WARNING

Etanercept injection is a medication primarily used to treat autoimmune diseases like rheumatoid arthritis, psoriasis, and ankylosing spondylitis. While it can be effective in managing these conditions, there are potential risks associated with its use. Some of these risks include:

• Increased Risk of Infections: Etanercept can suppress the immune system, making the body more susceptible to infections. This includes bacterial, viral, and fungal infections. Patients taking etanercept should be cautious about exposure to infectious agents and report any signs of infection promptly to their healthcare provider.
• Risk of Reactivation of Latent Infections: There is a risk of reactivating latent infections such as tuberculosis (TB) or hepatitis B in individuals who have previously been exposed to these infections. Prior screening for these infections is often recommended before starting etanercept therapy.
• Risk of Injection Site Reactions: Injection site reactions such as redness, swelling, pain, or itching may occur. These reactions are usually mild and transient but should be monitored.
• Increased Risk of Malignancies: Some studies suggest a possible increased risk of certain types of cancers, such as lymphoma, in patients treated with etanercept. However, the overall risk is still relatively low.
• Development of Autoantibodies: In some cases, etanercept treatment may lead to the development of autoantibodies, which are antibodies that mistakenly target the body’s own tissues, potentially leading to autoimmune disorders.
• Potential for Cardiovascular Events: Some studies have suggested a potential association between tumor necrosis factor (TNF) inhibitors like etanercept and an increased risk of cardiovascular events such as heart attack or stroke. However, the evidence is still inconclusive.

It’s essential for patients considering or currently taking etanercept to discuss these risks with their healthcare provider thoroughly. They should also be closely monitored for any signs of adverse effects while on treatment.

Why is this medication prescribed?

Etanercept injection is prescribed for the treatment of various autoimmune diseases, including:

• Rheumatoid arthritis: Etanercept is used to reduce signs and symptoms of rheumatoid arthritis, including joint pain, swelling, and stiffness.
• Psoriatic arthritis: It can help alleviate symptoms such as joint pain, swelling, and skin lesions associated with psoriatic arthritis.
• Ankylosing spondylitis: Etanercept is used to manage symptoms of ankylosing spondylitis, a type of arthritis that primarily affects the spine and sacroiliac joints, reducing pain, stiffness, and inflammation.
• Plaque psoriasis: Etanercept can also be prescribed for the treatment of moderate to severe plaque psoriasis, reducing the severity and extent of skin lesions.

How should this medicine be used?

The dosage and administration of etanercept injection can vary depending on the condition being treated and individual patient factors. However, it is typically administered by subcutaneous injection (under the skin). Here are general guidelines for using etanercept:

• Dosage: The recommended dosage of etanercept varies depending on the condition being treated. It is typically administered once or twice weekly.
• Administration: Etanercept is supplied as a prefilled syringe or autoinjector pen. The injection is usually given in the thigh, abdomen (except for the area around the navel), or outer area of the upper arm. Patients should rotate injection sites to minimize the risk of injection site reactions.
• Storage: Etanercept should be stored in the refrigerator at a temperature between 36°F to 46°F (2°C to 8°C). It should not be frozen. Before administration, the medication should be allowed to reach room temperature for about 15 to 30 minutes.
• Monitoring: Patients taking etanercept should be monitored regularly by their healthcare provider to assess treatment response and monitor for any potential side effects or complications.
• Adherence: It’s crucial for patients to adhere to the prescribed dosage and schedule of etanercept to ensure optimal treatment outcomes.

As with any medication, it’s essential for patients to follow their healthcare provider’s instructions carefully and to discuss any questions or concerns about etanercept use.

Other uses for this medicine

In addition to the conditions mentioned above, Etanercept may also be used off-label for other inflammatory conditions such as inflammatory bowel disease (Crohn’s disease, ulcerative colitis), uveitis (inflammation of the eye), and other autoimmune diseases. However, the use of Etanercept for these conditions should be done under the guidance and supervision of a healthcare professional.

What special precautions should I follow?

Special precautions should be taken when using etanercept injection. Here are some important considerations:

• Infections: Since etanercept can suppress the immune system, patients are at an increased risk of infections. Before starting treatment, patients should be screened for latent infections such as tuberculosis (TB) and hepatitis B. They should also be advised to report any signs of infection to their healthcare provider promptly.
• Vaccinations: Live vaccines should generally be avoided while on etanercept therapy due to the risk of vaccine-induced infections. However, certain non-live vaccines may be recommended before starting treatment, as they may be less effective once therapy begins.
• Monitoring: Patients should be monitored regularly for signs of infections, including fever, chills, cough, and any unusual symptoms. Blood tests may also be performed periodically to monitor for changes in white blood cell counts and liver function.
• Malignancies: While the overall risk is low, there is a potential increased risk of certain types of cancers, such as lymphoma, associated with etanercept therapy. Patients should be advised to undergo regular cancer screenings as recommended by their healthcare provider.
• Heart Failure: Etanercept has been associated with exacerbation of heart failure in some patients. Patients with a history of heart failure should be closely monitored while on etanercept therapy.
• Neurological Disorders: Rare cases of central nervous system demyelinating disorders, such as multiple sclerosis, have been reported in patients treated with etanercept. Patients with a history of neurological disorders should use etanercept with caution.
• Pregnancy and Breastfeeding: The safety of etanercept during pregnancy and breastfeeding is not well-established. It should be used during pregnancy only if the potential benefits outweigh the potential risks, and breastfeeding should be avoided while on treatment.

