What is Etanercept (Enbrel®)?
Etanercept is a drug that reduces the signs and symptoms of moderate to severe rheumatoid arthritis (RA), such as joint swelling, pain, fatigue, and length of morning stiffness. It is also prescribed for psoriasis, psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis. Etanercept is commonly known as Enbrel. It is a biologic drug that is in a class of drugs called anti-TNFs or TNF blockers.
How do I take it?
Etanercept is injected under the skin (similar to insulin injections) once a week. The injections are 50 mg each and are available in either a prefilled syringe or an automatic “pen” injector. You will be instructed on how to give yourself injections.
What about side effects?
The most common side effect is serious infection. Etanercept can lower the body’s ability to fight infection. Be sure to contact your physician if you have any signs of infection, such as fever, cough, or red or painful skin. You may have to stop etanercept while being treated for an infection. You may also have to stop etanercept if you are planning a surgery.
You will need to have a negative tuberculosis (TB) skin test before beginning etanercept therapy. Your doctor may also want to check your blood to make sure you do not have Hepatitis B or C.
You should not be given any live vaccines, such as Flu-Mist (the nasal-spray flu vaccine), the chicken pox vaccine, the shingles vaccine or the measles vaccines, while on etanercept. The flu-shot (flu injection vaccine) is not a live virus and all patients should consider having this vaccination yearly.
Occasionally some patients develop a reaction at the injection site such as, redness, pain or swelling. Notify your doctor to find out the best way to handle any reactions.
Make sure your doctor knows if you have any symptoms of heart disease, like shortness of breath when you lie down or exert yourself, swelling or edema of both legs, ankles, and feet, or chest pain or heaviness. This class of drugs may cause your heart disease to get worse.
Tell your doctor if you live or have lived in an area where fungal infections are more common. You may be at higher risk of getting a fungal infection while taking etaercept.
Allergic reactions may happen. Call your healthcare provider or an emergency medical provider if you have any signs of an allergic reaction, such as rashes or hives; swollen face, eyelids, lips, or tongue; and difficulty breathing.
What about other medications?
When you are taking etanercept, it is very important that your doctors know if you are taking any other medicine. This includes prescription and non-prescription medicines as well as birth control pills, vitamins, and herbal supplements.
Etanercept can be taken with other medications – NSAIDS (Celebrex, ibuprofen, naproxen), prednisone, methotrexate, and Plaquenil. You cannot take etanercept with other TNF-blockers, or other biologic drugs used to treat RA.
What else should I know?
This medication should be refrigerated in its original container. Do not freeze this medicine. If you are traveling, you may store etanercept at room tempereature (up to 77oF) for up to 14 days. Once etanercept reaches room temperature, you cannot put it back in the refrigerator.
You must continue your regular visits to the rheumatologist. Your doctor will monitor you for any improvements in your rheumatoid arthritis and for any signs of infections.
Lymphoma and other malignancies, some fatal, have been reported in children and adolescent patients treated with TNF blockers, including Enbrel.
A Federal Drug Administration medication guide can be found at: