What is Tysabri (Natalizumab)?
Tysabri, with the active ingredient natalizumab, is a lab-created monoclonal antibody used to treat relapsing forms of Multiple Sclerosis (MS) and moderately to severely active Crohn's Disease (CD) [1.3.3, 1.3.5]. It works by preventing harmful immune cells from entering the brain and spinal cord or gut tissue, thus reducing inflammation [1.2.2]. Given as an intravenous (IV) infusion, typically every four weeks, Tysabri is a powerful disease-modifying therapy that helps manage these chronic conditions [1.3.5, 1.5.6]. However, it also comes with significant side effects, including a risk of a serious brain infection called progressive multifocal leukoencephalopathy (PML) and potential liver injury [1.2.6, 1.3.4].
Tysabri and Alcohol: The Official Stance
Official prescribing information and drug interaction checkers do not list a direct pharmacological interaction between Tysabri and alcohol [1.2.1, 1.2.3]. This means there isn't a chemical reaction between the two substances that immediately causes a specific adverse effect. However, the lack of a direct interaction does not mean the combination is safe [1.3.3]. Healthcare providers often advise patients to limit or avoid alcohol during treatment due to several indirect risks and overlapping side effects [1.2.1].
The Primary Concern: Liver Health
The most significant risk of combining Tysabri and alcohol relates to liver function. Tysabri itself carries a warning for causing clinically significant liver injury [1.3.4]. Cases of liver damage, indicated by markedly elevated serum hepatic enzymes and total bilirubin, have been reported in patients, sometimes as early as six days after the first dose [1.3.4]. Alcohol is also a well-known hepatotoxin, meaning it is damaging to the liver. Consuming alcohol, especially in large amounts, puts a strain on the liver [1.8.1]. When you combine a medication known to potentially harm the liver with alcohol, you may increase the cumulative burden on this vital organ, raising the overall risk of liver problems [1.2.1, 1.5.1]. For this reason, patients on Tysabri typically undergo regular liver function tests to monitor for any signs of damage [1.4.2].
Exacerbation of Underlying Condition Symptoms
Beyond liver concerns, alcohol can directly worsen the symptoms of the very conditions Tysabri is used to treat.
- For Multiple Sclerosis: Even a small amount of alcohol can temporarily worsen MS symptoms such as poor balance, lack of coordination, fatigue, and bladder issues [1.2.2, 1.5.3]. Since MS itself can affect balance and cognition, the added impact of alcohol can increase the risk of falls and injury [1.2.2].
- For Crohn's Disease: Alcohol can irritate the gastrointestinal tract, potentially leading to increased inflammation and a flare-up of Crohn's symptoms [1.2.1, 1.2.3].
Weakening the Immune System
Tysabri works by suppressing parts of the immune system to control autoimmune activity [1.3.3]. Alcohol is also known to have immunosuppressive effects [1.8.2, 1.8.3]. Combining the two could theoretically create an additive effect, further weakening the body's ability to fight off infections [1.2.2]. This is a critical consideration for a medication that already increases the risk of certain serious infections like PML [1.2.6].
Comparison Table: Tysabri Lifestyle Considerations
| Factor | Interaction/Risk with Tysabri | Recommendation |
|---|---|---|
| Alcohol | Increased risk of liver strain; may worsen MS/Crohn's symptoms; potential for additive immune suppression [1.2.1, 1.2.2]. | Discuss with your doctor; moderate or avoid consumption [1.2.1]. |
| Other Immunosuppressants | Co-administration is generally contraindicated as it can significantly increase the risk of serious infections [1.3.5]. | Always inform your doctor of all medications you are taking [1.2.4]. |
| Live Vaccines | Live vaccines should be avoided as Tysabri's immunosuppressive action can increase the risk of infection from the vaccine itself [1.3.4]. | Consult with your doctor about vaccination schedules. |
| Certain Herbal Supplements | Some supplements can affect liver function or interact with medications. | Disclose all supplements to your healthcare provider [1.2.4]. |
Guidelines for Patients
If you are being treated with Tysabri, the most crucial step is to have an open conversation with your neurologist or gastroenterologist about alcohol use. They can provide personalized advice based on your overall health, liver function, and the stability of your condition.
If your doctor agrees that occasional, moderate drinking is acceptable, follow these guidelines:
- Understand 'Moderate': For women, this typically means up to one drink per day; for men, up to two drinks per day [1.2.2].
- Monitor Your Symptoms: Pay close attention to how alcohol affects your MS or Crohn's symptoms. If you notice any worsening of balance, fatigue, or gut issues, it's best to abstain [1.5.3].
- Know the Signs of Liver Damage: Be aware of symptoms such as jaundice (yellowing of the skin or eyes), dark urine, unusual fatigue, nausea, or abdominal pain, and report them to your doctor immediately [1.3.6].
Conclusion
While there is no strict prohibition against drinking alcohol while on Tysabri, it is not a risk-free choice. The potential for increased liver stress, compounded immune suppression, and the worsening of underlying disease symptoms are significant concerns [1.2.1, 1.2.2]. The final decision rests on a careful and honest discussion between you and your healthcare provider, weighing your desire to drink against the potential health consequences.
For more information from the manufacturer, you may visit the official patient website: https://www.tysabri.com/
