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Natalizumab

Generic Name: natalizumab (NA-ta-LIZ-ue-mab)
Brand Name: Tysabri

Natalizumab increases the risk of a certain type of viral brain infection (progressive multifocal leukoencephalopathy [PML]). PML may cause severe disability or death. Your risk of PML may be greater if you take or have recently taken other medicines that may weaken your immune system, such as immunosuppressants (eg, 6-mercaptopurine, azathioprine, cyclosporine, methotrexate) or immunomodulators (eg, interferon beta). Your risk of developing PML may also increase if you have been exposed to JC virus or if you have used natalizumab for a long time, especially over 2 years. Tell your doctor at once if you notice any new or worsening symptoms while taking natalizumab or within 6 months after you stop taking it. These may include changes in thinking, eyesight, balance, memory, or strength; clumsiness; confusion; one-sided weakness; personality changes; or problems using your arms and legs.

You can only get natalizumab through a special program called the TOUCH Prescribing Program. Talk with your health care provider if you have questions about this program.


Natalizumab is used for:

Treating certain forms of multiple sclerosis (MS) by slowing the worsening of physical disability and reducing the number of symptom flare-ups. It is usually given to patients who cannot use other MS treatments or for whom other MS treatments have not worked well enough. Natalizumab is also used to treat moderate to severe Crohn disease in certain patients.

Natalizumab is a monoclonal antibody. Exactly how it works is not known. It may work by blocking certain inflammatory cells from getting into the brain, which may help slow the progression of MS.

Do NOT use natalizumab if:

  • you are allergic to any ingredient in natalizumab
  • you have ever had PML
  • you have Crohn disease and are also using an immunosuppressant (eg, 6-mercaptopurine, azathioprine, cyclosporine, methotrexate) or a tumor necrosis factor alpha (TNF-alpha) inhibitor (eg, adalimumab)

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: Multiple Sclerosis: What's New in Treatment Options?

Before using natalizumab:

Some medical conditions may interact with natalizumab. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have liver problems, immune system problems, a fever, herpes, shingles, or an infection
  • if you have a condition that may weaken your immune system (eg, HIV infection, leukemia, lymphoma) or you have had an organ transplant
  • if you are receiving chemotherapy or radiation treatments, or you are taking corticosteroids (eg, prednisone)
  • if you have been tested and know whether or not you have anti-JC virus antibodies

Some MEDICINES MAY INTERACT with natalizumab. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Antineoplastics (eg, cisplatin), corticosteroids (eg, prednisone), immunomodulators (eg, interferon beta), immunosuppressants (eg, 6-mercaptopurine, azathioprine, cyclosporine, methotrexate), or TNF-alpha inhibitors (eg, adalimumab) because the risk of developing PML may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if natalizumab may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use natalizumab:

Use natalizumab as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Natalizumab comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get natalizumab refilled.
  • Natalizumab is usually given as an injection at your doctor's office, hospital, or clinic.
  • If you miss a dose of natalizumab, contact your doctor right away.

Ask your health care provider any questions you may have about how to use natalizumab.

Important safety information:

  • Natalizumab may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use natalizumab with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Natalizumab is not a cure for MS or Crohn disease. Remain under the care of your doctor.
  • Natalizumab may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
  • Serious and sometimes fatal infections of the brain or spinal cord caused by herpes viruses have been reported in patients using natalizumab. Call your doctor right away if you have a sudden fever or a severe headache or if you feel confused after receiving natalizumab.
  • Natalizumab may cause serious liver problems, including liver failure. Call your doctor right away if you experience nausea, vomiting, loss of appetite, yellowing of the skin or eyes, dark urine, pale stools, stomach pain, or unusual tiredness or weakness.
  • Serious allergic reactions have occurred with the use of natalizumab. If a serious reaction occurs, it is usually within 2 hours after you receive natalizumab. However, a serious reaction may occur at any time. Contact your doctor at once if you develop hives, itching, trouble breathing, shortness of breath, wheezing, chest pain, dizziness, chills, fainting, fever, rash, nausea, or flushing.
  • Tell your doctor or dentist that you use natalizumab before you receive any medical or dental care, emergency care, or surgery.
  • Talk with your doctor before you receive any vaccine.
  • Lab tests, including complete blood cell counts, liver function, anti-JC virus antibody, and magnetic resonance imaging (MRI) scans, may be performed while you use natalizumab. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • You will need to see your doctor 3 months and 6 months after your first dose of natalizumab. You will also need to see your doctor at least every 6 months after that. Be sure to keep all doctor and lab appointments.
  • Safety and effectiveness of natalizumab in CHILDREN younger than 18 years old have not been confirmed. Natalizumab is not approved for use in children.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using natalizumab while you are pregnant. Natalizumab is found in breast milk. If you are or will be breast-feeding while you use natalizumab, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of natalizumab:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; headache; joint pain; mild stomach pain; muscle cramps; nausea; pain in the arms or legs; tiredness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); anxiety; changes in balance, eyesight, memory, strength, or thinking; chest pain or discomfort; clumsiness; confusion; depression; dizziness; fainting; fast heartbeat; feeling cold; fever, chills, cough, or persistent sore throat; flushing; muscle pain; one-sided weakness; painful menstrual periods; painful urination or changes in the amount of urine; personality changes; severe or persistent headache or tiredness; severe or persistent stomach or back pain; shortness of breath or wheezing; suicidal thoughts or attempts; swelling of the hands, ankles, or legs; tooth pain; tremor; vaginal discharge, itching, or odor.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of natalizumab:

Natalizumab is usually handled and stored by a health care provider. Keep natalizumab out of the reach of children and away from pets.

General information:

  • If you have any questions about natalizumab, please talk with your doctor, pharmacist, or other health care provider.
  • Natalizumab is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take natalizumab or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about natalizumab. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to natalizumab. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using natalizumab.

Issue Date: December 3, 2014
Database Edition 14.4.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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