ETANERCEPT

COMMON BRAND NAME(S): Enbrel

GENERIC NAME(S): ETANERCEPT

 

Description: Etanercept is a Tumor Necrosis Factor (TNF) inhibitor that works by inhibiting the protein that causes inflammation in the body.

Indications:

This medication is used alone or in combination with an immunosuppressant (such as methotrexate) to treat certain types of arthritis (such as rheumatoid, psoriatic, juvenile idiopathic, and ankylosing spondylitis), as well as a skin condition called psoriasis.

Treatment decreases redness, itching and scaly patches in psoriasis as well as the pain, swelling and stiffness of joints in arthritis.

This medication can stop the progression of disease and joint damage, resulting in improved daily functioning and quality of life.

This medication treats but does not cure autoimmune diseases. Symptoms usually return within 1 month of stopping the medication.

Contraindications:

Should not be given to patients with sepsis.

How to use etanercept subcutaneous injection:

Dosage: Inject 25 mg subcutaneously or under the skin, twice weekly, 3 to 4 days apart.  Alternatively, you can inject 50 mg subcutaneous doses once weekly.

  • Etanercept is injected under the skin of the thigh, abdomen, or upper arm, usually once or twice weekly exactly as prescribed by your doctor.
  • If you are removing the medication from the refrigerator, allow it to warm to room temperature before injecting. This takes about 15 to 30 minutes.
  • Do not shake the product. The prefilled syringe or pen injector may have small white particles in the liquid which is normal. Before using, check this product visually for other particles, cloudiness, or discoloration. If you see any of these things, do not use the liquid.
  • Before injecting each dose, clean the injection site with rubbing alcohol.
  • It is important to change the location of the injection site each time you use this drug to prevent problems under the skin.
  • New injections should be given at least 1 inch (2.5 centimeters) from an old injection site. Do not inject into areas of the skin that are sore, bruised, red, or hard.

Infections: Because etanercept works by blocking the immune system, it may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection (such as fungal infections, bacterial infections including tuberculosis) or make any infection you have worse.

Cancer: The immune system is also important in preventing and controlling cancer. Though it is very unlikely to happen, there is a risk (especially in children/teens/young adults) of developing cancer (such as lymphoma, skin) due to this medication or due to your medical condition.

You should check with your doctor immediately if any of these side effects occur when taking etanercept:

More common

  • Chills
  • cough
  • fever
  • sneezing
  • sore throat

Less common

  • Congestion in the chest
  • depression
  • fast heartbeat
  • frequent or painful urination
  • itching, pain, redness, or swelling on the skin
  • joint or muscle stiffness, tightness, or rigidity
  • shortness of breath
  • stomach discomfort or pain

Some of the side effects that can occur with etanercept may not need medical attention:

More common

  • Abdominal or stomach pain
  • loss of energy or weakness
  • nausea and vomiting
  • pain or burning in the throat
  • redness or itching, pain, or swelling at the site of injection (under the skin)
  • runny or stuffy nose

Less common

  • Bumps below the skin
  • depression
  • dry eyes
  • dry mouth
  • hair loss or thinning
  • heartburn
  • irritation or soreness of the mouth
  • itching, redness, or tearing of the eye
  • skin rash
  • weight gain

Precautions

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Caution is advised when using this drug in the elderly because they may be more prone to infections.

It is recommended that children be up to date on all their childhood vaccinations before starting etanercept.

  • Allergy: Before using etanercept, tell your doctor or pharmacist if you are allergic to it; or to latex or natural dry rubber (found in the prefilled syringes or pen injectors); or if you have any other allergies.
  • Medical History: Before using this medication, tell your doctor or pharmacist if you had: active or recurrent infection (such as hepatitis B, HIV, tuberculosis), blood disorders (such as leukemia, anemia), weakened bone marrow, history of cancer (such as lymphoma), diabetes, heart failure, seizures, nervous system problems (such as multiple sclerosis), a certain liver problem (alcoholic hepatitis), blood vessel disorders (such as vasculitis).
  • Immunozation: Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine.
  • Serious Infections: Treatment with etaercept should not be given to patient who has infection because it may lead to progression of infection.  Drug must be stopped if patient develops infection while taking etanercept.
  • Tuberculosis: Reactivation or New infection of tuberculosis may occur while taking etanercept.  Anti-tuberculosis therapy should be considered before giving etanercept, especially to those living in areas with high incidecne of tuberculosis or those who has close contact to persons who has TB.
  • Fungal Infections: Infections such as histoplasmosis have been reported with TNF blockers.  Consider giving anti-fungal therapy to these patients.
  • Neurologic events: Cases of transverse myelitis, optic neuritis, multiple sclerosis, Guillain-Barré syndromes, other peripheral demyelinating neuropathies, and new onset or exacerbation of seizure disorders have been reported with etanercept. Prescribers should exercise caution in considering the use of etanercept in patients with preexisting or recent-onset central or peripheral nervous system demyelinating disorders.

Pregnancy Risk: Category B. No proven risk in humans.

Breastfeeding:  Etanercept is present in low levels in human milk and minimally absorbed by a breastfed infant. Caution should be exercised when etanercept is administered to a nursing woman.

 

Interactions

  • Some products that may interact with this drug include: abatacept, interleukin-1 blockers (such as anakinra, canakinumab, rilonacept), live vaccines (such as measles, mumps, polio, rubella, typhoid, varicella, yellow fever), other medications for autoimmune disease (such as azathioprine, cyclophosphamide, tofacitinib).

If overdose is suspected, contact a poison control center or emergency room immediately.

Notes

Do not share this medication with others.

Laboratory and/or medical tests (such as complete blood count, liver function, TB test) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

This medication may interfere with certain lab tests. Be sure to tell the lab personnel that you are on this medication.

Missed Dose

For the best possible benefit, it is important to receive each scheduled dose of this medication as directed. If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule. Do not double the dose to catch up.

Storage

Store unopened vials, pen injectors, and prefilled syringes in a refrigerator between 36-46 degrees F (2-8 degrees C) away from light. Do not freeze. The unopened vials, pen injectors, and prefilled syringes may also be stored at room temperature away from light and moisture, but only for a certain amount of time. Consult your pharmacist or read the product package to see how long you can store this product at room temperature. Once the medication has been stored at room temperature, it should not be placed back in the refrigerator. Once a vial is mixed, the drug must be used right away or can be stored in the refrigerator for up to 14 days. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Brands

Available Brands:

Enbrel [ Pfizer ]

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