When I was taking the Asacol, I never really noticed any nausea, so i’ve got to say no about that.

      Good luck Andrea, feel free to write in whenever you like. For me concerning the eating etc.. I’ve noticed that once my colon is healed and I’m gaining weight again, my cravings to eat more are much less. I think since so much more is being absorbed, my body is basicaly getting more “bang for the buck” type of idea.

      your UC buddy,

  6. I was diagnosed with UC 4 weeks ago and promptly put on Asacol – unfortunately for me, I had a very rare adverse reaction to the med and ended up in the intensive care for a few days, a week in the hospital altogether. I almost lost my colon due to the med doing the very opposite it was designed for, it ended up exacerbating the uc, my kidneys had begun to shut down. The first sign of the adverse reaction for me was a 102 temp and fatigue. I did speak with the drug company that manufacturers Asacol, it is a great drug with only less than 2% having adverse reaction. I am now on Prednisone, not sure what the maintenance drug will be. Boston hospital,great docs but no one had ever heard of an adverse reaction to Asacol – it is written up in the drug reference handbook.

    1. Hi Corey,
      I’m very sorry to hear about your horrific experience with Asacol. I really hope that you get some relief soon with prednisone. Prednisone is most definitely one of the most commonly prescribed medications to help control inflammation (which I’m sure you’re read about, and it has a much longer history in the medical world, millions upon millions of people have used it before) and hopefully it will help you out with getting things under control. Thanks for sharing your experience, and I wish you the very best. I think it just goes to show, that rare reactions are super tough on patients, and the same is true for medical professionals. But it sounds like you have a great medical group helping you out, and its great that they figured out the Asacol was the problem instead of telling you to up your dose/take more which often happens to others when things aren’t going well. Keep us posted on your progress moving forward. Wishing you the best,

  7. Hello! I was recently diagnosed with UC in July of 2012. I had my first complication with it back in January. I didn’t know what was going on with my body. The symptoms were kind of like a stomach virus. When I visited my doctor I was told that I probably had a virus or food poisoning. My symptoms would go away then return a few days later. I thought I was going crazy especially when my doctor didn’t seem to know what was going on either. Eventually I was referred to a GI specialist who recommended a Sigmoidoscopy. That showed that I in fact had UC. Part of me was happy to finally know what was going on but my other half was scared. I was prescribed Asacol 800 HD and prednisone. It took about a week or so but I immediately noticed the difference. Asacol saved my life. I was actually able to leave my house without being afraid of having to run to the bathroom. I was on the Asacol for a month and a half and then prescribed Lialda. The Lialda was not strong enough. After adding Prednisone to it twice, my GI put me back on the Asacol. Now I am taking Asacol 2 tablets twice a day and one Prednisone once a day. It seems to be doing the trick!

  8. Hi Adam,
    I’ve had Colitis for 24 Years. I had been off all meds and flare up free for the last 5 years and I thought I had crossed into the land of complete recovery until recently when I started seeing some symptoms again. I just started taking my Asacol again 4 tablets 2 times a day. I know not to eat too much wheat or gluten but doctors really don’t give us a diet to help with symptoms.. I wish i had a daily diet list of foods to eat… Any suggestions?
    Staci B.

    1. Hey Staci,

      I follow alot of the SCD diet rules in terms of foods. Here is a link that you might want to look into which has a pretty extensive list of the foods on a “legal” illegal” basis:

      give it a peak, and you’ll get a pretty good idea of what i’m talking about.

      Best of luck to you with getting the symptoms under control in the real near future.



  10. Hey Adam, im 26 years old and ive recently been diagnosed with UC after having months of bloody loose bowel movements (3/4/5 a day), lots of gas and mild abdominal cramps. The day after having a Colonoscopy (taking Biopsy’s) the bleeding was quite heavy but it has calmed down a bit.
    My doctor prescribed my to take 3 Asacol tablets a day and today is the first day.

    Im not ready to fully commit to a specific food diet yet but I really want to start cutting out some of the main no no’s so I can start helping the healing. Any tips??


    1. Hey Lee,

      Yes, if you’re a drinker, I’d cut out the alcohol right away.
      As for foods, I’d cut out breads as well. That’s two biggies, but a good think to try to wack out of your diet. I wish you the best. And also, lots of people notice increases symptoms after getting their colonoscopies, so if that’s what happened to you, don’t sweat it, unfortunately its rather common to go down that way.


  11. Tool Asacol for years and then switched to Aziathioprine. Managed to go back toAsacol as didn’t want to stay on immunosuppressants when pregnant. Pregnancy worked wonders in terms of stabilising the disease (luckily). Consultant changed me onto Mezavascanol (similar to Asacol but easier to take just one pill morning and night) Lucky to have been in remission for over 6yes but recently started to flare and going through all the different prednisalone methods. Just waiting for the inevitable hamster cheeks to make their appearance
    : ( The worst bit is coming down from the high dose and hitting the wall from memory , I rarely had success coming down off steroids!

