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Drug - Giazo [Salix Pharmaceuticals]

January 2018

Therapeutic area - Ulcerative Colitis

Approval criteria

  • Patient is male AND
  • Patient is >18 years of age AND
  • Patient has a diagnosis of ulcerative colitis AND 
  • Patient has tried and failed balsalazide 750 mg capsules and cannot tolerate thrice daily dosing AND
  • Supporting documentation must be provided at the time of request

Quantity limit

204 tablets per 34-day supply

Background information

GIAZO is a locally acting aminosalicylate indicated for the treatment of mildly to moderately active ulcerative colitis in male patients 18 years of age and older. Patients taking Giazo are directed to take three 1.1 g tablets 2 times a day for 8 weeks. The generically available balsalazide daily dose is similar to that of Giazo; the only difference is the frequency of administration.


MHCP Provider Call Center 651-431-2700 or 800-366-5411

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