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Entyvio
vedolizumab
Adult Dosing .
Dosage forms: INJ (pen): 108 mg per injection; INJ (pre-filled syringe): 108 mg per 0.68 mL; INJ (vial): various
ulcerative colitis, moderate-severe
- [IV route]
- Dose: 300 mg IV q8wk; Start: 300 mg IV x1 at wk 0, 2, 6, then 300 mg IV q8wk; Info: may switch from IV to SC dosing at or after wk 6, give 1st SC dose at next scheduled IV dose; D/C if no response by wk 14
- [SC route]
- Dose: 108 mg SC q2wk; Start: 300 mg IV x1 at wk 0, 2, then 108 mg SC q2wk starting at wk 6; Info: if switching from IV to SC dosing after wk 6, give 1st SC dose at next scheduled IV dose; D/C if no response by wk 14
Crohn disease, moderate-severe
- [IV route]
- Dose: 300 mg IV q8wk; Start: 300 mg IV x1 at wk 0, 2, 6, then 300 mg IV q8wk; Info: may switch from IV to SC dosing at or after wk 6, give 1st SC dose at next scheduled IV dose; D/C if no response by wk 14
- [SC route]
- Dose: 108 mg SC q2wk; Start: 300 mg IV x1 at wk 0, 2, then 108 mg SC q2wk starting at wk 6; Info: if switching from IV to SC dosing after wk 6, give 1st SC dose at next scheduled IV dose; D/C if no response by wk 14
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- infection, active
- caution: infection, recurrent
- caution: infection, chronic
- caution: infection risk
- caution: TB infection, latent
- caution: TB infection risk
Drug Interactions .
Overview
vedolizumab
integrin antagonist
- immunomodulatory effects
Contraindicated
- adenovirus vaccine, live
- BCG live intravesical
- chikungunya vaccine, live
- cholera vaccine, live
- dengue vaccine, live
- influenza nasal vaccine, live
- measles/mumps/rubella vaccine, live
- rotavirus vaccine, live
- smallpox vaccine, live
- talimogene laherparepvec
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Avoid/Use Alternative
- abrocitinib
- adalimumab
- anifrolumab
- certolizumab pegol
- cladribine oral
- deuruxolitinib
- etanercept
- etrasimod
- golimumab
- infliximab
- natalizumab
- pimecrolimus topical
- rabies vaccine
- ritlecitinib
- ruxolitinib topical
- upadacitinib
Monitor/Modify Tx
- anthrax vaccine
- carfilzomib
- chikungunya vaccine
- COVID-19 vaccine
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- ebola vaccine, live
- everolimus
- Haemophilus b vaccine
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- influenza H5N1 vaccine
- influenza vaccine
- Japanese encephalitis vaccine
- meningococcal vaccine
- mitomycin
- pneumococcal vaccine
- poliovirus vaccine
- respiratory syncytial virus vaccine
- sipuleucel-T
- smallpox/mpox vaccine, live
- tick-borne encephalitis vaccine
- typhoid vaccine
Caution Advised
- abatacept
- abemaciclib
- acalabrutinib
- afamitresgene autoleucel
- aldesleukin
- alemtuzumab
- anakinra
- anti-thymocyte globulin
- atidarsagene autotemcel
- avacopan
- axicabtagene ciloleucel
- azacitidine
- azathioprine
- baricitinib
- basiliximab
- beclomethasone inhaled
- beclomethasone nasal
- belatacept
- belimumab
- belinostat
- bendamustine
- betamethasone
- bimekizumab
- blinatumomab
- bortezomib
- brentuximab vedotin
- brexucabtagene autoleucel
- brodalumab
- budesonide
- budesonide inhaled
- budesonide nasal
- budesonide rectal
- busulfan
- cabazitaxel
- canakinumab
- carboplatin
- carmustine
- chlorambucil
- ciltacabtagene autoleucel
- cisplatin
- cladribine injection
- clobetasol ophthalmic
- clofarabine
- coccidioides immitis skin test antigen
- copanlisib
- corticotropin
- cortisone
- crovalimab
- cyclophosphamide
- cyclosporine
- cytarabine
- dactinomycin
- danicopan
- daratumumab
- daunorubicin
- decitabine
- deflazacort
- delgocitinib topical
- deucravacitinib
- dexamethasone
- dexamethasone ophthalmic
- difluprednate ophthalmic
- dimethyl fumarate
- dinutuximab
- diroximel fumarate
- docetaxel
- doxorubicin
- dupilumab
- duvelisib
- eculizumab
- efgartigimod alfa
- elivaldogene autotemcel
- elotuzumab
- elranatamab
- emapalumab
