Asacol vs. Remicade

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Treats inflammatory bowel disease. Lialda (Mesalamine) is an effective first-line medicine for inflammatory bowel disease. There isn't a generic version and you'll have to take it multiple times a day.Calms down your immune system. Remicade (Infliximab) is very effective at calming down your immune system, but you have to get each dose at your doctor's office and watch out for serious side effects.
How it works
Lialda (Mesalamine) is an anti-inflammatory medication. Researchers don't know exactly how Lialda (Mesalamine) works in the colon, but it seems to lower the chemicals in the body that cause inflammation.Remicade (Infliximab) is a biologic response modifier. It works in the immune system to block a protein called TNF (tumor necrosis factor). Blocking TNF relieves symptoms and prevents disease progression.
Type of medication
Anti-inflammatoryPrescription only
Biological response modifier
Prescription only
Available as
  • Pill
  • Extended release
  • Enema
  • Suppository
  • Injection
Used for (click to learn more)
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
Reviews for Remicade (Infliximab)
-23% vs. Lialda (Mesalamine)
-6% vs. Lialda (Mesalamine)
-13% vs. Lialda (Mesalamine)
Side effects
  • Pain 6%
  • Indigestion 5%
  • Constipation 4%
  • Abdominal pain 4%
  • Vomiting 3%
  • Rash 3%
  • Stiff or rigid muscles 2%
  • Sore throat 2%
  • Joint pain 2%
  • Back pain 2%
More Asacol side effects »
  • Infusion reaction 13%
  • Infections 11%
More Remicade side effects »
Risk factors for serious side effects
  • Asthma
  • Rhinitis
  • Nasal polyps
  • Aspirin allergy
  • NSAID allergy
  • Phenylketonuria (PKU)
  • Kidney problems
  • Liver problems
  • Age 65 or older
  • Liver problems
  • Taking Lialda (Mesalamine) at the start of treatment
Detailed Lialda (Mesalamine) risks & warnings »
    • History of heart failure
    • Taking other immunosuppressant drugs
    • Age 60 or older
    • Taking other immunosuppressant drugs
    • History of malignancy
    • History of neurologic condition
        Detailed Remicade (Infliximab) risks & warnings »
        Pregnancy category
        CFDA pregnancy category (Weigh risks vs. benefits)

        Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

        See the FDA package insert
        BFDA pregnancy category (Probably safe)

        Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

        See the FDA package insert
        No specific alcohol-related info.No specific alcohol-related info.
        No specific food-related info.No specific food-related info.
        Kidneys and liver
        • Not a good option if you have kidney disease.
        • Lialda (Mesalamine) is broken down by the kidney and liver. If you have kidney or liver problems, talk to your doctor because you may need to take a different dose of the medication.
        No specific kidneys and liver-related info.
        No specific sex-related info.No specific sex-related info.
        No specific sleep-related info.No specific sleep-related info.
        No specific weight-related info.
        • Remicade (Infliximab) can increase your risk of serious or life-threatening bacterial, fungal and viral infections. In some cases infections can be reactivated from an inactive virus in your body like tuberculosis (TB) or hepatitis B virus (HBV). You may need to take medicine for TB before you can begin taking Remicade (Infliximab). If you develop symptoms of cough, fever, chills, muscle aches, feel very tired, or you notice dark urine, yellowing of skin/eyes, appetite/weight loss, vomiting, change in stool color, stomach discomfort, and skin rash, tell your doctor and get medical care right away.
        • Although rare, Remicade (Infliximab) can cause serious liver injury. You'll need to have your liver enzymes tested regularly. If liver enzymes are significantly elevated and you have appetite/weight loss, stomach discomfort, vomiting, and notice dark urine, yellowing of skin/eyes, change in stool color, and skin rash you should stop treatment with Remicade (Infliximab) until you can be completely assessed,
        Upsides and benefits
        • Effective first-line medication for treating and lowering the symptoms of mild inflammatory bowel disease.
        • About half the people who have mild to moderate colon inflammation and take Lialda (Mesalamine) will see improvement.
        • Available in tablets, capsules, enemas, and suppositories.
        • Certain forms of Lialda (Mesalamine) can be used during pregnancy. Talk to your doctor if you're pregnant, or plan on becoming pregnant, and you want to take Lialda (Mesalamine).
        • Treats certain types of arthritis and gastrointestinal conditions caused by an overactive immune system.
        • Remicade has almost two decades of clinical trial data and real-life experience with millions of people who have used it.
        • Initial dosing to introduce Remicade to your body might be a hassle, but then you only need to take it every 6-8 weeks depending on your condition.
        Downsides and risks
        • No generic versions are available for the tablets, capsules, and suppositories (meaning it could be somewhat expensive).
        • Doesn't work well for severe colon inflammation.
        • You may need to take Lialda (Mesalamine) three or four times a day.
        • Not a good option if you have kidney disease.
        • You have to get every dose through an IV infusion at your doctor's office.
        • It's expensive because there's no generic available yet.
        • Remicade has a higher risk of serious infusion-related side effects during or after it's given since it's injected right into your veins. Your doctor can prescribe medication before your dose that may lower this risk.
        • Remicade lowers your ability to fight infection and can cause serious life-threatening illness. The risk is greater if you take other drugs that lower your immune system, have an active infection, diabetes, or had tuberculosis (TB) in the past.
        • Not the best choice if you have heart failure.
        • Talk to your baby's doctor if you're pregnant or breast-feeding. When women in a study took Remicade (Infliximab), the medicine was found in their breast milk 2 to 3 days after each dose, and in the baby's blood 6 months after they were born.
        Tips from our pharmacists for people taking the medication
        • Don't take Lialda (Mesalamine) if you're allergic to aspirin. Talk to your doctor or pharmacist about any drug allergies you have before starting Lialda (Mesalamine).
        • Taking antacids with Lialda (Mesalamine) can make your inflammation worse. Talk to your doctor before you make any changes.
        • You can sunburn more easily when taking Lialda (Mesalamine). Use sunscreen and protective clothing when you go outdoors.
        • Don't break, chew, or crush the tablets because they're coated and won't work as well.
        • The suppositories should be kept in for at least 1 to 3 hours to get the most benefit.
        • Remicade (Infliximab) is a medication that's given as an infusion at your doctor's office or clinic.
        • It's very important to read the patient Medication Guide when you first start using Remicade (Infliximab).
        • It's possible to get an allergic reaction to Remicade (Infliximab) either immediately during the treatment or a several days after stopping it. Your doctor can give you medicines that'll lower this risk.
        • You'll need to have a TB test before you start taking Remicade (Infliximab) and periodically during treatment.
        • Remicade (Infliximab) lowers your immune system's ability to fight infections, so it's important to let your doctor know if you notice a fever, cough, or flu-like symptoms. Children seem to get more infections than adults, so keep a close eye on them.
        • If you have a young child, let their doctor know if you were on Remicade (Infliximab) while pregnant or nursing. It can increase their risk of infections for several months after your last dose and can delay their vaccine schedule.
        Learn more
        More about AsacolSide effectsReviews & ratingsAlternativesFDA package insert
        More about RemicadeSide effectsReviews & ratingsAlternativesFDA package insert