Asacol vs. Humira

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Asacol vs. Humira

What are Asacol and Humira?

Asacol (mesalamine) is an anti-inflammatory drug used to treat ulcerative colitis, proctitis, and proctosigmoiditis, and is also used to prevent the symptoms of ulcerative colitis from recurring.

Humira (adalimumab) is an injectable protein (antibody) used to treat rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis. Humira is also used to treat ulcerative colitis and Crohn's disease after other drugs have been tried without successful treatment of symptoms.

What are the side effects of Asacol and Humira?

Asacol

The most common side effects of mesalamine are:

Infrequent side effects include:

Kidney dysfunction has been associated with mesalamine. Kidney function should be evaluated prior to and periodically during mesalamine therapy.

Mesalamine may cause an acute intolerance syndrome that resembles a flare of inflammatory bowel disease (Crohn's disease or ulcerative colitis) with cramping, abdominal pain, and bloody diarrhea. Fever, headache, itching, and rash also may occur. Symptoms usually subside once mesalamine is discontinued.

Mesalamine enemas contain sulfites and should be avoided in persons who are sensitive to sulfites.

Since mesalamine is related to aspirin in structure, individuals who are allergic to aspirin should not take mesalamine.

Humira

The most common side effects are:

  • headache,
  • rash,
  • nausea and
  • stomach upset.

Adalimumab may cause swelling, redness, pain and itching at the site of injection. Adalimumab suppresses the immune system and is therefore associated with minor infections of the urinary tract, respiratory tract, and sinuses. Like other drugs that block TNF, use of adalimumab also has been associated with serious infections such as tuberculosis, sepsis (bacteria in the blood) and fungal infections. Individuals with active infections should not be treated with adalimumab.

Adalimumab also may worsen the symptoms of diseases of the nervous system. In studies some patients who used adalimumab or other TNF blocking drugs developed cancer. Since patients with rheumatoid arthritis have a higher rate of cancers than the general population, the connection between cancer and use of adalimumab is unclear.

Other side effects of adalimumab include:

Adalimumab may increase the risk of reactivating hepatitis B virus in chronic carriers of the virus.

What is the dosage of Asacol vs. Humira?

Asacol

(see dosing instructions provided by manufacturer)

  • Lialda: 2.4-4.8 g once daily with food
  • Apriso: 1.5 g orally once daily
  • Pentasa: 1 g four times daily
  • Asacol HD: 1.6 g 3 times daily
  • Delzicol: 800 mg 3 times daily (has replaced Asacol; also available in extended release tablets)
  • Rowasa: One rectal application (4 g per 60 mL enema) once a day, preferably at bedtime, and retained for approximately 8 hours.
  • Canasa: One suppository (1,000 mg) daily at bedtime. The suppository should be retained in the rectum for one to three hours or more if possible to achieve maximum benefit.

Humira

Adalimumab is injected under the skin. The recommended dose for rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis is 40 mg every other week, but some patients may need weekly administration.

Crohn's disease is treated with 160 mg initially, followed by 80 mg two weeks later, then 40 mg every 2 weeks.

Juvenile idiopathic arthritis is treated with 20 or 40 mg every other week and plaque psoriasis is treated with 80 mg followed by 40 mg every other week.

What drugs interact with Asacol and Humira?

Asacol

Oral mesalamine formulations are associated with several drug interactions. Combining mesalamine with drugs that affect kidney function, for example, nonsteroidal antiinflammatory drugs (NSAIDs) or ibuprofen may increase the likelihood of reduced function of the kidneys. Concurrent use of mesalamine and 6-mercaptopurine or azathioprine (Imuran) may increase the likelihood of disorders of the blood cells, particularly reduced numbers of cells. Mesalamine may increase the blood thinning effect of warfarin (Coumadin).

Humira

Adalimumab is injected under the skin. The recommended dose for rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis is 40 mg every other week, but some patients may need weekly administration.

Crohn's disease is treated with 160 mg initially, followed by 80 mg two weeks later, then 40 mg every 2 weeks.

Juvenile idiopathic arthritis is treated with 20 or 40 mg every other week and plaque psoriasis is treated with 80 mg followed by 40 mg every other week.

Are Asacol and Humira safe to take while pregnant or breastfeeding?

Asacol

There are no adequate human studies of mesalamine during pregnancy. Mesalamine is known to cross the placenta into the fetus, but animal studies revealed no evidence of harm to the fetus. Mesalamine should only be used during pregnancy if it is felt that the benefit of its use justifies the unknown risks.

Mesalamine is excreted in breast milk. Mesalamine should only be used by nursing mothers if it is felt that the benefit of its use justifies the potential but unknown risk to the infant.

Humira

Adalimumab has not been adequately studied in pregnant women.

Use of adalimumab by nursing mothers has not been adequately evaluated.

FDA Prescribing Information

Quick GuideInflammatory Bowel Disease (IBD) Causes, Symptoms, Treatment

Inflammatory Bowel Disease (IBD) Causes, Symptoms, Treatment

Summary

Both Asacol (mesalamine) and Humira (adalimumab) are used to treat different kinds of inflammatory bowel diseases. Humira is also an general anti-inflammatory used to treat other autoimmune conditions including:

Treatment & Diagnosis

Medications & Supplements

Prevention & Wellness

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Reviewed on 10/6/2017
References
FDA Prescribing Information

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