[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Other immunomodulating biologics](https://durgical.com/en/pharmacology/classes/other-immunomodulating-biologics/) › Vedolizumab

# Vedolizumab

## Other immunomodulating biologics?

Other immunomodulating biologics

A gut-selective antibody against α4β7 integrin that keeps inflammatory lymphocytes out of the bowel wall in Crohn's disease and ulcerative colitis.

Updated Nov 1, 2026

## Quick facts

**Group**
[Other immunomodulating biologics](https://durgical.com/en/pharmacology/classes/other-immunomodulating-biologics/)

**Target**
α4β7 integrin on gut-homing lymphocytes

**Used for**
Moderate to severe Crohn's disease

**Key effects**
Headache · Nausea · Joint or back pain

**Monitor**
Tuberculosis history · Liver symptoms · New confusion

**ATC**
L04AG05

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◎**α4β7 integrin on gut-homing lymphocytes**Vedolizumab

ⓘ The figure shows the human α4β7 integrin headpiece bound to the Fab of Act-1, a mouse antibody that also blocks α4β7; vedolizumab itself is not in this crystal.

**Target in 3D:** α4β7 integrin on gut-homing lymphocytes. PDB structure 3V4P (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/3V4P) · Drag to rotate · pinch to zoom

Vedolizumab is a humanised IgG1 antibody that binds the α4β7 integrin on lymphocytes. It blocks their attachment to MAdCAM-1, an adhesion molecule on the blood vessels of the intestinal mucosa, so fewer lymphocytes enter the inflamed gut. Unlike natalizumab, it does not block α4β1 binding to VCAM-1, which T cells use to enter the brain.

- Antibody binds α4β7 integrin on lymphocytes
- Lymphocytes cannot attach to gut MAdCAM-1
- Fewer lymphocytes enter the bowel wall
- Intestinal inflammation settles

## Indications

- Moderate to severe Crohn's disease [Crohn disease →](https://durgical.com/en/conditions/crohn-disease/)
- Moderate to severe ulcerative colitis [Ulcerative colitis →](https://durgical.com/en/conditions/ulcerative-colitis/)

## Adverse effects

### Common

- Headache
- Nausea
- Joint or back pain, pain in the limbs
- Sore throat and cold symptoms, tiredness

### Serious (rare, important)

- Allergic and infusion reactions, during or hours after the infusion
- Serious infections
- Liver injury
- Progressive multifocal leukoencephalopathy (PML), reported very rarely

## Contraindications

- Hypersensitivity to vedolizumab
- Active serious infection

## Key interactions

**TNF inhibitors (infliximab, adalimumab)**
May add to the adverse effects of vedolizumab; not combined routinely.

**Vaccines, especially live vaccines**
Brought up to date before starting; during treatment only with the team's agreement.

## What is monitored

- Allergic reactions during the infusion and for several hours after
- Tuberculosis history and exposure before starting
- Liver symptoms (dark urine, yellow skin or eyes)
- New confusion, weakness on one side, or speech or vision changes (PML)
- Response; treatment is reviewed if there is no benefit by week 14

## Administration and safety

- The intravenous infusion is given by a doctor or nurse.
- The subcutaneous form can be self-injected at home after teaching.
- Vaccines are brought up to date before the first dose.

## Pregnancy and breastfeeding

Human data are limited; pregnancy and breastfeeding plans are discussed with the treating team.

## Nursing care

- Watch for rash, itching, swelling or breathing difficulty during the infusion and for several hours after.
- Before starting, confirm tuberculosis history and screening.
- Teach to report fever, cough, painful urination or red, painful skin.
- Teach to report new confusion, memory problems, one-sided weakness or vision changes at once.

## Pharmacokinetics

**Absorption**
Intravenous infusion; after the first infusions it may be switched to subcutaneous injection

**Metabolism**
Broken down like other antibodies

## Memory aid

VEDOlizumab stays in the gut: α4β7 + MAdCAM-1 = 'Mucosa only', so the brain stays open (PML far rarer than with natalizumab).

## Test yourself

Think of the answer, then tap the question to see it.

## Which integrin does vedolizumab block?

α4β7 integrin on gut-homing lymphocytes.

## Why is PML much rarer with vedolizumab than with natalizumab?

Vedolizumab blocks only α4β7–MAdCAM-1 in the gut; natalizumab also blocks α4β1–VCAM-1, which T cells need to enter the brain.

## Which two diseases is vedolizumab used for?

Crohn's disease and ulcerative colitis.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/vedolizumab/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Natalizumab](https://durgical.com/en/pharmacology/natalizumab/)
- [Infliximab](https://durgical.com/en/pharmacology/infliximab/)
- [Ustekinumab](https://durgical.com/en/pharmacology/ustekinumab/)

## Related conditions 2

- [Crohn disease](https://durgical.com/en/conditions/crohn-disease/)
- [Ulcerative colitis](https://durgical.com/en/conditions/ulcerative-colitis/)

[← Back to the class: Other immunomodulating biologics](https://durgical.com/en/pharmacology/classes/other-immunomodulating-biologics/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Vedolizumab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a614034.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [RCSB PDB - 3V4P: crystal structure of a4b7 headpiece complexed with Fab ACT-1](https://www.rcsb.org/structure/3V4P) (RCSB Protein Data Bank, 2012); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L04AG05) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/vedolizumab/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/vedolizumab/