Natalizumab(nah tah liz’ yoo mab)
Tysabri
PREGNANCY CATEGORY C
Drug Classes
Monoclonal antibody
MS drug
Therapeutic Actions
Monoclonal antibody specific for the alpha-4 subunit on the surface of all leukocytes except neutrophils. Binding with this subunit inhibits adhesion of leukocytes to their counter-receptors, including those on vascular endothelium. Preventing leukocyte adhesion inhibits migration of leukocytes into inflamed tissue and may inhibit recruitment and inflammatory activity of activated immune cells. The exact mechanism of action in MS (thought to be an autoimmune disorder) is not known, but natalizumab may prevent migration of leukocytes into the brain and reduce plaque formation.
Indications
Monotherapy for patients with relapsing MS to delay physical disability and decrease the frequency of exacerbations.
Treatment of Crohn disease in patients who have not responded to or are unable to tolerate other therapies.
Contraindications and Cautions
Contraindicated with allergy to components of the preparation, murine proteins; progressive multifocal leukoencephalopathy (PML) or history of it; lactation.
Use caution with immune supression, pregnancy.
Available Forms
Single-use vials—300 mg/15 mL (20 mg/mL)
Dosages
Adults
300 mg by IV infusion over 1 hr every 4 wk.
Pediatric patients
Safety and efficacy not established.
Pharmacokinetics
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Metabolism: Tissue; T1/2: 11–15 days
Distribution: May cross placenta; may enter breast milk
Excretion: Tissue
IV Lines
