What Is Balsalazide? Uses, Dosage, and What You Need to Know in 2026

Balsalazide Is an Anti-Inflammatory Medication Used to Treat Ulcerative Colitis

Balsalazide (also known as Balsalazide Disodium) is a prescription aminosalicylate medication that treats mild to moderately active ulcerative colitis by delivering anti-inflammatory medicine directly to the colon.

If you or someone you care for has been prescribed Balsalazide, this guide covers everything you need to know — from how it works to how much it costs.

What Is Balsalazide?

Balsalazide belongs to a class of medications called aminosalicylates (also known as 5-ASA drugs). It's available under two brand names:

• Colazal — 750 mg capsules, manufactured by Salix Pharmaceuticals. Approved for adults and children aged 5 and older.
• Giazo — 1.1 g tablets, manufactured by Bausch Health. Approved for adult males 18 and older only.

Generic versions of Balsalazide 750 mg capsules are also available from manufacturers like Apotex and Mylan, making it more affordable for most patients.

Balsalazide is not a controlled substance and is not classified under any DEA schedule. It was FDA-approved for the treatment of ulcerative colitis and has been available in generic form for years.

What Is Balsalazide Used For?

Balsalazide is FDA-approved to treat:

• Mild to moderately active ulcerative colitis in adults (both Colazal capsules and Giazo tablets)
• Mild to moderately active ulcerative colitis in children aged 5 and older (Colazal capsules only)

Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes inflammation and sores in the lining of the large intestine (colon) and rectum. Symptoms typically include bloody diarrhea, abdominal cramping, urgency, and rectal pain.

Balsalazide works by reducing this inflammation directly in the colon, helping to control symptoms and promote healing. To understand the science behind it, read our article on how Balsalazide works.

Doctors sometimes also use Balsalazide off-label for:

• Maintenance of remission in ulcerative colitis (after the initial treatment course)
• Mild Crohn's colitis (limited evidence)

How Is Balsalazide Taken?

Dosage for Adults

Colazal capsules: Three 750 mg capsules taken three times daily (total of 6,750 mg per day) for 8-12 weeks.

Giazo tablets: Three 1.1 g tablets taken twice daily for up to 8 weeks. (Note: Giazo is approved only for males 18 and older.)

Dosage for Children (Ages 5+)

One to three 750 mg capsules taken three times daily for up to 8 weeks, depending on the child's weight and the doctor's recommendation.

How to Take It

• Take with or without food
• Swallow capsules whole
• If you have trouble swallowing capsules, you can open them and sprinkle the contents on applesauce — swallow immediately without chewing
• Do not chew the capsule contents
• Store at room temperature, away from moisture and heat

That's nine capsules a day for adults on Colazal — it's a lot of pills, but each one is getting medicine right where you need it.

Who Should Not Take Balsalazide?

Balsalazide is not right for everyone. You should not take it if you have:

• An allergy to Balsalazide, Mesalamine, or other salicylates — This includes aspirin and bismuth subsalicylate (Pepto-Bismol)
• Severe kidney disease — Balsalazide can worsen kidney function
• Severe liver disease — Use with caution and monitoring
• Pyloric stenosis — This stomach condition may prevent the drug from reaching the colon where it works

Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Balsalazide is Pregnancy Category B, meaning animal studies haven't shown risk, but it should only be used during pregnancy if clearly needed.

Also important: Giazo tablets were not shown to be effective in females in clinical trials and are approved only for males. If you're female, your doctor should prescribe the capsule form (Colazal or generic) instead.

Be sure to tell your doctor about all medications you take, as Balsalazide has important drug interactions, especially with Azathioprine, 6-Mercaptopurine, and NSAIDs.

How Much Does Balsalazide Cost?

The cost of Balsalazide varies significantly depending on whether you use insurance, coupons, or pay cash:

• Retail cash price (no insurance): $350-$430 for a 30-day supply (270 capsules of 750 mg)
• With a coupon (GoodRx/SingleCare): $80-$100 for the same supply
• With insurance: Generic Balsalazide is typically covered on Tier 2 (preferred generic) or Tier 3. Copays vary by plan.

Prior authorization is uncommon for generic Balsalazide, though brand-name Colazal or Giazo may require prior authorization or step therapy.

Medicare Part D generally covers generic Balsalazide as well.

For a complete breakdown of how to lower your costs, check out our guide to saving money on Balsalazide. Programs like Prescription Hope offer Colazal or Giazo for $70/month for qualifying patients.

Final Thoughts

Balsalazide is a well-established, effective treatment for mild to moderate ulcerative colitis. It delivers anti-inflammatory medication directly to the colon with fewer systemic side effects than many alternatives. While the pill count is high (nine capsules daily for adults), most patients tolerate it well.

If you've been prescribed Balsalazide, make sure you understand the potential side effects and know how to find it at a pharmacy near you.

Ready to fill your prescription? Use Medfinder to check stock and compare prices at pharmacies in your area.