What is Tyruko?

Overview

Natalizumab injection is used to treat patients with relapsing forms of multiple sclerosis (MS). This medicine will not cure MS, but it may slow some of the disabling effects and decrease the number of flare-ups (relapses) of the disease.

Natalizumab injection is also used to treat moderate to severely active Crohn's disease (CD) when other medicines or treatments did not work well. This medicine will not cure CD, but may prevent it from occurring again.

This medicine is available only under a restricted distribution program called the TYRUKO REMS Program.

Commonly Used Brand Name(s)

Tysabri

Therapeutic Classifications

Immune Suppressant

Pharmacologic Classifications

Monoclonal Antibody

Blackbox Warning

Intravenous route (Solution)

Progressive Multifocal Leukoencephalopathy - Natalizumab increases the risk of progressive multifocal leukoencephalopathy (PML), an opportunistic viral infection of the brain that usually leads to death or severe disability. Risk factors for PML include the presence of anti-JC virus antibodies, duration of therapy, and prior use of immunosuppressants. These factors should be considered in the context of expected benefit when initiating and continuing treatment with natalizumab. Monitor patients, and withhold natalizumab immediately at the first sign or symptoms suggestive of PML. Because of the risk of PML, natalizumab is available only through a restricted distribution program called the TYRUKO REMS Program.

Proper Use

A nurse or other trained healthcare professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins. The medicine must be injected slowly, so the needle will have to remain in place for about an hour.

It is very important that you understand the requirements of the TYRUKO REMS Program, and become familiar with the medication guide. Read and follow these instructions carefully. Ask your doctor if you have any questions. Ask your pharmacist for the medication guide if you do not have one.

Your doctor may need to check your brain before you start receiving this medicine. To do this, you may need to have a Magnetic Resonance Imaging (MRI) scan.

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make.

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your healthcare professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of natalizumab injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of natalizumab injection in the elderly.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Infliximab
• Tofacitinib

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Herpes infection—Use with caution. May increase the risk for more serious infections (e.g., encephalitis, meningitis, retinal necrosis).
• Liver disease—Use with caution. This medicine may make this condition worse.
• Progressive multifocal leukoencephalopathy (PML, rare brain infection) or history of—Should not be used in patients with this condition.
• Weak immune system (caused by HIV infection, AIDS, leukemia, lymphoma, or organ transplant)—Use is not recommended. May increase risk of developing infections, including PML.

Precautions

Your doctor will want to check your progress at 3 months and 6 months after the first injection, then every 6 months after that. Blood and urine tests may be needed to check for unwanted effects.

This medicine may increase your risk of developing infections, including a rare and serious brain infection called progressive multifocal leukoencephalopathy (PML). This is more likely to occur if you have had JCV infection, have been receiving natalizumab for a long time (longer than 2 years), or if you have been using medicine that weakens your immune system (e.g., azathioprine, cyclophosphamide, cyclosporine, mercaptopurine, methotrexate, mitoxantrone, mycophenolate mofetil, or steroid medicine) before receiving this medicine. Check with your doctor right away if you have vision changes, loss of coordination, clumsiness, memory loss, difficulty speaking or understanding what others say, or weak legs.

Natalizumab may cause a rare condition called immune reconstitution inflammatory syndrome (IRIS). This may occur after a person stops receiving this medicine after developing PML during treatment. Tell your doctor right away if you have an inflammatory reaction to an infection that includes mild burning, stinging, or tingling of the skin, or a feeling of heat, redness, or swelling of the skin.

Natalizumab may increase the risk of developing encephalitis, meningitis, or acute retinal necrosis caused by herpes and varicella viruses. Check with your doctor if you have a fever, headache, eye pain or redness, sensitivity of the eyes to the sun, or confusion.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing or swallowing, or any swelling of your hands, face, or mouth after receiving this medicine.

This medicine may lower the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.

Tyruko Images

TYRUKO 300mg/15mL Solution for Injection

Other integrin antagonists

Entyvio

Tysabri

Other Conditions

Crohn's Disease

Multiple Sclerosis