WARNING

Enbrel (generic name: etanercept) is a medication primarily used to treat autoimmune diseases such as rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis. While Enbrel can be effective in managing these conditions, it also carries certain risks and potential side effects. Some of the risks associated with taking Enbrel include:

• Increased susceptibility to infections: Enbrel works by suppressing the immune system, which can increase the risk of developing infections. This includes bacterial, viral, fungal, and other opportunistic infections. Patients taking Enbrel should be cautious and vigilant for signs of infection and seek medical attention if they develop symptoms such as fever, chills, cough, or other signs of illness.
• Risk of serious infections: In some cases, the infections contracted while on Enbrel can be severe and may require hospitalization or even be life-threatening. These infections can affect various parts of the body, including the respiratory tract, skin, and bloodstream.
• Increased risk of tuberculosis (TB): Enbrel can increase the risk of developing tuberculosis, including latent tuberculosis becoming active. Patients should be screened for TB before starting Enbrel, and precautions should be taken to monitor for signs of TB during treatment.
• Risk of malignancies: There have been reports of an increased risk of certain types of cancer in patients taking Enbrel, including lymphoma and skin cancer. However, the overall risk appears to be low, and the benefits of treatment often outweigh the potential risks.
• Potential for allergic reactions: Some patients may experience allergic reactions to Enbrel, which can manifest as rash, itching, swelling, dizziness, or difficulty breathing. Patients who experience severe allergic reactions should seek immediate medical attention.
• Injection site reactions: Common side effects of Enbrel include reactions at the injection site, such as pain, redness, swelling, or itching. These reactions are usually mild and temporary but can be bothersome for some patients.
• Neurological side effects: Rarely, Enbrel has been associated with neurological side effects such as seizures, multiple sclerosis-like symptoms, or optic neuritis. Patients experiencing these symptoms should seek medical attention promptly.

It’s essential for patients considering Enbrel to discuss the potential risks and benefits with their healthcare provider and to undergo regular monitoring during treatment to detect and manage any adverse effects promptly.

Why is this medication prescribed?

Enbrel (generic name: etanercept) is prescribed for several autoimmune conditions, including:

• Rheumatoid Arthritis (RA): Enbrel is used to reduce the signs and symptoms of moderate to severe rheumatoid arthritis, including joint pain, swelling, and stiffness, and to improve physical function.
• Psoriatic Arthritis (PsA): Enbrel is indicated for the treatment of active psoriatic arthritis, which is a type of arthritis that occurs in some people with psoriasis. It helps reduce joint inflammation, pain, and swelling associated with this condition.
• Ankylosing Spondylitis (AS): Enbrel is used to treat adults with active ankylosing spondylitis, a type of arthritis that affects the spine and can cause pain, stiffness, and reduced mobility.
• Plaque Psoriasis: Enbrel is prescribed for adults with moderate to severe plaque psoriasis, a chronic skin condition characterized by raised, red, and scaly patches on the skin.
• Juvenile Idiopathic Arthritis (JIA): Enbrel is used to treat polyarticular juvenile idiopathic arthritis in children aged 2 years and older, reducing symptoms such as joint pain and swelling.

How should this medicine be used?

Enbrel (generic name: etanercept) is typically administered as a subcutaneous injection, meaning it is injected under the skin. Here’s a general guide on how Enbrel should be used:

• Preparation: Before administering the injection, wash your hands thoroughly with soap and water. Allow the Enbrel solution to reach room temperature by placing it on a clean surface for about 15-30 minutes. Do not shake the vial or syringe.
• Choose the injection site: Common injection sites include the front of the thighs, abdomen (except for the area around the navel), or the outer area of the upper arm. Rotate injection sites to minimize irritation.
• Clean the injection site: Use an alcohol swab to clean the skin at the chosen injection site. Allow the skin to air dry completely before injecting.
• Prepare the injection: If using a prefilled syringe, remove the cap from the syringe needle. If using a vial and syringe, carefully remove the needle cover and inject air into the vial equal to the dose you will withdraw.
• Administer the injection: Hold the syringe like a pencil or a dart at a 45 to 90-degree angle to the skin. Pinch a fold of skin at the injection site and insert the needle quickly and firmly at the correct angle. Slowly push the plunger to inject the medication.
• Remove the needle: Once the injection is complete, release the pinched skin and carefully remove the needle from the skin.
• Dispose of the materials: Safely dispose of needles, syringes, and any unused medication as per local regulations. Do not reuse needles or syringes.
• Monitor for side effects: Keep track of any side effects or reactions after the injection. Contact your healthcare provider if you experience any concerning symptoms.
• Storage: Store Enbrel in the refrigerator at a temperature between 36°F to 46°F (2°C to 8°C). Do not freeze. If needed, Enbrel can be kept at room temperature (up to 77°F or 25°C) for up to 14 days. Once removed from the refrigerator, do not put it back.

It’s essential to follow the specific instructions provided by your healthcare provider or the manufacturer’s guidelines for proper administration of Enbrel. If you have any questions or concerns about how to use Enbrel, consult your healthcare provider or pharmacist for guidance.

Other uses for this medicine

While Enbrel is primarily used to treat autoimmune diseases like rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, and plaque psoriasis, it has also been used off-label for other conditions such as uveitis (inflammation of the eye), psoriasis-related nail disease, and Behçet’s disease.

What special precautions should I follow?

