Etanercept is a drug that helps people with some diseases that affect their immune system, such as skin problems, joint pain, and spine inflammation. It is a type of medicine that blocks a substance in the body that causes inflammation. This activity explains when and how to use etanercept for these diseases and other problems. It also tells you how etanercept works, what are the possible side effects, and what else you need to know (e.g., other uses, doses, how it affects the body, how to check its effects, how it interacts with other drugs) if you are part of the health care team that treats patients with skin, joint, and spine problems.
Etanercept can make it easier for you to get serious and/or deadly infections, including a type of lung infection called tuberculosis. You can also get other kinds of infections from bacteria, viruses, and fungi, such as aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, histoplasmosis, pneumocystosis, legionellosis, and listeriosis.
These infections are more likely to happen if you also take other medicines that weaken your immune system, such as methotrexate or corticosteroids. Doctors should be careful when giving etanercept to people who are more prone to infections, such as older people, people with weak immune systems, people who get infections often or easily, and people who have been around tuberculosis or certain fungi. Doctors should also think about giving antifungal medicine to people who live in or travel to places where they can get fungal infections.
Cancers
Some people who take etanercept may get cancers, especially children and teenagers. The most common cancers are lymphomas, which affect the blood cells, and melanoma and other skin cancers. We don’t know exactly how etanercept and cancers are related, but studies and reports have shown that people who take etanercept have a higher chance of getting lymphoma and other cancers than people who don’t. However, it is important to remember that rheumatoid arthritis itself can also increase the risk of lymphoma and leukemia.
How do you use it?
Etanercept is a medicine that you inject under your skin, once or twice a week. This is called a subcutaneous injection.
You can use a syringe or a pen to inject etanercept. You or someone in your family can learn how to do these injections at home. You should keep them in the fridge.
If you miss your etanercept dose, talk to your rheumatology team. They will tell you when to take it next.
How do you use this medicine?
Etanercept injection products are a liquid that comes in different types of containers. Some containers have one dose of medicine and some have more than one dose. Etanercept is a medicine that you inject under your skin. You usually inject it once a week. If you have chronic plaque psoriasis, you may inject it twice a week for the first 3 months and then once a week after that. Follow the instructions on your prescription label and ask your doctor or pharmacist if you don’t understand something. Use etanercept injection products the way your doctor tells you to. Don’t use more or less of it or use it more often than your doctor says.
Your first injection of etanercept injection products will be at the doctor’s office. After that, you or someone else can inject the medicine at home. Ask your doctor or pharmacist to teach you or the person who will do the injections how to inject etanercept injection products. Read the written instructions for use that come with etanercept injection products before you inject the medicine. Ask your doctor or pharmacist if you have any questions about how to inject the medicine.
If you have a container of etanercept injection products that has more than one dose, you need to put it in the refrigerator right away, but no later than 4 hours after you mix it. You can keep the container of etanercept injection product in the refrigerator for up to 14 days after you mix it if there is enough medicine left for a full dose. But don’t mix two or more containers of etanercept injection products together to make a full dose. And don’t mix any other medicines with etanercept injection products.
If your medicine comes in a container that has one dose, use each container only once and inject all the liquid in it. Even if there is some liquid left in the container, don’t use it again. Throw away used needles, containers, and devices in a special container that can’t be punctured. Ask your doctor or pharmacist how to get rid of the special container.
If you are using an etanercept injection product that was in the refrigerator, put it on a flat surface and let it warm up to room temperature for 15-30 minutes before you inject the medicine. Don’t try to warm up the medicine by putting it in a microwave, putting it in hot water, or any other way.
Don’t shake a container that has etanercept in it. Be careful not to drop the device on a hard surface because this may break the device, container, syringe, or needle.
Always look at etanercept liquid before injecting it. Check that it is not expired. Check with the written instructions for use to see what your etanercept injection product liquid should look like. Don’t use a container if it is cracked or broken, if it is expired, or if the liquid doesn’t look like it is supposed to.
The best place to inject etanercept injection is the front of your middle thighs. You can also inject the medicine in your lower stomach below your navel, but not near your navel. If someone else is giving you the injection, they can also inject the medicine into your upper arms. Choose a different place for each injection. Don’t inject into an area where the skin is sore
Etanercept may take some time to work, so don’t stop taking it if you don’t feel better right away. You should also keep taking it as your doctor told you when your symptoms get better, as this will help you stay well.
Most people will need to have blood tests regularly while taking etanercept.
What is the best way to take this drug?
You need to inject this drug under your skin. You will learn how to get it ready and give it to yourself. Follow the directions on the label. Do not stop taking it unless your doctor or nurse tells you to.
This drug comes with a GUIDE FOR USE. Ask your pharmacist how to use this drug. Read the guide carefully. If you have any questions, ask your pharmacist or doctor or nurse.
If you use a pen, remember to remove the outer cover of the needle before you use the dose.
You need to put your used needles and syringes in a special container for sharps. Do not throw them in the garbage. If you do not have a sharps container, call your pharmacist or doctor or nurse to get one.
