Home Drug Guide Vedolizumab

Drug Guide

Generic Name

Vedolizumab

Brand Names Entyvio

Classification

Therapeutic: Immunosuppressant, Monoclonal Antibody

Pharmacological: Integrin receptor antagonist

FDA Approved Indications

Ulcerative colitis
Crohn's disease

Mechanism of Action

Vedolizumab is a humanized monoclonal antibody that binds to the α4β7 integrin, blocking its interaction with mucosal addressin cell adhesion molecule-1 (MAdCAM-1). This prevents lymphocyte trafficking to the gut, reducing inflammation.

Dosage and Administration

Adult: 300 mg IV infusion at weeks 0, 2, and 6, then every 8 weeks; doses may be adjusted based on response.

Pediatric: Not FDA approved for pediatric use; dosing not established.

Geriatric: No specific dosage adjustments, but monitor for infection risk.

Renal Impairment: No specific adjustments needed.

Hepatic Impairment: No specific adjustments needed.

Pharmacokinetics

Absorption: Administered IV; bioavailability is 100%.

Distribution: Vd approximately 5-7 L.

Metabolism: Degraded via proteolytic pathways; not metabolized by liver enzymes.

Excretion: Broken down into amino acids.

Half Life: approximately 22 days.

Contraindications

Hypersensitivity to vedolizumab or any component of the formulation.

Precautions

Risk of infections (e.g., JC virus, tuberculosis); screening recommended prior to initiation.
Progressive multifocal leukoencephalopathy (PML) risk; monitor neurological symptoms.

Adverse Reactions - Common

Headache (Likely)
Nasopharyngitis (Likely)
Arthralgia (Likely)

Adverse Reactions - Serious

PML (progressive multifocal leukoencephalopathy) (Rare)
Infusion reactions (Uncommon)
Severe infections (Uncommon)

Drug-Drug Interactions

Immunosuppressants, e.g., azathioprine, corticosteroids

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, infusion reactions, and neurological symptoms.

Diagnoses:

Risk for infection
Impaired skin integrity

Implementation: Administer IV infusion as prescribed; monitor infusion site and patient response.

Evaluation: Assess disease activity and adverse effects regularly; efficacy in reducing inflammation.

Patient/Family Teaching

Report any signs of infection or neurological symptoms immediately.
Inform about potential infusion reactions; report any symptoms such as rash, difficulty breathing.
Adhere to schedule of infusions for optimal effect.

Special Considerations

Black Box Warnings:

Progressive multifocal leukoencephalopathy (PML).

Genetic Factors: None established.

Lab Test Interference: May interfere with certain assays; notify lab of therapy.

Overdose Management

Signs/Symptoms: Possible hypersensitivity reactions or infusion-related reactions.

Treatment: Supportive care; discontinue infusion and provide symptomatic treatment.

Storage and Handling

Storage: Store vials under refrigeration (2°C to 8°C).

Stability: Stable until the expiration date; protect from light.