Abatacept and Vedolizumab: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 16, 2026 · Source data updated Jul 16, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Abatacept
Vedolizumab
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Both of these medicines calm down your immune system. Abatacept (Orencia) and vedolizumab are biologic drugs that work on immune pathways. When two immune-lowering drugs are used together, your body can have a harder time fighting off germs, so there is a higher chance of getting a serious infection. Studies with abatacept plus similar biologics showed more infections without any extra benefit.
The good news is your care team knows about this. Combining these two usually isn't recommended, so please don't stop or change either one on your own. Talk with your doctor or pharmacist, and let them know right away if you get a fever, chills, or feel run down.
Effect: Additive immunosuppression, increasing the risk of serious infection. Neither agent is enzymatically metabolized in a way relevant here; the concern is pharmacodynamic overlap, not a PK interaction.
- Direction: Increased infection risk (additive immune suppression).
- Mechanism: Unknown/theoretical; extrapolated from data on abatacept plus TNF antagonists and other RA/PsA biologics.
- Evidence: Theoretical for this specific pair; magnitude not quantified.
- Onset: Unspecified.
- Management: Concurrent use of abatacept with other RA/PsA biologics is not recommended. If transitioning between agents, monitor closely for signs and symptoms of infection.
What happens
An increased risk of infection
Interaction Deep Dive
In controlled clinical trials, combining abatacept with tumor necrosis factor (TNF) antagonists was shown to raise the likelihood of serious infection while offering no extra therapeutic benefit. Data are inadequate to assess the safety and effectiveness of abatacept when given alongside anakinra or biologic agents used for rheumatoid arthritis or psoriatic arthritis, so using these medications together is not advised. Patients should be watched for indications of infection during the switch from TNF antagonist therapy to abatacept1.
Why it happens (mechanism)
Unknown
How to manage this interaction
What your care team may do:
- Generally avoid using abatacept and vedolizumab together, since combining biologics that lower the immune system isn't recommended and hasn't shown added benefit.
- Choose one agent, or plan a careful transition from one to the other rather than overlapping them.
- Watch you closely for signs of infection, especially when switching between these medicines.
What you should do: Keep taking your medicines as prescribed and don't stop either one on your own. Ask your pharmacist or prescriber before combining them, and report fever, chills, cough, or any sign of infection promptly.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
2 reports — tap to read
a) Taking abatacept together with etanercept produced no added benefit but did increase the risk of serious infection when compared with etanercept by itself. In a 1-year randomized study (N=121) that was followed by an open-label long-term extension (LTE; n=80), patients with rheumatoid arthritis who were already receiving etanercept 25 mg twice/week continued that etanercept and were randomized to receive either abatacept 2 mg/kg IV on days 1, 15, and 30, and then every 4 weeks (n=85) or placebo (n=36). After finishing the double-blind portion, patients could enter the LTE phase, during which the abatacept dose was raised to roughly 10 mg/kg. At 6 months, the 2 mg/kg abatacept group demonstrated no meaningful improvement over the placebo group in modified American College of Rheumatology 20% (ACR20; 48.2% vs 30.6%) or ACR50 (25.9% vs 19.4%) response rates, though there was a significant difference in modified ACR70 rates (10.6% vs 0%). At 1 year, no significant differences in ACR20, 50, or 70 response rates were observed between the two groups. Serious adverse events occurred more often in the 2 mg/kg abatacept group (16.5%) at one year and in the 10 mg/kg abatacept group after 2 years of LTE (32.5%) than in the placebo group (2.8%). Serious infections at 1 year were reported in 3.5% of the 2 mg/kg abatacept group and 0% of the placebo group 2.
b) In controlled clinical trials involving adults with active rheumatoid arthritis who received abatacept together with a tumor necrosis factor (TNF) antagonist (n=204) compared with TNF antagonist therapy on its own (n=134), the rate of infection (63% vs 43%, respectively) and of serious infection (4.4% vs 0.8%, respectively) was higher with the combined therapy; furthermore, the combined therapy offered no additional benefit 1.
Common questions
Can I take Abatacept and Vedolizumab together?
Using abatacept and vedolizumab together can raise your risk of serious infection with no added benefit, so this combination is generally not recommended. Talk to your doctor or pharmacist before using both and watch for any signs of infection. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abatacept and Vedolizumab interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Abatacept and Vedolizumab interaction managed?
What your care team may do: Generally avoid using abatacept and vedolizumab together, since combining biologics that lower the immune system isn't recommended and hasn't shown added benefit. Choose one agent, or plan a careful transition from one to the other rather than overlapping them. Watch you closely for signs of infection, especially when switching between these medicines. What you should d… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Abatacept or Vedolizumab need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: ORENCIA(R) intravenous, subcutaneous injection, abatacept intravenous, subcutaneous injection. Bristol-Myers Squibb Company (per FDA), Princeton, NJ, 2020. DailyMed
- Weinblatt M, Schiff M, Goldman A, et al: Selective costimulation modulation using abatacept in patients with active rheumatoid arthritis while receiving etanercept: a randomised clinical trial. Ann Rheum Dis 2007; 66(2):228-234. PubMed
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