  12. I have had the UD diagnosis for a year now. Canasa and enemas were not effective. I started taking asacol. A week into it, I found your awesome web page, ihaveUC and SCD. Only two days into the SCD eating plan and I made POOP! I actually feel as though I am getting my energy back. Thank you for putting up this web page. It is certainly life changing.

  13. Hey all, i have been useing asacol for about two weeks (enima formation) whilst waiting for a colonoscopy. The specialist said he was 90% sure it was UC, but i have weird symptoms (no pain, lots of blood, constipation) but when looking he said he didnt know how i wasnt in alot of pain. ANyway i have been feeling awful ever since taking it, dizzy all the time, feeling sick, temperature, very tired and terrible cramps. I have had to cut it down to one dose a day as i just couldn’t cope at work and my speclist was on holiday. Fingers crossed we can try something else when i see him next week!

  14. In 2010 I was on the brink of death because I had been bleeding for 6 months due to UC of my entire bowel. Prednisone saved my life and I’m thankful, but do not want to rely on drugs to get well. I was told by my Gastro that there is nothing I can do to prevent flair ups. They don’t know what causes the disease, so they don’t know how to cure it. He said to expect to have a flair about once a year and come see me and I’ll put you on Prednisone. Sounded like a life on Prednisone, which I didn’t want to accept.

    The Asacol never did cure me of symptoms. It wasn’t until I went on a Probiotic and a Digestive Enzyme along with the Asacol that the symptoms ceased. I was symptom free for 3 YEARS!!! I went through a flair this past winter when I underwent a great deal of stress and change in diet. I took just two pills of the Prednisone, learned to meditate and my symptoms are finally clearing.

    Just using common sense, the likelihood of colon cancer from UC is great. I refuse to die from colon cancer. I’m not getting any help from my Gastro so I’ll do my own research and get myself well, with the help of God directing me.

    Found this journal article today. I found it interesting and you will too. God bless.

  15. I was diagnosed with UC about 8 years ago. To initially calm the flare up my doctor prescribed prednisone and asacol combination. After the initial calming I kept using the asacol. For 6 years I took (4) 400 mg tablets a day and due to patent and insurance issues starting taking (2) 800 mg tablets daily. Reading other stories I can see I’m lucky as I’ve had no major flare ups or side effects being on this med and have been on a relatively low dose. However it is so expensive and is not even covered by my new insurance. So…should I ask my doctor to try sulfazine (nervous to do so) or go back to using online pharmacies?

  16. Hey! I was diagnosed with UC about 4 weeks ago. So this is all new to me. Before I went to the doctor I had been having symptoms for about 3 months. I first had a blood test which came back positive for UC and then a colonoscopy to confirm it. I was put on asacol 3 times a day one week ago. Since I have been taking the medication I feel like my UC is almost getting worse. I am noticing less blood but still a lot of diarrhea and not a big appetite. My stomach hurts more almost like acid is built up or something. I was just curious if anyone else had these problems when first starting asacol.

  17. Greetings fellow UCer’s. What a crappy club to be a member of huh? Literally. However I am glad that this site exists, helping to bring awareness to others afflicted with this disease and the people/loved ones of those afflicted. Knowledge is power and I applaud you kind sir for creating and maintaining such an informative site.
    A little background on myself…. I was diagnosed with UC at the age of 13. Apparently having bloody diarrhea for 2 consecutive months was not normal at my age, or any age for that matter. After finally seeing a G.I., and losing 12 lbs., I was diagnosed immediately following a colonoscopy. Side note: being as I was only 13 at the time of diagnosis, it was particularly a frightening procedure. I only suggest that if any of you have a child needing to have this procedure performed on them, that they pay extra attention to comforting them. Although we all know as adults that the worst part is the prep, at 13, the mere mention of a camera with a 5 foot cord disappearing inside my butt was enough to warrant a Xanax.
    In any case, I was put on sulfasalazine and a year later, Asacol. I’m now 39 years old and still taking Asacol everyday. In the 26 years of living with this annoying disease I have endured the hospital stays, colonoscopies, sigmoidoscopies, prednisone, enemas, diets, good advice, bad advice, etc. One thing I have learned….. There are virtually no two identical cases! Everyone’s disease is unique. And while many symptoms are the same, the cause and effect varies greatly. In my case, as long as I’m not flaring, I can eat or drink whatever I want. In my case (and I stress, MY CASE) food has no role in my flare ups. This may not be the case for everyone. But from what many doctors have told me, the best lead they have on it’s cause is that it is autoimmune.
    One other interesting tidbit is that I am a smoker. I have attempted quitting 4 times in my life. Each time I ended up hospitalized with severe flare ups. I am jot encouraging anyone to take up or continue smoking! I am merely injecting my experience, backed by a plethora of data linking longer emissions with smoking. If you do partake in some research, you will be very surprised.
    I apologize for the long post. I just wanted to add my story and say, none of you walk alone with this annoying disease. Being as I’ve been living with this for more than half my life, I am committed to helping others who are suffering. No question is off limits and I would be glad to answer any and all. Keep the faith people! And I wish each and everyone of you good health! Again, remember, knowledge is power.

