Tyruko vs. Tysabri for Multiple Sclerosis: 5 Similarities and Differences to Know

The landscape of multiple sclerosis (MS) treatment options has evolved substantially over the past few decades. Not only has the number of available medications increased, but the treatments are more effective at preventing MS progression than ever.

Tysabri (natalizumab) and Tyruko (natalizumab-sztn) are two of these medications. Tyruko was FDA approved in August 2023 as the first biosimilar to Tysabri, and it commercially launched in November 2025.

These medications share many common features. So how do you know if one is better for you? Here are five similarities and differences to consider for Tyruko versus Tysabri.

1. Tyruko is a biosimilar to Tysabri

Tysabri is a monoclonal antibody medication that was first approved to treat MS in 2004. It’s a type of biologic, which is a complex medication that’s made from natural and living sources.

Because of how they’re made, biologic medications don’t come in “brand name” and “generic” versions. Instead, they come as reference (original) biologics and biosimilars. A biosimilar is a biologic product that’s highly similar, but not identical, to a reference biologic. 

What does this mean? Tyruko is highly similar to Tysabri in terms of structure and function. One isn’t considered better or safer than the other. Clinically speaking, they’re expected to have the same benefits and risks.

The biggest differences between them are cost and availability. Biosimilars are generally more affordable than reference biologics. But the best and cheapest medication for you will depend on your health insurance coverage as well as what’s available at your infusion center.

Keep in mind: Tyruko isn’t interchangeable with Tysabri. You can only switch from one to the other with a new prescription order from your healthcare professional.

2. Tyruko and Tysabri work the same way

Tyruko and Tysabri lessen nerve inflammation in the same way. They bind to integrin proteins in your body and prevent white blood cells from causing brain inflammation.

They’re also administered the same way. The recommended dosage of Tyruko or Tysabri for MS is 300 mg every 4 weeks. They’re given as an intravenous (IV) infusion over 1 hour. 

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With either medication, you’ll likely keep receiving it as long as it’s working and isn’t causing bothersome side effects.

Good to know: Tyruko and Tysabri lessen gut inflammation using a similar strategy. In addition to MS, they’re both approved to treat Crohn's disease that hasn’t responded well to other treatments.

3. Tyruko and Tysabri treat the same forms of multiple sclerosis

Tyruko and Tysabri are disease-modifying therapies that treat relapsing forms of MS. They aim to slow the progression of MS.

Both medications are approved to treat the following types of MS:

• Clinically isolated syndrome (CIS): This refers to the first episode of MS symptoms you may experience. Some people report vision and bladder problems, arm and leg weakness, and coordination challenges that last at least 24 hours.

• Relapsing-remitting MS (RRMS): This is the most common type of MS. It’s characterized by relapses in symptoms and periods of remission.

• Secondary progressive MS (SPMS): SMPS is similar to RRMS, but it can become more disabling over time. Tysabri and Tyruko are only approved for SPMS during an “active” phase.

Your treatment plan depends on the type of MS you currently have. MS is a continuous condition, meaning it can change over time. It’s often unpredictable and tends to progress. You might go through periods of remission (when symptoms improve) followed by relapses (when symptoms return or worsen) without much warning.

Good to know: There is a fourth type of MS called primary progressive MS (PPMS). People with PPMS experience worsening symptoms over time and don’t have periods of relapse or remission. Tysabri and Tyruko aren’t approved for this form of MS.

4. These medications have the same benefits and side effects

During the FDA-approval process, biosimilar manufacturers must show that there are no meaningful differences in safety or effectiveness between their product and the reference biologic.

In a phase 3 study of more than 250 adults with MS, half received Tyruko and half received Tysabri. After about 6 months, there were no major differences in how well the medications worked or in their side effects. You can expect similar benefits and risks from either one.

Tyruko and Tysabri both have serious risks to keep in mind

Tyruko and Tysabri are thought to have the same side effects. Some of the most common ones are headaches, fatigue, and joint pain. Serious side effects are uncommon. But they can cause new or worsening infections, liver problems, and allergic reactions, among other serious issues.

One notable infection to be aware of is progressive multifocal leukoencephalopathy (PML). This rare brain infection is life-threatening. Your prescriber should check your blood for the virus that causes PML. If you test positive for the JC virus (JCV), your risk for PML is higher during treatment with Tyruko or Tysabri.

Because of the risk of PML, close monitoring is important. The FDA requires anyone prescribed Tysabri to be enrolled in the TOUCH Prescribing Program. And Tyruko is only available through the Tyruko Risk Evaluation and Mitigation Strategies (REMS) program. These medication safety programs help make sure the benefits of Tysabri and Tyruko outweigh the risks for people who need them.

5. There are ways to save on both Tyruko and Tysabri

Biosimilars usually cost less than their reference biologics. That’s because the FDA allows biosimilar manufacturers to use some of the research from the original medication, which saves time and money. These savings often lead to a lower list price.

Still, the most affordable option for you depends on your situation. If you have insurance, your plan may prefer one medication over the other, which directly affects how much you'll pay. In most cases, your insurance plan and infusion center will decide which medication you receive.

If you’re having trouble with coverage, GoodRx can help you navigate other ways to save on your prescription:

• Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, Tysabri’s price is as little as $0 if you use a manufacturer’s copay savings card. Tyruko’s manufacturer also offers a copay savings card that lowers the price to $0.

• Save with a patient assistance program. If you’re uninsured or underinsured, you may be eligible to receive your medication for free through Tysabri or Tyruko’s patient assistance program.

Why trust our experts?

Written by:

Cassandra Pardini, PharmD, MS

Cassandra Pardini has been a freelance medical writer for 7 years. In that time, she has concentrated on publishing articles on medication-related information for healthcare professionals and patients.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

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