Natalizumab
About Natalizumab
Natalizumab is a prescription medicine used to treat relapsing forms of multiple sclerosis (MS) and moderate to severe Crohn's disease. It is prescribed when other treatments have not worked well enough or cannot be tolerated. The primary medical purpose of this medicine is to help control symptoms, manage inflammation, and reduce the frequency of disease flare-ups.
You will receive this medicine as an injection or infusion at regular intervals scheduled by your medical team. Because it is given directly by a healthcare provider, there are no specific food or meal instructions for taking it. To achieve the best possible results, it is important to keep all your scheduled appointments and combine your treatment with healthy habits, such as regular low-impact physical activity and a balanced diet tailored to your condition.
While this medicine is effective, it can cause common side effects like headaches, tiredness, and joint pain. There is also a rare but serious risk of a brain infection and liver damage. You must monitor your body closely and consult your doctor immediately if you notice any sudden changes in your mental state, vision, balance, or skin tone.
Do not take this if you have a history of a rare brain infection called progressive multifocal leukoencephalopathy (PML) or if you have a severely compromised immune system. Before starting treatment, tell your doctor if you have any active infections, liver problems, or other medical conditions. Your doctor will help determine if this medicine is safe for you.
This medicine can interact with other drugs that weaken your immune system, which can significantly increase your risk of serious infections. If you are pregnant, planning to become pregnant, breastfeeding, or are an older adult, talk to your doctor or pharmacist to discuss the risks and benefits before starting treatment.
Uses of Natalizumab
Medicinal Benefits
Natalizumab helps manage autoimmune and inflammatory conditions by reducing harmful inflammation in the body. With regular use as prescribed, it helps control disease activity, reduce flare-ups, and improve overall quality of life.
- Reduces Disease Flare-Ups: By targeting the underlying inflammatory process, this medicine helps reduce the frequency of flare-ups in conditions such as relapsing multiple sclerosis and Crohn's disease, supporting more stable disease control.
- Improves Daily Comfort and Function: By reducing inflammation, this medicine helps relieve symptoms such as abdominal pain, diarrhoea, and digestive discomfort in Crohn's disease, while helping preserve mobility, coordination, and physical function in multiple sclerosis.
- Supports Long-Term Disease Management: Regular treatment helps slow disease progression, reduce ongoing tissue damage, and improve overall quality of life by allowing you to maintain your daily activities with fewer interruptions.
Directions for Use
- Follow your doctor’s instructions on the dosage and timing of this medication.
- Natalizumab will be administered by a nurse or doctor.
- Do not self-administer.
Storage
Side Effects of Natalizumab
Common Side Effects (Usually mild):
- Headache
- Feeling tired or fatigued
- Joint pain
- Nausea or stomach discomfort
- Common cold symptoms, such as a sore throat or stuffy nose
Serious Side Effects (Consult a doctor right away):
- Signs of a rare brain infection (PML), such as confusion, memory loss, vision changes, difficulty walking, or weakness on one side of your body
- Signs of liver damage, including yellowing of the skin or eyes (jaundice), unusually dark urine, or severe nausea
- Signs of a severe allergic reaction, such as hives, swelling of the face, lips, or throat, and difficulty breathing
- Signs of an infection, including a high fever, severe chills, persistent cough, or painful urination
Drug Warnings
- Watch for brain infection symptoms: This medicine increases the risk of a rare, serious brain infection called PML. Immediately tell your doctor if you experience any changes in your thinking, vision, balance, or strength.
- Stay for the observation period: Always remain at the clinic for at least one hour after your injection or infusion, so healthcare staff can monitor you for sudden allergic reactions.
- Keep your medical alert card: Carry the patient alert card provided by your doctor at all times to inform emergency medical staff that you are using this medication.
- Check the solution before injection: If you are assisting in verifying your medicine, ensure the liquid is clear and colourless to pale yellow. Do not use it if it is cloudy, discoloured, or contains visible particles.
- Monitor liver health: Your doctor will perform regular blood tests to check your liver function. Report any yellowing of your eyes, severe itching, or dark urine immediately.
Drug Interactions
- Immunosuppressants and Cancer Therapies: Taking this medicine with other drugs that suppress the immune system (such as interferon beta, glatiramer acetate, or chemotherapy) can significantly increase your risk of serious infections, including PML.
- TNF Blockers: Combining this medicine with TNF inhibitors used for inflammatory diseases can further weaken your immune system and should be avoided.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
consult your doctorIt is unknown whether alcohol interacts with Natalizumab. Consult your doctor for any concerns regarding this.
