II. Indications

III. Contraindications

  1. Severe Infection

V. Precautions

  1. See Monoclonal Antibody for preparation before first dose

VI. Dosing

  1. Infuse 300 mg IV over 1 hour every 4 weeks
  2. Discontinue if insignificant clinical response at 12 weeks or unable to taper off chronic Corticosteroids at 6 months

VII. Safety

  1. Unknown safety in pregnancy
  2. Unknown safety in Lactation

VIII. Adverse Effects

  1. Anaphylaxis
  2. Medication reaction
  3. Other serious adverse effects
    1. Elevated Liver Function Tests (Transaminitis, Hyperbilirubinemia)
    2. Progressive Multifocal Leukoencephalopathy (PML)
      1. Obtain John Cunningham Virus (JCV) Antibody every 6 months
      2. Discontinue Natalizumab if positive Antibody (increased PML risk)
      3. Discontinue (and MRI) if motor weakness, Incoordination or personality changes

IX. Efficacy

  1. Slower effects than with TNF Inhibitors

XI. References

  1. (2023) Biologics for Crohn's Disease, Presc Lett, #390826
  2. (2023) Drugs for Inflammatory Bowel Disease, Med Lett Drug Ther 65: 105-12

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