Etanercept

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Enbrel; Enbrel Mini; Enbrel SureClick

Brand Names: Canada

Brenzys; Enbrel; Erelzi

Warning

  • Severe infections have happened in patients who take this drug. Some of these have led to treatment in a hospital or death. Most people who had these infections were taking other drugs to lower the immune system like methotrexate or steroid drugs. If you have any infection, are taking antibiotics now or in the recent past, or have had many infections, talk with your doctor.
  • TB (tuberculosis) has been seen in patients started on this drug. These patients were exposed to TB in the past, but never got the infection. You will be tested to see if you have been exposed to TB before starting this drug. You may also be tested for TB while you take this drug.
  • Lymphoma and other cancers have happened in people who take this drug or drugs like it. This has been deadly in some cases. Talk with the doctor.

What is this drug used for?

  • It is used to treat some types of arthritis.
  • It is used to treat ankylosing spondylitis.
  • It is used to treat plaque psoriasis.
  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have granulomatosis with polyangiitis.
  • If you have a blood infection or other severe infection.
  • If you are taking any of these drugs: Abatacept or anakinra.
  • If you are taking cyclophosphamide.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • You may have more chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu.
  • Talk with your doctor before getting any vaccines. Use of some vaccines with this drug may either raise the chance of an infection or make the vaccine not work as well.
  • Make sure you are up to date with all your vaccines before treatment with this drug.
  • Do not get a weakened bacteria like BCG for bladder cancer while you use this drug. Talk with your doctor.
  • If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
  • The chance of skin cancer may be raised. Avoid lots of sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
  • Have your skin checked. Tell your doctor if you have any skin changes like a new wart, skin sore or reddish bump that bleeds or does not heal, or a change in the color or size of a mole.
  • Rarely, bone marrow and blood problems have happened with this drug. This includes a severe health problem called aplastic anemia. Sometimes, this has been deadly. Call your doctor right away if you have any signs of infection like fever, chills, or sore throat; any unexplained bruising or bleeding; purple “splotches” on your skin; or feeling very tired or weak.
  • If you have had hepatitis B before or carry the virus, talk with your doctor. Drugs like this one can cause the virus to become active. This can lead to very bad and sometimes deadly liver problems.
  • Hepatitis B testing needs to be done as you were told by the doctor. Talk with the doctor.
  • If you have a latex allergy, talk with your doctor. Some products have latex.
  • If you are 65 or older, use this drug with care. You could have more side effects.
  • If the patient is a child, use this drug with care. The risk of some side effects may be higher in children.
  • If giving this drug to your child and your child’s weight changes, talk with the doctor. The dose of this drug may need to be changed.
  • Some products have benzyl alcohol. If possible, avoid products with benzyl alcohol in newborns or infants. Serious side effects can happen in these children with some doses of benzyl alcohol, including if given with other drugs that have benzyl alcohol. Talk with the doctor to see if this product has benzyl alcohol in it.
  • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.
  • If you used this drug when you were pregnant, tell your baby’s doctor.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
  • Signs of lupus like a rash on the cheeks or other body parts, sunburn easy, muscle or joint pain, chest pain or shortness of breath, or swelling in the arms or legs.
  • Feeling confused.
  • Pale skin.
  • Red scaly patches or bumps that are pus filled.
  • A skin lump or growth.
  • Call your doctor right away if you have a swollen gland, night sweats, shortness of breath, or weight loss without trying.
  • Severe and sometimes deadly liver problems have happened with this drug. Call your doctor right away if you have signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Rarely, people using drugs like this one have had nervous system problems. Sometimes, these problems have not gone away. Call your doctor right away if you have a burning, numbness, or tingling feeling that is not normal; change in eyesight; dizziness; seizures; or weakness in your arms or legs.
  • Heart failure has happened with this drug, as well as heart failure that has gotten worse in people who already have it. Tell your doctor if you have heart disease. Call your doctor right away if you have shortness of breath, a big weight gain, a heartbeat that is not normal, or swelling in the arms or legs that is new or worse.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Irritation where the shot is given.
  • Diarrhea.
  • Headache.
  • Signs of a common cold.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

All products:

  • It is given as a shot into the fatty part of the skin on the top of the thigh, belly area, or upper arm.
  • If you will be giving yourself the shot, your doctor or nurse will teach you how to give the shot.
  • Wash your hands before and after use.
  • Do not shake.
  • Move the site where you give the shot with each shot.
  • Do not give into skin that is irritated, tender, bruised, red, scaly, hard, scarred, or has stretch marks.
  • Do not give into skin within 2 inches (5 cm) of the belly button.
  • Different brands of this drug may be clear or have a slight color. Be sure you know what your brand needs to look like when ready to use. Do not use if the solution changes color. If you are not sure, talk with the pharmacist.
  • Throw away needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow all local rules for getting rid of it. Talk with a doctor or pharmacist if you have any questions.

Auto-injectors, prefilled pens, and prefilled syringes:

  • You may need to leave this drug at room temperature for 30 minutes before using. Do not remove the cap or cover until ready to use. Do not heat this drug. If you are not sure if the brand you have needs to be left at room temperature before using, talk with your pharmacist or read the package insert.
  • This product may contain small white particles. Do not use if the solution is cloudy, leaking, or has large lumps, flakes, or other particles.

Auto-injectors and prefilled pens:

  • Check the window on the auto-injector when the injection is done. If the window does not show that the dose has been given or if it looks like this drug is still injecting, call the doctor right away to find out what to do.

Single-use vial:

  • To make the injection feel better, take this drug out of the refrigerator and allow it to sit at room temperature for at least 30 minutes before use. Do not remove the cap or cover. Do not heat this drug.
  • This product may contain small white particles. Do not use if the solution is cloudy, leaking, or has large lumps, flakes, or other particles.

Multi-dose container:

  • This drug needs to be mixed before use. Follow how to mix as you were told by the doctor.
  • To make the injection feel better, take this drug out of the refrigerator and allow it to sit at room temperature for up to 30 minutes before use. Do not remove the cap or cover. Do not heat this drug.
  • Do not use if the solution is cloudy, leaking, or has particles.

What do I do if I miss a dose?

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.
  • If you are not sure what to do if you miss a dose, call your doctor.

How do I store and/or throw out this drug?

Auto-injectors, prefilled pens, and prefilled syringes:

  • Store in a refrigerator. Do not freeze.
  • If needed, you may store at room temperature. The amount of time you may store at room temperature depends on the product you are using. Read the patient information leaflets found in the product package to see how long you may store the product at room temperature.
  • Do not put this drug back in the refrigerator after it has been stored at room temperature.

Auto-injector shot:

  • If using the AutoTouch reusable autoinjector, do not refrigerate the autoinjector.

Single-use vial:

  • Store in a refrigerator. Do not freeze.
  • If needed, you may store at room temperature for up to 30 days. Write down the date you take this drug out of the refrigerator. If stored at room temperature and not used within 30 days, throw this drug away.
  • Do not put this drug back in the refrigerator after it has been stored at room temperature.

Multi-dose container:

  • Store in a refrigerator. Do not freeze.
  • If needed, you may store at room temperature. The amount of time you may store at room temperature depends on the product you are using. Read the patient information leaflets found in the product package to see how long you may store the product at room temperature.
  • Do not put this drug back in the refrigerator after it has been stored at room temperature.
  • Use right away after mixing or you may store in a refrigerator for up to 2 weeks.

All products:

  • Store in the original container to protect from light.
  • Protect from very hot or very cold temperatures.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2022-12-06

Copyright

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Last Updated

Monday, December 12, 2022