- epcoritamab
- epirubicin
- eribulin
- etoposide
- etuvetidigene autotemcel
- fingolimod
- floxuridine
- fludarabine
- fludrocortisone
- flunisolide nasal
- fluocinolone intravitreal
- fluorometholone ophthalmic
- fluticasone furoate
- fluticasone propionate
- fruquintinib
- gemtuzumab ozogamicin
- glofitamab
- guselkumab
- hydrocortisone
- hydrocortisone ophthalmic
- hydroxyurea
- ibritumomab tiuxetan
- ibrutinib
- icotrokinra
- idarubicin
- idecabtagene vicleucel
- idelalisib
- ifosfamide
- inebilizumab
- inotuzumab ozogamicin
- iptacopan
- irinotecan
- isatuximab
- ixabepilone
- ixekizumab
- lebrikizumab
- leflunomide
- lenalidomide
- lifileucel
- linvoseltamab
- lisocabtagene maraleucel
- lomustine
- loncastuximab tesirine
- loteprednol ophthalmic
- lymphocyte immune globulin, anti-thymocyte globulin
- melphalan
- mercaptopurine
- methotrexate
- methylprednisolone
- mirikizumab
- mitoxantrone
- mogamulizumab
- momelotinib
- mometasone implant
- mometasone inhaled
- mometasone nasal
- monomethyl fumarate
- mosunetuzumab
- mycophenolate mofetil
- mycophenolic acid
- nadofaragene firadenovec intravesical
- narsoplimab
- nelarabine
- nipocalimab
- obecabtagene autoleucel
- obinutuzumab
- ocrelizumab
- ofatumumab
- oxaliplatin
- ozanimod
- paclitaxel
- pegcetacoplan
- pentostatin
- pirtobrutinib
- polatuzumab vedotin
- pomalidomide
- ponatinib
- ponesimod
- pozelimab
- prednisolone
- prednisolone ophthalmic
- prednisone
- procarbazine
- quizartinib
- ravulizumab
- regorafenib
- rilonacept
- rilzabrutinib
- risankizumab
- rituximab
- romidepsin
- ropeginterferon alfa-2b
- rozanolixizumab
- ruxolitinib
- sarilumab
- satralizumab
- secukinumab
- selinexor
- sibeprenlimab
- siltuximab
- siponimod
- sirolimus
- sirolimus albumin-bound
- spesolimab
- sulfasalazine
- sutimlimab
- tacrolimus
- tafasitamab
- talquetamab
- tarlatamab
- teclistamab
- temozolomide
- temsirolimus
- teplizumab
- teriflunomide
- thioguanine
- thiotepa
- tildrakizumab
- tisagenlecleucel
- tocilizumab
- tofacitinib
- topotecan
- trabectedin
- tralokinumab
- triamcinolone
- tuberculin purified protein derivative
- ustekinumab
- vamorolone
- venetoclax
- vilobelimab
- vinblastine
- vincristine
- vinorelbine
- voclosporin
- zanubrutinib
- zilucoplan
Adverse Reactions .
Serious Reactions
- infusion reaction, severe
- hypersensitivity reaction
- anaphylaxis
- infection, serious
- opportunistic infection
- tuberculosis
- sepsis
- PML
- acute pancreatitis
- interstitial lung disease
- pneumonitis
Common Reactions
- nasopharyngitis
- headache
- arthralgia
- injection site reaction (SC use)
- nausea
- fever
- URI
- fatigue
- cough
- infusion reaction
- bronchitis
- influenza
- back pain
- rash
- pruritus
- sinusitis
- oropharyngeal pain
- extremity pain
Safety/Monitoring .
Monitoring Parameters
TB test before tx start; signs/symptoms of PML
Pregnancy/Lactation .
Pregnancy
Clinical Summary
may use during pregnancy; give last dose 6-10wk before estimated delivery date, then resume 48h postpartum; no known risk of teratogenicity based on human data; possible risk of decr. neonatal immune response based on drug's mechanism of action; for infants exposed to vedolizumab during 3rd trimester, avoid live vaccines for at least 6mo after birth
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; inadequate human data available, though risk of infant harm not expected based on drug properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for vedolizumab: unknown; CYP450: unknown
Excretion: for vedolizumab: unknown; Half-life: 26 days
Subclass: Inflammatory Bowel Disease (IBD)
Mechanism of Action
for vedolizumab: specifically binds alpha 4 beta 7 integrin and blocks its interaction with mucosal addressin cell adhesion molecule-1, leading to inhibition of memory T-lymphocyte migration into inflamed GI parenchymal tissue (monoclonal antibody)
Formulary .
No Formulary Selected
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