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vedolizumab

Sold as Entyvio. Class: Monoclonal antibodies. First FDA approval 05/20/2014: 12 years on the US market.

This grade answers one narrow question: how strong is the public evidence and safety record behind this drug, and how clean is its money trail and court record? It is not a verdict on whether the drug is right for you.

B

Score breakdown (77/100)

Safety ×35%
A
Evidence ×25%
D
Regulatory ×15%
A
Money & lawsuits ×15%
D
Options ×10%
C

Safety: 95

Evidence: 56

Regulatory history: 95

Money & lawsuits: 55

Options: 70

What the FDA label says

Approved uses

is indicated in adults for the treatment of: moderately to severely active ulcerative colitis (UC). moderately to severely active Crohn's disease (CD). ENTYVIO is an integrin receptor antagonist indicated in adults for the treatment of: moderately to severely active ulcerative colitis (UC). ( 1 ) moderately to severely active Crohn's disease (CD). ( 1 )

Contraindications

is contraindicated in patients who have had a known serious or severe hypersensitivity reaction to ENTYVIO or any of its excipients (such as dyspnea, bronchospasm, urticaria, flushing, rash and increased heart rate) [see Warnings and Precautions (5.1) ] . Patients who have had a known serious or severe hypersensitivity reaction to ENTYVIO or any of its excipients. ( 4 )

Warnings and precautions

Infusion-Related Reactions and Hypersensitivity Reactions : Discontinue ENTYVIO and initiate appropriate treatment if serious reactions occur. ( 5.1 ) Infections : Treatment with ENTYVIO should not be initiated in patients with a clinically important active infection until the infection resolves or is adequately treated. If a serious infection develops, ENTYVIO should not be administered until the infection resolves. ( 5.2 ) Progressive Multifocal Leukoencephalopathy (PML) : Although unlikely, a risk of PML cannot be ruled out. Monitor patients for any new or worsening neurological signs or symptoms. ( 5.3 ) 5.1 Infusion-Related Reactions and Hypersensitivity Reactions Infusion-related reactions and hypersensitivity reactions have been reported, including anaphylaxis, dyspnea, bronchospasm, urticaria, flushing, rash, and increased blood pressure and heart rate [see Adverse Reactions (6.1 , 6.2) ]. These reactions may occur with the first or subsequent infusions of ENTYVIO and may vary in their time of onset from during infusion or up to several hours post-infusion. If anaphylaxis or other serious infusion-related or hypersensitivity reactions occur, discontinue administration of EN...

Adverse reactions (label)

The following topics are also discussed in detail in the Warnings and Precautions section: Infusion-Related Reactions and Hypersensitivity Reactions [see Warnings and Precautions (5.1) ] Infections [see Warnings and Precautions (5.2) ] Progressive Multifocal Leukoencephalopathy [see Warnings and Precautions (5.3) ] Liver Injury [see Warnings and Precautions (5.4) ] Most common adverse reactions (incidence ≥3% and ≥1% higher than placebo) are: nasopharyngitis, headache, arthralgia, nausea, pyrexia, upper respiratory tract infection, fatigue, cough, bronchitis, influenza, back pain, rash, pruritus, sinusitis, oropharyngeal pain, and pain in extremities. ( 6.1 ) Adverse reactions with subcutaneous ENTYVIO are similar to those reported with intravenous ENTYVIO with the exception of injection site reactions reported with subcutaneous ENTYVIO. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Takeda Pharmaceuticals U.S.A., Inc. at 1-877-TAKEDA-7 (1-877-825-3327) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot...

Recent major label changes

Dosage and Administration Important Administration Information ( 2.1 ) 2/2026 Warnings and Precautions Infections ( 5.2 ) 2/2026

Source: FDA SPL label for ENTYVIO (Takeda Pharmaceuticals America, Inc.), effective 20260429. Full label on DailyMed.

Side-effect reports sent to the FDA

These are counts of reports people filed, not rates of harm. Anyone can file one, and nobody checks whether the drug was the cause. Millions of doses are taken for every report sent, so the useful part is how this drug compares with the average across all drugs.

85,742reports that mention this drug
85,718of those blame this drug, not another one the person was taking
87%of reports describe a serious outcome, such as a hospital stay (average for all drugs: 57%)
4.9%of reports include a death, from any cause (average for all drugs: 9.1%)

Problems reported most often

Off Label Use · 22,326Colitis Ulcerative · 15,631Crohn^S Disease · 11,371Drug Ineffective · 9,920Diarrhoea · 8,706Abdominal Pain · 7,454Fatigue · 6,308Haematochezia · 6,142Frequent Bowel Movements · 5,261Arthralgia · 4,741Malaise · 4,329Nausea · 4,165Headache · 4,121Inappropriate Schedule Of Product Administration · 4,036Product Dose Omission Issue · 3,817

Reports per year

20192020202120222023202420252026
5,5207,46910,5409,44511,04912,18811,2245,190

Source: the FDA's Adverse Event Reporting System (FAERS). Reports are voluntary and unverified. Drugs that are prescribed a lot, in the news, or in lawsuits attract more reports, so the percentages are compared with the whole database to correct for that partly, not fully.

Recalls and regulatory record

0recall actions on file
0 / 0brand / generic applications
0label changes since 2021
NoREMS program

Evidence base

45randomized trials (PubMed)
51systematic reviews
217registered trials
50%of completed trials posted results
12%terminated or withdrawn
54%industry-funded

Independent Cochrane reviews

Counts measure how much evidence exists and how transparent it is, not how big the benefit is. For that, ask your prescriber: if 100 people like me took this, how many would get better because of it, and how many would be harmed? (Doctors call these the "number needed to treat" and "number needed to harm.") It differs by condition and is the number drug ads leave out. Sources: PubMed, ClinicalTrials.gov.

Money and lawsuits

In 2024, drug companies reported $30,029,706 in payments to US physicians and hospitals tied to this drug across 59,568 transactions (Entyvio $30,029,706).

No pending federal MDL names this drug or its brands.

Not named in any federal pharmaceutical settlement of $100M or more on record.

Sources: CMS Open Payments (Sunshine Act); Judicial Panel on Multidistrict Litigation pending docket list; DOJ settlements as tabulated on Wikipedia with links to the primary record. State-court and individual suits are not included.

Who takes it and what it costs

3,697Medicare Part D patients (2024)
18,679prescriptions filled
$8,399average cost per fill
$157Mtotal Medicare spend
ProductFills$/fill
Entyvio14,773$8,749
Entyvio Pen3,906$7,074

Same-class alternatives

alemtuzumabanifrolumabaxatilimabbelimumabefalizumabemapalumabinebilizumabmuromonab-cd3natalizumabofatumumabrozanolixizumabsibeprenlimabublituximab

Same ATC pharmacological class, graded ones first, best grade at the top. Being in the same class does not make them interchangeable for your condition; it makes them worth asking about.

Questions to ask your prescriber

  1. The most-reported problems in FDA's adverse event data are colitis ulcerative, crohn^s disease. How would we recognize and handle those?
  2. Off-label use is among the most-reported items for this drug. Is my use on-label, and if not, what evidence supports it?
  3. Why this one over alemtuzumab, anifrolumab, axatilimab? What would make you pick one of those instead?
  4. There is no generic. Is there an older generic in the same class that works as well for my situation?
  5. The manufacturer pays physicians heavily to promote this drug. Have you received anything from them?
  6. What result are we expecting, by when, and what is the plan if it does not happen?
  7. If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)