Enbrel is used to treat moderate to severe autoimmune conditions in adults and children two years of age and older. It’s available in different injectable forms and is taken once or twice a week. It works by suppressing an overactive immune system. That helps to reduce symptoms and slows the progression of disease, but can also lead to a higher risk of serious infections and some forms of cancer.
Enbrel overview
BRAND NAMES:
Enbrel, Enbrel Mini
Generic Names:
Etanercept
Uses:
Treats rheumatoid arthritis, psoriatic arthritis, juvenile psoriatic arthritis, polyarticular juvenile idiopathic arthritis, ankylosing spondylitis, and plaque psoriasis.
Therapeutic Classes:
Immune suppressant
Immunological agent
Forms:
Injectable
How it’s taken:
Injected under the skin once or twice a week as directed
What is Enbrel used for?
Enbrel is used to treat moderate to severe forms of:
Rheumatoid arthritis
Psoriatic arthritis
Juvenile psoriatic arthritis
Polyarticular juvenile idiopathic arthritis
Ankylosing spondylitis
Plaque psoriasis
Key takeaways
Enbrel helps to reduce symptoms and limit the progression of moderate to severe forms of certain autoimmune conditions.
Enbrel is taken as an injection under the skin once or twice a week as prescribed by a healthcare provider.
Enbrel helps to regulate an overactive immune system. That helps to decrease symptoms of autoimmune diseases. But it may also increase the risk of certain types of infections and cancers.
Before starting Enbrel and while taking it, a healthcare provider will assess the risk for serious infections.
Talk with a healthcare provider about all medications, medical history, and infection risks before starting Enbrel.
What form(s) does Enbrel come in
Single-dose prefilled syringe
25 mg/0.5 mL
50 mg/mL
Single-dose prefilled SureClick autoinjector
50 mg/mL
Mini single-dose prefilled cartridge for use with the AutoTouch reusable autoinjector
50 mg/ML
Single-dose vial
25 mg/0.5 mL
Powder for reconstitution in a multiple-dose vial
25 mg
What are common Enbrel doses?
For adults, the dose will vary by condition
50 mg injected under the skin once per week
25 mg injected under the skin twice per week
For children, the dose will vary by condition and by weight
0.8 mg/kg injected under the skin once per week
0.4 mg/kg injected under the skin twice per week
50 mg injected under the skin once per week
25 mg injected under the skin twice per week
Common Enbrel prescriptions
Enbrel
0.5ml of 25mg/0.5ml boxEnbrel
25mg solution reconstitutedEnbrel
0.51ml of 25mg/0.5ml syringeEnbrel
0.5ml of 25mg/0.5ml syringeEnbrel
0.98ml of 50mg/ml syringeEnbrel
1ml of 50mg/ml syringe
How to take Enbrel
Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.
Your doctor will prescribe your exact dose and tell you how often it should be taken. This medicine is taken as a shot under your skin.
A nurse or other health provider will give you this medicine and teach you how to take it.
You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.
Allow the medicine to come to room temperature for 15 to 30 minutes before you use it. Do not shake it.
Prefilled cartridge, syringe, or autoinjector
Do not remove the needle cap or cover from the cartridge, syringe, or autoinjector until you are ready to use it.
If the amount of liquid in the prefilled syringe does not fall between the purple indicator lines, do not use that syringe.
Push the door button on the AutoTouch reusable autoinjector and insert the Enbrel Mini prefilled cartridge. It should slide freely and completely into the door.
Vial
Mix the medicine with the liquid provided in your dose kit. Gently swirl the medicine to mix it.
Write the date you mixed the medicine on the sticker from the dose kit. Attach the sticker to the vial.
After your dose, put the unused mixture in the refrigerator right away. Do not mix vials together. Throw away any unused medicine after 14 days.
Use a new needle and syringe each time you inject your medicine.
This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
Missed dose: Call your doctor or pharmacist for instructions.
Storage
Enbrel single-dose vials, single-dose prefilled syringes, SureClick autoinjectors, and Mini cartridges may be stored in the refrigerator. Do not freeze. You may also store this medicine at room temperature, away from heat, light, or humidity for up to 30 days. Do not return it to the refrigerator.
