Enbrel (Etanercept)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Enbrel Used For?
Enbrel is a specialized medication that helps reduce inflammation in joints and skin by targeting a specific protein in your body that causes pain and swelling.
Primary Uses
Enbrel treats specific inflammatory joint and skin conditions including rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis (nr-AxSpA), psoriatic arthritis, and plaque psoriasis. It helps reduce pain and swelling in joints, treats skin lesions of psoriasis, and improves overall condition in patients with these inflammatory diseases.
How It Works
Etanercept is a biotechnology-derived protein that works by binding to and inactivating Tumour Necrosis Factor (TNF), a naturally occurring chemical in your bloodstream that contributes to pain and swelling in the joints.
Good to know: Enbrel is not addictive and is available only with a doctor’s prescription.
How to Take Enbrel
Enbrel is given as an injection under the skin. Your doctor will supervise and train you on proper injection technique when you first start treatment.
Dosage Instructions
For adults: The recommended dose is 50 mg per week, given either as a single 50 mg injection once weekly, or as two separate 25 mg injections 3-4 days apart. For children: The dose depends on body weight and the specific condition being treated. For juvenile idiopathic arthritis, the dose is 0.8 mg per kg bodyweight (up to 50 mg maximum) once weekly, or 0.4 mg per kg bodyweight (up to 25 mg maximum) twice weekly. Each injection should be at a different site, at least 3 cm from previous injection sites. Use at the same time each week or every 3-4 days as directed.
What If You Miss a Dose?
If you miss your dose at the usual time, inject the next dose as soon as you remember, unless your next dose is scheduled for the next day. In that case, skip the missed dose and continue your normal schedule. If you notice you skipped a dose on the day of your next dose, do NOT take a double dose.
Important: Never inject more than the dose recommended by your doctor. Each vial or syringe is for single use only in one patient. Powder for injection must be discarded 6 hours after preparation.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Injection site reactions (itching, bruising, redness, bleeding, swelling, pain, hardness)
- Infections (cold, sinus infections)
- Allergic reactions (wheezing, shortness of breath, swelling, rash, itching, dizziness)
- Headaches
- Fever
Seek immediate medical attention if you experience:
- Serious infections (tuberculosis, blood poisoning/sepsis, fever, chills, mouth ulcers, sore throat)
- Lung disease (breathlessness during exercise, dry cough)
- Soft tissue infections (bumps or sores that don’t heal, swollen, red, or pus-filled)
- Nervous system disorders (seizures, numbness, tingling, weakness, dizziness, vision problems)
- Inflammation (spinal cord, inner eye, blood vessels, inflammatory bowel symptoms)
- Kidney problems (urinating less, pink/dark brown foamy urine, swelling, high blood pressure)
- Severe allergic reactions (face/lip/tongue swelling, difficulty swallowing/breathing, hives)
- Lupus or lupus-like syndrome (weight changes, persistent rash, fever, joint/muscle pain, fatigue)
- Blood disorders (tiredness, headaches, shortness of breath, dizziness, paleness, unusual bleeding/bruising, frequent infections)
- Heart failure (shortness of breath, persistent cough, difficulty exercising, irregular heartbeat, leg/feet swelling)
- Cancer (skin cancers, lymphoma, Kaposi’s sarcoma, leukemia)
Important Warnings
Enbrel can affect your body’s ability to fight infections, so it’s crucial to discuss your medical history and current health status with your doctor.
Who Should Not Take Enbrel
Do not use Enbrel if you are allergic to etanercept, latex, or any ingredients; have or are at risk of developing sepsis (blood poisoning) or long-term/localized infections (like leg ulcers); are currently taking anakinra or other Interleukin-1 antagonists; if packaging is damaged or expired.
Medical Conditions to Discuss
Tell your doctor if you have: serious infections including sepsis, tuberculosis, or recurring infections; low resistance to disease; diabetes; liver problems or hepatitis B/C; heart failure; blood disorders; cancer; upcoming major surgery; nerve disorders including multiple sclerosis or optic neuritis; seizures; chickenpox or recent exposure to chickenpox; latex allergies.
Pregnancy and Breastfeeding
The effects of Enbrel in pregnant women are not well understood, so it should only be used during pregnancy if clearly needed. Contraception is recommended during Enbrel therapy and for 3 weeks after stopping treatment. Small amounts can pass into breast milk, so discuss options with your doctor if breastfeeding. It’s important to discuss Enbrel use before the baby receives any vaccines.
Infection Risk: Enbrel can affect your body’s ability to fight serious infections. Contact your doctor immediately if you develop signs of infection such as fever, chills, mouth ulcers, or sore throat.
Drug Interactions
Some medicines may interfere with Enbrel and affect how it works, or increase the risk of side effects.
- abatacept and Interleukin-1 antagonists such as anakinra (should not be used with Enbrel)
- cyclophosphamide (cancer/transplant medicine – use not recommended)
- sulfasalazine
- some vaccines
- warfarin (blood thinner)
- digoxin (heart medicine)
- medicines used to treat diabetes
Alcohol & Driving
Limited information is available about alcohol use and driving while taking Enbrel.
Alcohol
No specific information is available about alcohol interactions with Enbrel.
Driving and Operating Machinery
It is not known whether Enbrel causes dizziness or drowsiness that could affect your ability to drive or operate machinery.
Storage
Keep Enbrel in the refrigerator between 2°C and 8°C. Do not freeze. Store in original cartons to protect from light. If refrigeration is not possible, Enbrel may be stored at room temperature (below 25°C) for up to 4 weeks. Once removed from refrigeration, use within 4 weeks or discard. Do not use if exposed to high temperatures or out of refrigerator for more than 4 weeks. Powder for injection must be discarded 6 hours after preparation. Keep away from children.
Overdose Information
If you think you have used too much Enbrel, seek urgent medical attention immediately. Phone the Poisons Information Centre (13 11 26), contact your doctor, or go to the nearest hospital Emergency Department. Take the medicine carton with you, even if empty. There is very limited data on Enbrel overdose, so medical evaluation is important even if you feel fine.
Frequently Asked Questions
For nr-AxSpA, if Enbrel has no effect within 12 weeks, your doctor may tell you to stop using it. For psoriasis in children, if there’s no effect after 12 weeks, your doctor may discontinue treatment. Your doctor will monitor your response and adjust treatment accordingly.
Live vaccines, such as oral polio vaccine, should not be given while receiving Enbrel. Make sure children are up to date with all vaccinations (including chickenpox) before starting Enbrel treatment. Discuss with your doctor about vaccine timing.
No, Enbrel is not addictive. It is a prescription medication that works by targeting specific proteins involved in inflammation.
Do not stop using Enbrel suddenly or lower the dosage without checking with your doctor. Your condition may flare up if you reduce the dose or stop using Enbrel. Continue treatment for as long as your doctor recommends.
No specific information is available about alcohol interactions with Enbrel. Discuss alcohol consumption with your doctor, especially if you have liver problems or hepatitis B/C.
If refrigeration is not possible during travel, Enbrel may be stored at room temperature (below 25°C) for up to 4 weeks. Once removed from refrigeration, you must use it within 4 weeks or discard it, even if returned to the refrigerator.
Contact your doctor immediately if you develop any signs of infection such as fever, chills, mouth ulcers, or sore throat. Do not inject any more Enbrel until you speak with your doctor, as Enbrel can affect your body’s ability to fight infections.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.