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Salix Pharmaceuticals



Grant
Request Forms

Grant Request Forms

Click on the following links to download grant request forms.

Package of forms:


Individual forms:

Remember to include the following with your submission:

  • Program agenda, if applicable, with timing, title(s), faculty and learning objectives
  • The amount of funding requested, including a budget detailing the proposed use of funds
  • IRS Letter of Determination providing evidence of 501 (c)(3) tax-exempt status (for charitable grants)

Please send all forms to Salix by one of the means below:

  • E-mail:

or

  • Fax: 888-314-5934

or

  • Mail:
  • Salix Pharmaceuticals, Inc.
  • Grants Coordinator, Medical Affairs
  • 1700 Perimeter Park Drive
  • Morrisville, NC 27560

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COLAZAL® (balsalazide disodium) Capsules 750 mg are indicated for the treatment of mildly to moderately active Ulcerative Colitis in patients 5 years of age and older. COLAZAL does not relieve symptoms in all patients; your patients' results may vary. In four well-controlled clinical trials, patients receiving a COLAZAL dose of 6.75g/day most frequently reported the following events (reporting frequency > 3%): headache (8%), abdominal pain (6%), diarrhea (5%), nausea (5%), vomiting (4%), respiratory infection (4%), and arthralgia (4%). Withdrawal from therapy due to adverse events was comparable to placebo. In the pediatric trial, patients most frequently reported the following adverse events: headache (15%), abdominal pain upper (13%), abdominal pain (12%), vomiting (10%), diarrhea (9%), colitis ulcerative (6%), nasopharyngitis (6%) and, pyrexia (6%). COLAZAL is contraindicated in patients with a hypersensitivity to salicylates or the components of COLAZAL capsules or balsalazide metabolites. The safety and effectiveness of COLAZAL beyond 8 weeks in children (ages 5-17 years) and 12 weeks in adults have not been established.

Consult with your physician to see if this product is right for you.

For complete Prescribing Information, please click here.

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Colazal Co-Pay Value Card