Regarding special precautions for Enbrel, here are some key points to consider:

• Infections: Enbrel can increase the risk of infections due to its immunosuppressive effects. Patients should be screened for infections, including tuberculosis, before starting Enbrel. It’s essential to monitor for signs of infection during treatment and to promptly report any symptoms such as fever, cough, or other signs of illness to a healthcare provider.
• Vaccinations: Patients should be up-to-date with all appropriate vaccinations before starting Enbrel therapy. Live vaccines should generally be avoided while on Enbrel due to the risk of infection. Discuss vaccination schedules and options with a healthcare provider.
• Malignancies: There have been reports of an increased risk of certain types of cancer, including lymphoma and skin cancer, in patients receiving Enbrel. Patients with a history of cancer or those at increased risk should be carefully monitored during treatment.
• Allergic reactions: Some patients may experience allergic reactions to Enbrel, including rash, itching, swelling, or difficulty breathing. Patients should seek medical attention if they develop severe allergic reactions.
• Neurological effects: Rarely, Enbrel has been associated with neurological side effects such as seizures, multiple sclerosis-like symptoms, or optic neuritis. Patients experiencing these symptoms should seek medical attention promptly.
• Pregnancy and breastfeeding: The safety of Enbrel during pregnancy and breastfeeding is not well-established. Women who are pregnant, planning to become pregnant, or breastfeeding should discuss the risks and benefits of Enbrel with their healthcare provider.

It’s important for patients to discuss any concerns or questions about Enbrel with their healthcare provider before starting treatment. Regular monitoring and follow-up appointments are essential to ensure the safe and effective use of Enbrel.

What special dietary instructions should I follow?

Regarding special dietary instructions, there are no specific dietary restrictions associated with Enasidenib. However, it’s essential to maintain a balanced and healthy diet to support your overall well-being during treatment.

What should I do if I forget a dose?

If you forget to take a dose of Enasidenib, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are unsure about what to do, contact your healthcare provider or pharmacist for advice.

What side effects can this medication cause?

Enbrel (etanercept) is generally well-tolerated, but like any medication, it can cause side effects in some people. Common side effects of Enbrel may include:

• Injection site reactions: Pain, redness, swelling, or itching at the injection site are common side effects of Enbrel. These reactions are usually mild and temporary.
• Upper respiratory tract infections: Patients taking Enbrel may experience symptoms such as sore throat, cough, or sinus congestion due to upper respiratory tract infections.
• Headache: Some patients may experience headaches while taking Enbrel.
• Nasopharyngitis: This refers to inflammation of the nose and throat, which can cause symptoms such as a runny or stuffy nose and sore throat.
• Nausea: Some patients may experience nausea as a side effect of Enbrel.
• Diarrhea: Diarrhea can occur in some patients taking Enbrel.

Less common but more serious side effects of Enbrel may include:

• Serious infections: Enbrel can increase the risk of developing serious infections, including bacterial, viral, fungal, and other opportunistic infections. Symptoms of infection may include fever, chills, cough, or other signs of illness.
• Tuberculosis (TB): Enbrel can increase the risk of developing tuberculosis, including reactivation of latent tuberculosis infection. Patients should be screened for TB before starting Enbrel and monitored for signs of TB during treatment.
• Allergic reactions: Some patients may experience allergic reactions to Enbrel, which can manifest as rash, itching, swelling, dizziness, or difficulty breathing. Severe allergic reactions require immediate medical attention.
• Neurological side effects: Rarely, Enbrel has been associated with neurological side effects such as seizures, multiple sclerosis-like symptoms, or optic neuritis.
• Malignancies: There have been reports of an increased risk of certain types of cancer, including lymphoma and skin cancer, in patients receiving Enbrel. However, the overall risk appears to be low.

It’s important for patients to be aware of the potential side effects of Enbrel and to promptly report any concerning symptoms to their healthcare provider. Additionally, patients should undergo regular monitoring and follow-up appointments to assess the effectiveness of treatment and monitor for any adverse effects.

What should I know about storage and disposal of this medication?

• Storage of Enbrel:
  • Store Enbrel in the refrigerator at a temperature between 36°F to 46°F (2°C to 8°C). Do not freeze.
  • Keep Enbrel in its original carton to protect it from light.
  • If needed, Enbrel can be kept at room temperature (up to 77°F or 25°C) for up to 14 days. Once removed from the refrigerator, do not put it back.
• Disposal of Enbrel:
  • Safely dispose of needles, syringes, and any unused Enbrel as per local regulations.
  • Do not reuse needles or syringes.
  • Ask your healthcare provider or pharmacist for information on how to properly dispose of Enbrel and its accessories.

In case of emergency/overdose

• In case of an overdose or accidental injection of too much Enbrel, seek emergency medical attention or contact a poison control center immediately.
• Symptoms of overdose may include increased risk of infection, severe allergic reactions, or other serious side effects.

What other information should I know?

• Inform your healthcare provider about all the medications you are currently taking, including prescription drugs, over-the-counter medicines, vitamins, and supplements.
• Keep all appointments with your healthcare provider for monitoring and follow-up during Enbrel treatment.
• Notify your healthcare provider if you experience any new or worsening symptoms while taking Enbrel, including signs of infection, allergic reactions, or other side effects.
• Enbrel should not be used in combination with other biologic medications without consulting a healthcare provider.
• Patients should be cautious when driving or operating machinery, as Enbrel may cause dizziness or fatigue in some individuals.

It’s crucial to follow your healthcare provider’s instructions carefully regarding the storage, disposal, and use of Enbrel. If you have any questions or concerns about Enbrel or its administration, don’t hesitate to consult your healthcare provider or pharmacist for guidance.