Enbrel, also known as etanercept, is a medicine used to treat autoimmune disorders like rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, plaque psoriasis, and polyarticular juvenile idiopathic arthritis. Enbrel is part of the tumor necrosis factor (TNF) blockers family of medicine. Etanercept and similar medications work by blocking over-active immune responses that attack healthy cells.

Enbrel is an injectable medicine. It’s available both in prefilled syringes and unmixed vials which patients mix, prepare, and dose themselves. Most patients take Enbrel once a week. The FDA has labeled Enbrel with major warnings because it’s associated with serious infections and cancer.

How Does Enbrel Work?

Etanercept is part of the tumor necrosis factor class of medication. Tumor necrosis factor (TNF) is an immune system protein that performs many functions. It’s made by inflammatory cells and is involved in cell reproduction, development, and death. In healthy immune systems, TNF triggers infected or cancerous cells to die. It also

However, TNF can cause problems in people with autoimmune disorders. High TNF levels signal the immune system to attack, even if no infection is present.

Enbrel interferes with TNF by blocking the normal signal pathways. Enbrel absorbs TNF proteins which keeps them from connecting with other parts of the immune system. This keeps TNF from triggering inflammation and other immune responses. Enbrel is effective in blocking TNF in patients with the following conditions:

  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Ankylosing spondylitis
  • Plaque psoriasis
  • Juvenile idiopathic arthritis

Precautions and Warnings About Enbrel

Patients should understand the precautions and warnings about Enbrel. This medication is a helpful treatment for some autoimmune disorders. However, it is also associated with dangerous conditions such as serious infections and cancer. Talk to your doctor about these risks to make sure Enbrel is the right choice for you.

Children and young adults who take Enbrel have increased rates of lymphoma and other cancers. Patients with severe autoimmune disorders were more likely to develop cancer while on Enbrel. Discuss this risk with your doctor before beginning your prescription.

Risk of Infections

Enbrel reduces the body’s immune response. This is a desired outcome in patients with autoimmune disorders, where the immune response is unnecessarily elevated. However, this effect still puts patients at risk for infections and diseases. People taking Enbrel are more likely to develop the following kinds of infections:

  • Fungal
  • Viral
  • Bacterial
  • Tuberculosis
Signs of an Infection

Tell your doctor immediately if you have signs of an infection, such as:

  • Nausea or vomiting
  • Fever
  • Fatigue
  • Diarrhea

Side Effects of Enbrel

Enbrel causes a range of side effects. Some may be mild while others are harder to handle. However, side effects that feel mild or manageable can be a sign of a more serious reaction. Tell your doctor about all Enbrel side effects, especially while you’re still adjusting to the medication.

Enbrel side effects can include:

  • Respiratory or sinus infections
  • Redness, pain, or irritation at the injection site
  • Rash
  • Itchiness
  • Fever
  • Diarrhea
  • Muscle or joint pain
  • Vision changes
  • Memory loss
  • Confusion
  • Fatigue
  • Bruising or bleeding easier than usual
  • Seizures
  • Multiple sclerosis
  • Optic neuritis
  • Blood disorders
  • Lupus-like autoimmune reactions
  • New or worsening psoriasis
  • Inflammatory bowel disease
  • Tuberculosis
  • Congestive heart failure

Drug Interactions of Enbrel

Taking multiple medications at the same time can change how the drugs work in your body. Some drugs can keep Enbrel from working the way it should. In other cases, Enbrel can prevent other medicines from functioning normally. Tell your doctor about all your medications, over-the-counter treatments, supplements, vitamins, and herbs. They may also ask about your alcohol, cannabis, and other drug usage.

Enbrel is known to interact with the following medicines:

  • Orencia
  • Cyclophosphamide (found in Procytox)
  • Kineret
  • Sulfasalazine
  • Live vaccines

Strengths and Dosages of Enbrel

Enbrel is typically administered once a week. Adults are usually prescribed 50mg a week while children’s dosing is based on age and weight.

ConditionAge of PatientDosageFrequency
Ankylosing spondylitisAdult50mgWeekly
Rheumatoid arthritisAdult50mgWeeky
Psoriatic arthritisAdult50mgWeekly
Plaque psoriasisAdult50mgTwice weekly for three months, then weekly thereafter
Plaque psoriasisChildren 4+ years weighing less than 63k0.8mg/kgWeekly
Juvenile idiopathic arthritisChildren 2+ years weighing less than 63kg0.8mg/kgWeekly
Juvenile idiopathic arthritisChildren 2+ years weight 63 kg or more50 mgWeekly

Cost of Enbrel in America

Enbrel is considered a specialty drug. It does not have a generic option available. A one-month supply of pre-loaded, 50mg syringes costs approximately $13,000. Patients with insurance coverage may pay less. Discount programs, coupons, and patient assistance programs can also lower the cost. A one-month supply of 50mg syringes is around $7,500 with coupons.

Alternatives to Enbrel

There is not a generic version of Enbrel. However, there are some other options. Two biosimilar versions of Enbrel are available. Biosimilar drugs have slight chemical differences but are as effective and safe as the original formulation. Enbrel’s biosimilar drugs are Eticovo and Erelzi.

Other TNF blockers also treat auto-immune disorders. These drugs include:

  • Amjevita
  • Avsola
  • Cimzia
  • Clytezo
  • Hulio
  • Humira
  • Hyrimoz
  • Idacio
  • Inflectra
  • Infliximab
  • Remicade
  • Simponi
  • Simponi Aria
  • Yuflyma

Enbrel FAQs

Why did my doctor prescribe Enbrel?

Enbrel is a tumor necrosis factor (TNF) blocking medicine that reduces your body’s immune response. If you have an autoimmune disorder, Enbrel will reduce your typical response. This should reduce symptoms such as inflammation and pain.

How do I use Enbrel?

Enbrel is a subcutaneous injection, which means it’s injected under the skin. Enbrel should not be injected into a muscle or blood vessel. This medicine is available in syringes, vials, and auto-injectors. Each method has its own application instructions. Ask your doctor to teach you how to perform the injection.

How do I store Enbrel?

Enbrel should be refrigerated. You can keep it at room temperature for up to two weeks (14 days) if you don’t have access to a refrigerator. Once the medicine has adjusted to room temperature, don’t put it back in the fridge. Enbrel should also not be frozen.

Can I get vaccinated while I’m taking Enbrel?

Yes, you can receive many vaccines while you’re taking Enbrel. However, you shouldn’t have live vaccines. Live vaccines contact weak but living versions of the disease they protect against. Since Enbrel suppresses your immune system, you may get sick from the weakened vaccine dose. Live vaccines include:

  • MMR (measles, mumps, rubella)
  • Rotavirus
  • Smallpox
  • Chickenpox
  • Yellow fever

Can I drink alcohol while taking Enbrel?

Occasional or moderate alcohol use has not been proven to interfere with Enbrel. However, alcohol can impact your liver health, which could impact your autoimmune condition. You should ask your doctor about drinking while on Enbrel.

Is there a generic version of Enbrel?

No, there is not a generic version of Enbrel. It is only available as a name-brand drug.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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