Patients should discuss these precautions with their healthcare provider before starting etanercept therapy. It’s essential to weigh the potential benefits against the risks and to follow all recommendations for monitoring and management.

What special dietary instructions should I follow?

Regarding dietary instructions, there are no specific dietary restrictions associated with etanercept injection. However, maintaining a balanced diet and healthy lifestyle can support overall health and may complement your treatment.

What should I do if I forget a dose?

If you forget a dose of etanercept injection, take it as soon as you remember. However, if it’s almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up. If you’re unsure about what to do, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Etanercept injection, like any medication, can cause side effects. Common side effects may include:

• Injection site reactions: Pain, redness, itching, or swelling at the injection site are common. These reactions are usually mild and improve over time.
• Upper respiratory tract infections: Such as the common cold, sinus infections, or throat infections may occur more frequently.
• Headache: Mild to moderate headaches are common.
• Nausea: Some individuals may experience nausea or stomach discomfort.
• Dizziness: Feeling lightheaded or dizzy can occur in some cases.
• Fatigue: Feeling tired or fatigued may occur, especially during the initial stages of treatment.
• Skin reactions: Including rash or itching may occur.
• Musculoskeletal symptoms: Some patients may experience muscle or joint pain.

Less common but more severe side effects may include:

• Serious infections: Etanercept can increase the risk of serious infections, including bacterial, viral, or fungal infections. Symptoms may include fever, chills, cough, or unusual fatigue.
• Allergic reactions: Rarely, severe allergic reactions may occur, including anaphylaxis. Seek immediate medical attention if you experience symptoms such as difficulty breathing, swelling of the face or throat, or severe itching.
• Neurological symptoms: Rare cases of central nervous system disorders, such as multiple sclerosis or seizures, have been reported.
• Blood disorders: Etanercept can affect blood cell counts, leading to anemia, leukopenia (low white blood cell count), or thrombocytopenia (low platelet count).
• Heart failure exacerbation: In individuals with a history of heart failure, exacerbation of symptoms may occur.
• Hepatitis B reactivation: In individuals with a history of hepatitis B infection, reactivation of the virus may occur.
• Autoimmune disorders: Rarely, etanercept may trigger the development of autoimmune disorders.

It’s essential to report any side effects to your healthcare provider promptly. They can help manage side effects and determine whether any adjustments to treatment are necessary. If you experience severe or life-threatening symptoms, seek immediate medical attention.

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

Storage and disposal of Etanercept Injection:

• Storage:
  • Store Etanercept Injection in the refrigerator at a temperature between 36°F to 46°F (2°C to 8°C).
  • Do not freeze.
  • Protect from light.
  • Keep the medication in its original packaging until ready to use.
  • Do not use Etanercept Injection if it has been frozen or if the expiration date has passed.
• Disposal:
  • Dispose of used needles and syringes in a puncture-resistant container.
  • Follow local regulations or guidelines for the disposal of biohazardous waste.
  • Do not dispose of Etanercept Injection in household trash or flush down the toilet unless instructed to do so by your healthcare provider or pharmacist.

In case of emergency/overdose

• If you suspect an overdose or experience severe adverse reactions, seek immediate medical attention or contact your local poison control center.
• Do not attempt to treat an overdose on your own.
• Symptoms of overdose may include increased risk of infections, severe allergic reactions, or exacerbation of side effects.

What other information should I know?

• Follow-up appointments: Attend all scheduled follow-up appointments with your healthcare provider to monitor your response to treatment and adjust the dosage if necessary.
• Medication interactions: Inform your healthcare provider about all medications, supplements, and herbal products you are taking, as they may interact with Etanercept Injection.
• Pregnancy and breastfeeding: Discuss the risks and benefits of using Etanercept Injection during pregnancy or breastfeeding with your healthcare provider. It’s essential to weigh the potential risks to the fetus or infant against the benefits of treatment.
• Travel considerations: If you need to travel with Etanercept Injection, ensure proper storage and transportation to maintain the medication’s efficacy. Plan ahead to have an adequate supply of medication for the duration of your trip.
• Patient education: Familiarize yourself with the proper injection technique and storage requirements for Etanercept Injection. Your healthcare provider or pharmacist can provide detailed instructions and guidance.

Always consult your healthcare provider or pharmacist if you have any questions or concerns about using Etanercept Injection. Follow their recommendations closely for safe and effective treatment.