Enbrel multiple-dose vials and solution may be stored in the refrigerator. You may also store this medicine at room temperature, away from heat, light, or humidity for up to 14 days. The reconstituted solution should be used right away or may be refrigerated for up to 14 days. Throw away unused medicine after 14 days.
Do not use medication after its expiration date.
What to do if you miss a dose of Enbrel
Use an alarm or reminder system to remember to take your dose as prescribed. If you do forget a dose, take it as soon as you remember. Then take the next dose at its scheduled time. If you’re unsure about when to take a dose of Enbrel, talk to your healthcare provider or pharmacist. Do not use Enbrel at a higher dose or more often than prescribed.
Enbrel contraindications
This medicine is not right for everyone. Do not use it if you have had an allergic reaction to etanercept. People with tuberculosis (TB) or other serious infections should not take Enbrel. Those with lymphoma and other types of cancer may also be advised to not use Enbrel.
Enbrel warnings
Before taking Enbrel, talk to your healthcare provider if you:
Are pregnant or plan to become pregnant. Enbrel’s effects on a fetus are unknown. If you took Enbrel while pregnant, talk to a healthcare provider before your infant receives any live vaccines.
Are breastfeeding. Enbrel does pass into breast milk.
Have diabetes. People with diabetes may be at higher risk for infections while taking Enbrel. The dose of some diabetes medications may also need to be adjusted.
Have heart failure now or have had it in the past
Have liver problems, including hepatitis
Have had multiple sclerosis, seizures, Guillain-Barre syndrome, or any condition that involves the nervous system
Have cancer now or have had it in the past
Are allergic to latex
Have had any type of serious infection, including tuberculosis or hepatitis. Also, tell your doctor if a family member has a history of tuberculosis (TB).
You will need a test for TB before you start using this medicine. Tell your doctor if you or anyone in your home has ever had a positive TB test.
Have HIV or any condition that may weaken the immune system
Have a history of frequent infections, or skin conditions that cause open cuts or sores
Lived in areas where certain infections are more common. Your healthcare provider will check for different types of infections that may be more serious while taking Enbrel.
Have been around someone with varicella zoster (chicken pox)
Are planning to have surgery or receive any live vaccines
This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
Keep all medicine out of the reach of children. Never share your medicine with anyone.
Enbrel interactions
Tell your healthcare provider about all the medicines you take. That includes prescription medication, but also over-the-counter medicines, vitamins, and supplements.
The most important medication interactions with Enbrel include:
Orencia (abatacept) or Kineret (anakinra). Taking these medications together with Enbrel results in a higher risk of serious infections.
Cyclophosphamide (Cytoxan). Taken with Enbrel, there is a higher risk of certain cancers.
Diabetes medication. You may need an adjustment in your dose of medication.
Live vaccines. Most vaccines for adults are not live vaccines. But there are a few for children that are. Talk to your healthcare provider before getting vaccines if you or your child use Enbrel.
Enbrel side effects
Symptoms that may indicate a serious side effect while taking Enbrel include:
Swollen glands in your neck, armpits, or groin
Signs of liver problems including dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, and yellow skin or eyes
Changing moles or growths on the skin
Seizures or problems with movement
Blistering, peeling, red skin rash
Numbness, tingling, or burning pain in your hands, arms, legs, or feet
Chest pain, coughing up blood, muscle pain, night sweats, weight loss
Sores or white patches on your lips, mouth, or throat
High fever or other signs of infection
Unusual bleeding, bruising, tiredness, or weakness
Changes in vision, eye pain
Severe allergic reactions including itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
Signs of heart failure including trouble breathing, cold sweats, swelling in your hands, ankles, or feet
Swollen, tender blood vessels or areas of skin
Less serious and more common side effects include:
Pain, redness, swelling, itching, bleeding, or bruising where the shot was given
Upper respiratory infections like a cold
Diarrhea
Mild fever
Urticaria (hives)
Contact your healthcare provider right away if you have a high fever, trouble breathing, unusual bleeding, or severe weakness or pain. Also let them know if you have any symptoms of serious side effects, or something that is getting worse or just won’t go away.
Sources:
Enbrel dosage, forms, and strengths, SingleCare
Enbrel, DailyMed National Library of Medicine (2023)
Principles of vaccination, Centers for Disease Control and Prevention (2021)
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