Pregnancy
cautionIf you are pregnant or planning pregnancy, inform your doctor before receiving Natalizumab. Your doctor may prescribe this medicine if the benefits outweigh the risks.
Breast Feeding
cautionNatalizumab is known to pass in the breastmilk. Hence, if you are breastfeeding, inform your doctor before receiving Natalizumab. Your doctor may administer this medicine only if the benefits outweigh the risks.
Driving
not applicable-
Liver
cautionNatalizumab is known to cause hepatotoxicity in some patients. Hence, caution should be exercised. Inform your doctor if you observe any symptoms of tiredness, loss of appetite, dark urine, yellowing of the skin and eyes, or pain in the abdomen. Dose adjustment may be needed in patients with liver impairment.
Kidney
cautionNatalizumab should be used with caution if you have kidney disease. Dose adjustment may be needed in patients with liver impairment.
Children
unsafeNatalizumab is not recommended in children below 18 years of age as the safety and efficacy are not established.
Habit Forming
Diet & Lifestyle Advise
- Prioritise infection prevention: Because this medicine affects your immune system, wash your hands frequently, avoid close contact with people who are sick, and ask your doctor before getting any vaccines.
- Eat a gut-friendly diet (for Crohn's disease): Work with a nutritionist to identify trigger foods. During flare-ups, focus on soft, easily digestible foods and stay well-hydrated.
- Incorporate low-impact exercise (for MS): Gentle physical activities like swimming, walking, or stationary cycling can help maintain muscle strength, flexibility, and balance.
- Manage stress: High stress levels can trigger MS and Crohn's flare-ups. Practice relaxation techniques such as deep breathing, meditation, or yoga to help manage daily stress.
Special Advise
- It is advised to closely monitor the patient for infections like active tuberculosis, and HIV infection during and after the treatment.
- It is essential to inform your doctor if you have any active viral, bacterial, and fungal infections before starting Natalizumab.
- Natalizumab is used to treat the condition but does not cure it.
- This medicine is administered only once every four weeks by a trained oncologist.
- Natalizumab will be only given to patients who have enrolled in to TOUCH program.
Patients Concern
Disease/Condition Glossary
Multiple sclerosis: Multiple sclerosis is a condition that affects the brain and spinal cord. The immune system attacks the protective covering of the nerves (myelin) and causes disrupted communication between the brain and body due to nerve damage. This causes symptoms such as problems with sensation, balance, vision, pain, impaired coordination, and fatigue.
Crohn’s disease: Crohn’s disease is a type of chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract, from mouth to anus. But mostly occurs in the small intestine and large intestine. The symptoms include blood in stools, stomach cramps, tiredness, diarrhoea, fever, weight loss, or loss of appetite.
FAQs
Natalizumab is used to treat Multiple sclerosis and Crohn’s disease.
Natalizumab works by binding to the chemical substance called α4β7 integrin (present on the surface of the WBC that enters the gut), which is responsible for inflammation. This alters the gene expression of blood monocytes and thus helps reduce inflammation.
Inform your doctor about your complete medical and medication history especially, if you have any history of serious infections, tuberculosis, liver or kidney diseases, or a weak immune system, as it can worsen your health condition.
Natalizumab is given by a healthcare professional as an intravenous (IV) infusion or injection in a clinical setting. You will not self-inject this medication at home. Talk to your doctor to learn more about your specific treatment routine.
The most serious risk is a rare, life-threatening brain infection called progressive multifocal leukoencephalopathy (PML). Your doctor will assess your risk, which may include testing you for the JC virus antibody before you start treatment. Talk to your doctor for more details.
You should consult your doctor before using this medicine if you are pregnant, planning to become pregnant, or breastfeeding. Your doctor will help weigh the benefits of treatment against the potential risks to your baby.
It is generally not recommended to receive live vaccines while using this medicine, as your weakened immune system may not react safely to the vaccine. Always talk to your doctor or pharmacist before scheduling any vaccinations.
If you miss an appointment, contact your healthcare clinic immediately to reschedule your dose. Keeping a consistent treatment schedule is highly important for managing your disease effectively. Talk to your doctor if you regularly struggle with appointments.
No, this medicine does not cure MS or Crohn's disease. Instead, it helps manage the symptoms, reduces the frequency of flare-ups, and slows down the progression of physical damage. Talk to your doctor to discuss long-term treatment expectations.
Signs of liver damage include yellowing of your skin or eyes, dark urine, severe stomach pain, or unexplained nausea and vomiting. Your doctor will perform regular blood tests to monitor your liver. Talk to your doctor immediately if you notice any of these symptoms.