You will get a special MedGuide from the pharmacist every time you get a new prescription or refill. Read the MedGuide carefully every time.
Ask your doctor or nurse about using this drug in children. They may prescribe it for children who are at least 2 years old for some conditions, but there are some risks.
Too much: If you think you have used too much of this drug, call a poison control center or emergency room right away.
How can I know if this medicine is working for me?
Go to your health team often so they can check how you are doing. Let your health team know if you still feel bad or worse.
This medicine may make it easier for you to get sick. If you have a fever, chills, sore throat, or other signs of a cold or flu, call your health team and ask what to do. Do not try to make yourself better. Stay away from people who are sick. If you have not had shots for measles or chickenpox, tell your health team right away if you are near someone with these diseases.
You will be tested for a disease called tuberculosis (TB) before you start this medicine. If your health team gives you any medicine for TB, you should start taking the TB medicine before starting this medicine. Make sure to take all the TB medicine.
Do not take medicines that have aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless your health team says so. These medicines may hide fever.
Ask your health team about your chance of getting cancer. You may be more likely to get some kinds of cancer if you take this medicine.
This medicine can make a vaccine less effective. If you need to get a vaccine, tell your health team if you have taken this medicine. You may need more doses of the vaccine. Talk to your health team to see if you need a different vaccine plan.
Some people who got TNF-blockers in medical tests had more chances of getting lymphoma, a type of cancer, than people who did not get them. But this was very rare, and the people who did not get them were not checked for as long. Some people who got TNF-blockers after the tests also had leukaemia, another type of cancer.
People with rheumatoid arthritis, a problem that makes their joints hurt and swell, have more chances of getting these cancers anyway, so it is hard to know how much the TNF-blockers affect this. We do not know for sure if TNF-blockers can cause lymphoma, leukaemia or other cancers in people who use them. We should be careful when giving TNF-blockers to people who had cancer before or who get cancer while using them.
Some young people (up to 22 years old) who got TNF-blockers, including Enbrel, also got cancers after that. Some of them died. About half of them had lymphoma. The others had different kinds of cancers, some of them very rare and linked to weak immune systems. We do not know for sure if TNF-blockers can cause cancers in young people who use them.
Etanercept injection is a medicine that helps people with active arthritis, rheumatoid arthritis, or psoriatic arthritis. It can make their joints less swollen, painful, and stiff. It can also prevent more damage to their body from these diseases. It can also treat a disease called ankylosing spondylitis.
Etanercept is also used in children 2 years and older for juvenile idiopathic arthritis. It is also used to treat plaque psoriasis, a skin condition, in patients 4 years and older.
You need a doctor’s prescription to get this medicine.
Etanercept is a medicine that can help with some health problems, but it can also make you more likely to get some kinds of cancer, especially if you are a child or a teenager. This is because etanercept affects your body’s natural defense system. Your doctor can tell you more about the chances of getting cancer with etanercept.
Before you start using etanercept, you should tell your doctor if you or anyone you live with has ever had a disease called tuberculosis, or if you have traveled to places where tuberculosis or some other infections are common. You could have been exposed to these infections without knowing it.
You should also tell your doctor if you are pregnant or want to have a baby. Etanercept can affect your baby’s health, especially before the baby gets any shots to prevent diseases.
It may not be safe to breastfeed your baby while using etanercept. Ask your doctor what to do.
How should I use etanercept?
Follow the instructions on the label and the leaflet that comes with your medicine. Use etanercept exactly as your doctor tells you to.
Your doctor may check you for infections before you start using etanercept.
Etanercept is given as an injection under your skin. You or someone else can learn how to do the injections at home. Read and follow the instructions that come with your medicine carefully. Ask your doctor or pharmacist if you have any questions.
Do not shake this medicine. Use it only when you are ready to inject it. Do not use it if it looks cloudy, has a different color, or has bits in it. Get a new medicine from your pharmacist.
You may need to mix etanercept with another liquid before injecting it. Make sure you know how to do this correctly and how to store the medicine after mixing it.
The amount of etanercept that children need depends on their weight. Your child’s dose may change if they gain or lose weight.
If you need an operation, tell the doctor that you are using etanercept.
Etanercept makes your body’s defense system weaker. This means you can get sick more easily, even from serious or deadly infections. Your doctor will need to see you often to check your health.
If you have ever had a liver infection called hepatitis B, etanercept can make it worse or active again. You may need regular tests for your liver while using this medicine and for some time after you stop.
Follow the storage instructions that come with your medicine carefully. Some forms of etanercept need to be kept in the fridge and used before a certain date. Others can be kept at room temperature for a short time. Do not use any medicine that is past its expiry date.
Keep the etanercept in its original box and away from light. Do not freeze it. Do not use it if it gets very hot or very cold. If you take the medicine out of the fridge, do not put it back in.
Each cartridge, injection pen, or prefilled syringe has only one dose of medicine. Use it once and then throw it away, even if there is some medicine left in it.
Use a needle and syringe only once and then put them in a special container that cannot be pierced by needles. Follow the rules in your area about how to get rid of this container safely. Keep it away from children and pets.
