A gut-selective biologic (anti-integrin)
Vedolizumab
A gut-selective biologic used for inflammatory bowel disease, with action focused mainly on the gut.
What is Vedolizumab?
Vedolizumab is a biologic medicine for inflammatory bowel disease, namely Crohn's disease and ulcerative colitis. It works in a gut-selective way, mainly stopping inflammatory cells from entering the bowel lining, so it tends to dampen the immune system less across the whole body than some other biologics. It is usually given as a drip into a vein, with an under-the-skin version for maintenance, and is not a tablet. Even so, you are still screened for tuberculosis and hepatitis B and C before starting, live vaccines are avoided, and signs of infection should be reported promptly. It is sold under the brand name Entyvio.
Education and reference only. This is a plain-language guide to Vedolizumab — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Vedolizumab is a biologic medicine, made using living cells rather than as a chemical tablet, used to treat the inflammatory bowel diseases Crohn's disease and ulcerative colitis. It belongs to a group called anti-integrin biologics, which work in a gut-selective way. It is usually started as an infusion (a drip) into a vein, and an injection under the skin can be used for ongoing maintenance. It is sold under the brand name Entyvio.
How it works
Vedolizumab blocks a docking signal that inflammatory white blood cells use to leave the bloodstream and enter the lining of the gut. By stopping these cells from getting into the bowel wall, it reduces the inflammation that causes the symptoms of Crohn's disease and ulcerative colitis. Because this action is focused mainly on the gut, it tends to lower the body's overall immune defences less than some whole-body biologics, although it still affects the immune system and infection risk remains important. The benefit builds over weeks and is reviewed at follow-up.
Company & origin
Originated / developed by: Takeda.
A gut-selective biologic used in the UK for Crohn's disease and ulcerative colitis.
Practical use
How to take Vedolizumab
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is usually given as a drip into a vein at a hospital or clinic, not as a tablet.
- You will be monitored during and after each infusion in case of a reaction.
- An injection under the skin may be used for ongoing maintenance, which you can be taught to do at home.
- Attend all your scheduled appointments, as the medicine is given on a planned timetable.
- Avoid live vaccines while on treatment and tell any healthcare professional that you take a biologic.
- Contact your team promptly if you develop a fever, persistent cough, night sweats or other signs of infection.
Weighing it up
Advantages & disadvantages of Vedolizumab
Advantages
- Gut-selective action means it tends to dampen the whole-body immune system less than some other biologics.
- Effective for Crohn's disease and ulcerative colitis when other treatments have not worked well.
- Maintenance can be given as an under-the-skin injection that may be done at home.
Disadvantages
- Still affects the immune system, so infections can occur and screening is needed before starting.
- Usually started as a drip, which means hospital or clinic visits.
- Can take some weeks to reach its full effect, and live vaccines must be avoided.
Practical use
Good to know
Vedolizumab is gut-selective, meaning it works mainly in the bowel, so it tends to dampen the immune system across the whole body less than some other biologics. Even so, it still affects the immune system, so before starting you are screened for tuberculosis and for hepatitis B and C, as these can reactivate. Live vaccines must be avoided while on it, but other vaccines such as the annual flu jab and pneumonia vaccine are encouraged and are best arranged before starting where possible. Report signs of infection, such as fever, persistent cough or night sweats, promptly. Because it is usually given as a drip, you are monitored during and after the infusion in case of a reaction. It may take some weeks to show its full effect, so it is important to keep to the planned schedule.
Who should not take it / use with caution
- People with an active serious infection, including active or untreated tuberculosis, should not start it until this is treated.
- It should not be used by people who have had a severe allergic reaction to vedolizumab or its ingredients.
- It is used with caution alongside other strong immune-suppressing medicines, guided by a specialist.
Monitoring
- Screening for tuberculosis and hepatitis B and C before starting, with ongoing watch for infection.
- Observation during and after each infusion for reactions.
- Regular review of how well the bowel condition is responding, including symptoms and blood tests.
Side effects
- Infusion-related reactions, an increased risk of infections (often colds and chest infections), and joint aches.
- Headache, nausea, tiredness and a sore throat or blocked nose can occur.
- Less commonly, reactivation of tuberculosis or hepatitis B, and rare serious infections or allergic reactions needing urgent care.
Key interactions
- Should not be combined with live vaccines, which must be avoided during treatment.
- Combining it with another immune-suppressing biologic raises infection risk and is generally avoided.
- It may be used alongside steroids or other bowel-disease medicines, which your team will manage together.
Available as: Infusion (drip) into a vein, with an injection under the skin for maintenance.
Answers
Vedolizumab: frequently asked questions
How is vedolizumab different from other biologics?
It works in a gut-selective way, mainly stopping inflammatory cells from entering the bowel lining, so it tends to dampen the whole-body immune system less than some other biologics.
Do I still need infection screening?
Yes. Although it is gut-selective, it still affects the immune system, so you are screened for tuberculosis and hepatitis B and C before starting.
How is it given?
It is usually started as a drip into a vein, with an injection under the skin available for ongoing maintenance, which you can be taught to do at home.
Can I have vaccinations?
Live vaccines must be avoided while on vedolizumab, but non-live vaccines such as the flu and pneumonia jabs are encouraged, ideally before you start.
How quickly will it work?
It can take some weeks to reach its full effect, so it is important to keep to the planned schedule and attend your appointments.
Authoritative sources
- BNF
- NICE CKS
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