Enbrel

Also called etanercept

Key points about Enbrel

Enbrel is also known as etanercept.
Enbrel is used to treat some types of autoimmune conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis and skin diseases such as chronic plaque psoriasis.
Find out how to take it safely and possible side effects.

Enbrel is used to treat some types of autoimmune conditions (diseases in which your body's defence system or immune system attacks healthy tissues), such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis and skin diseases such as chronic plaque psoriasis.

Enbrel is usually used when other treatments have not worked well. It is a type of medicine called a TNF inhibitor. It works by blocking a natural inflammatory substance in your body called tumour necrosis factor-alpha (TNFa). Enbrel helps to reduce swelling (inflammation) and weaken your immune system, thereby slowing or stopping the damage from the disease.

In New Zealand, Enbrel is available as an injection, which is given under the skin. Enbrel is available as a single-use pre-filled syringe and an autoinjector. The dose of Enbrel is different for different people, depending on its use.

Watch this video about Enbrel

Note: this video is from Canada so may have information that differs from New Zealand recommendations.

(RheumInfo, Canada, 2011)

The usual dose is 50 mg once a week or 25 mg every 2 weeks. Some people may need a higher dose to start with. In children the dose is usually less and may be given twice a week.
Inject Enbrel exactly as your doctor or nurse has told you. The pharmacy label will tell you how much Enbrel to use, how often to use it and any special instructions.
You may not notice the effects of Enbrel straight away. It may take 2 weeks or up to 6 months.

Enbrel is given as an injection, just under your skin (called subcutaneous injection). Some people can give themselves the injection, or it can be given by another person, eg, a family member or friend, after proper training or by your doctor or nurse. If you are unsure about how to inject Enbrel, ask your doctor, nurse or pharmacist to show you.

Preparation

Enbrel is usually stored in the fridge. Take it out of the fridge and leave it at room temperature for 15 to 30 minutes before injecting. Do not warm Enbrel in any other way, eg, do not warm it in the microwave or in hot water.

Injection sites

Choose an injection site, such as on the front of your thighs or your abdomen (belly) at least 5 cm from your belly button. The injection site should be different from your last injection and at least 3 cm away. Do not inject into skin that is sore, bruised, red, hard, scarred or has stretch marks or psoriasis plaques.

Note: In New Zealand, people taking Enbrel can get support by phoning 0800 362 735.

Like all medicines, Enbrel can cause side effects, although not everyone gets them.

Increased risk of infections

Because Enbrel weakens your body's immune system, it can make it more likely for you to get infections. These infections may be mild (such as colds or sinusitis) or more severe such as TB (tuberculosis) and septicaemia (infection of your blood).

Before starting Enbrel you need to:
- have blood tests and a chest x-ray to check for infections and to check your liver
- check with your doctor what vaccines you might need – you should not have a live vaccine while using Enbrel.
Tell your doctor immediately if you:
- come into contact with someone who has an infection such as TB (tuberculosis) while you are taking Enbrel
- develop an ongoing cough, weight loss, fever, sore throat, bruising or bleeding.
You will need to be monitored for infections during treatment and for several months after you have stopped taking it.
Before you start taking Enbrel let your doctor know if you are pregnant or planning to become pregnant or if you have TB or Hepatitis B.

Other side effects

Side effects	What should I do?
Reaction at the injection site such as bruising, redness, tenderness	Change the site for each subcutaneous injection (see tips above). Tell your doctor if this does not settle.
Nausea (feeling sick) Vomiting (being sick) Indigestion Tummy upset	Tell your doctor if troublesome.
Problems sleeping, anxiety, depression. itchy skin	Let your doctor know or phone Healthline 0800 611 116.
Blood in your stools (poo), coughing up blood (red or brown) or other signs of bleeding such as bruising	Let your doctor know or phone Healthline 0800 611 116.
Signs of problems with your heart such as swollen feet or legs or problems breathing, shortness of breath, or feeling like your heart is racing	Tell your doctor immediately or phone Healthline 0800 611 116.
Signs of TB such as a cough that won’t go away, night sweats, fever, weight loss	Tell your doctor immediately or phone Healthline 0800 611 116.
Signs of an allergic reaction such as muscle or joint pain, fever, rash, intense itching, swelling of the face or hands, sore throat, headache or difficulty swallowing	Tell your doctor immediately or phone Healthline 0800 611 116.
For more information on side effects, see the Medsafe consumer information leaflet Enbrel(external link). Read more about medicines and side effects and reporting a reaction you think might be a side effect.