What is etanercept?
Etanercept is a medicine that you can inject yourself. It has five different forms that you can use with a needle, a pen, a bottle, or a device that injects for you.
Etanercept injectable solution has two brand names: Enbrel and Erelzi (Erelzi is a biosimilar*). Etanercept does not have a generic name.
You may have to use etanercept injectable solution with other medicines.
* A biosimilar is a kind of medicine that comes from living things, like cells. A biosimilar is like a brand-name medicine that comes from living things, but it is not exactly the same. (A generic medicine, on the other hand, is exactly the same as a medicine that comes from chemicals. Most medicines come from chemicals.)
A biosimilar can be used to treat some or all of the problems that the brand-name medicine treats and should work the same way for a patient. In this case, Erelzi is a biosimilar version of Enbrel.
Etanercept injectable solution is a type of medicine called tumor necrosis factor (TNF) blockers. Medicines in this group have a similar effect. They are often used for conditions that are similar.
TNF is a normal substance in your body that causes swelling. But some diseases can make your body produce too much TNF. This can lead to too much swelling, which can be harmful. Etanercept helps to reduce the amount of TNF in your body, which helps to control excess swelling.
Etanercept is a type of medicine that blocks a chemical called tumour necrosis factor (TNF). TNF is a substance that sends messages in the body. The original name for this medicine is Enbrel®. There are also other versions of etanercept in some countries, such as etanercept-ykro (Eticovo™, approved by FDA in 2019) and etanercept-szzs (Erelzi™, 2016).
Etanercept can help people with psoriasis, psoriatic arthritis, and ankylosing spondylitis. These are conditions that affect the skin and joints. Adults can use etanercept for these conditions. Children and teenagers from 2 to 17 years old can use etanercept for psoriasis and juvenile idiopathic arthritis. This is a condition that causes joint pain and swelling in children. In the USA, children and teenagers from 4 to 17 years old can also use etanercept for chronic plaque psoriasis. This is a type of psoriasis that causes red, scaly patches on the skin.
In New Zealand, PHARMAC pays for etanercept for adults with severe psoriasis that does not get better with other treatments. The doctor has to apply for this. Children older than 4 years can use etanercept for up to 24 weeks.
How does etanercept work?
Etanercept is made from human protein. It works by sticking to TNF molecules in the blood and affected tissue. When TNF is stuck to etanercept, it cannot attach to or activate TNF receptors. TNF-alpha helps the body fight infection and cancer, but too much of it can cause problems. In psoriasis, there is too much TNF.”
What is the best way to take etanercept?
Etanercept is a medicine that you inject under your skin. It can help with psoriasis by reducing inflammation and skin plaques. You usually take 50 mg of etanercept two times a week for the first three months, then once a week. A health professional will teach you how to use a needle or a device to inject the medicine yourself at home. You can inject it in your thigh, belly, or upper arm. You should change the injection spot every time to avoid pain and skin problems.
You can take etanercept alone or with other treatments, such as creams, methotrexate, or light therapy.
The normal amount of etanercept for adults is 50 mg every week, either as one injection or two injections with a gap of 3–4 days. You inject it under your skin.
Older RA patients (age ? 65 years) have similar results and side effects as younger adults who take etanercept. They do not need to change the amount they take.
In children, aged 4 years and above, the amount is 0.8 mg/kg up to a maximum of 50 mg once a week. You inject it under their skin for up to 24 weeks. If their psoriasis does not get better after 12 weeks, they should stop taking it.
Etanercept injections need to stay cold, even when you travel. See travel letter, which explains why you need to carry the medicine in your hand luggage.
What can go wrong when you take etanercept?
Etanercept is usually safe to use. The most common problem is that the place where you inject it may get red, swollen, itchy or sore. This happens more often in the first month and then gets better. You can use a cold cloth and a cream with 1% hydrocortisone to make it feel better. Some people may also have itchy skin or gain weight.
You should tell your doctor if you have any of these symptoms or signs that are bad or don’t go away:
Coughing, wheezing, trouble breathing or chest pain
Feeling sick and/or throwing up and/or stomach pain
Fever, headache, shivering or other signs of infection
A hot, red, swollen area on the skin
Bleeding or bruising
Losing weight without trying
Sore eyes (etanercept may sometimes cause eye inflammation).
Very rarely, etanercept may cause serious skin reactions, such as hives, swelling, shock and skin peeling. Etanercept may also cause white patches on the skin.
People who take etanercept may have a slightly higher chance of getting lymphoma and maybe other cancers than people who don’t take it. In most cases, these people have also been taking other medicines that weaken the immune system such as azathioprine or mercaptopurine.
People with psoriasis who have sun damage or who have had more than 200 light treatments with a drug called PUVA are more likely to get skin cancer, especially if they have also taken ciclosporin.
Other conditions that may happen in people on etanercept include nerve diseases such as MS, heart failure and low blood cell counts. New autoimmune diseases may also happen; these may be related to the skin disease or its treatment.