  18. Can some one please break down the diet for me. Sick of being sick. UC prositis on Lialdia but it makes me sick not trying asacol and still feel worse. I felt better when I weened of everything.

    1. HI Gwen,

      The diet I follow is based off of limiting the carbohydrates you eat.
      For example, I don’t eat any grains, NONE. (Not just “gluten free”…because that is often what people think. But in-fact no grains at all).

      As for dairy products, I try to stick to only a very small amount of hard cheeses, all soft cheeses..NOPE. Many people have good luck with making home made yogurt, here is a link(video) I made with this.

      As for meats, I eat quite a bit of fish, chicken, and other meat/proteins. I stay away from soy completely(although of course it is hard as it is added to so many things without us often being told).

      Drinks…I drink lots of water, that’s my drink of choice. No soft drinks(coke,pepsi,7up). And no refined sugars. So pretty much all the cookies, and candy bars, and anything with white grain sugar or corn syrup…nope as well..

      Here is a page with an example of something I do eat:

      And here is an example of foods I ate to get out of a colitis flare:

      Best to you,

  19. I’ve been using asacol suppositories 500mg once a day for the past week since being diagnosed. I’ve never had loose stools or pain just bleeding and mucus. I’ve noticed less mucus but still getting a little bit of blood with bowel movements. I’m still awaiting an appointment with my consultant to discuss the diagnosis and my biopsies so I’m a litter unsure on what I should expect .

  20. Please…I have the same as you…. the doctor said to me use only 1 supposotorie 500g per day. After 3 days using I am feeling constipated.
    How was your treatment? Are you feeling better?

    1. Hi Lisa I have now been using Asacol for almost 2 months and for the 1st month I had no symptoms. This last few weeks I have been getting occasional blood and mucus again but nothing like before . I ve always had constipation which is still a problem. My main concern is I’m sure flares don’t last just one day .if I get mucus it only lasts for a day which is strange. I’m still awaiting my follow up appointment

      1. I had to stop with suppositories because was making me feel very tired. Now Im bleeding always and mucus. Im thinking about try they again :/
        And also my face is full of acne :(
        I was reading about intestinal candidiasis… I need to call to doctor to sort it out.
        I really would like to keep contact with you because our problem is kind of similar but I dont know how we can do it :(((
        Sorry about my english

  21. I had to stop with suppositories because was making me feel very tired. Now Im bleeding always and mucus. Im thinking about try they again :/
    And also my face is full of acne :(
    I was reading about intestinal candidiasis… I need to call to doctor to sort it out.
    I really would like to keep contact with you because our problem is kind of similar but I dont know how we can do it :(((
    Sorry about my english

    1. Hi Lisa how are you getting on ? I’m still waiting for my follow up which is next week so hopefully I ll have some answers .I’m still having maybe 2 or 3 days a week where I get bleeding so I don’t think the asacol is doing much for me .

      1. I have good news!!! ^_^ Ok I am being little hasty in saying that but well… I tried ASACOL again to be sure about the side effects and I had a horrible day…was like a horrible hangover… then I called and he changed to COLIFOAM…but I do not use it yet because I am always afraid of these medicines. Reading reading reading alooot in internet I found alot of good about a PROBIOTIC VSL#3 and I bought it .(mine is VIVOMIXX capsules 112 billions) …. I took it today after my lunch and at night I had a normal stool (something I have not seen for months because my constipation)..of course a saw little bit of blood and mucus but was almost nothing…and even the smell was different…healthier…(I dont know the right word for that) … I will take it everyday …only one and I hope it make me better and better every day…
        ps. Im gluten free and milk proteine free.

        Sorry my english

  22. Hi
    I did not use asacol again… Im little bit scared about medicines… how they can make you addicted and dependent :/
    I was bleedind alot…then I stopped eating milk protein and I stopped bleeding so much… but still has blood and Im still constipated.
    I have read alot…everyday trying to sort it out…
    Now I just read about parasites… about people who had colitis and was cured by anti parasites medicine. Everything sounds like a possibility for me… Make a research yourself about it.
    I will come back when I have good or bad news.
    Thank you

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