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Enbrel
Used for Ankylosing Spondylitis, Plaque Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis
Used for Ankylosing Spondylitis, Plaque Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis
Enbrel (etanercept) is used for certain autoimmune conditions in adults and children. This includes rheumatoid arthritis, psoriatic arthritis, and plaque psoriasis. It works as a tumor necrosis factor (TNF) blocker to reduce inflammation in the body. Enbrel (etanercept) is given as an injection under the skin, typically once a week. It comes as vials and prefilled syringes. There are also Enbrel SureClick autoinjectors, as well as Enbrel Mini prefilled cartridges for AutoTouch autoinjectors. Side effects include infections and injection site reactions.
What is Enbrel (etanercept)?
What is Enbrel (etanercept) used for?
- Rheumatoid arthritis (RA) in adults
- Ankylosing spondylitis (AS) in adults
- Psoriatic arthritis (PsA) in people ages 2 years and older
- Plaque psoriasis(PsO) in people ages 4 years and older
- Polyarticular juvenile idiopathic arthritis (pJIA) in children ages 2 years and older
How Enbrel (etanercept) works
Enbrel (etanercept) is a tumor necrosis factor (TNF) blocker. It works by blocking a protein called tumor necrosis factor (TNF). This protein causes inflammation in the body.
By blocking TNF and lowering inflammation, Enbrel (etanercept) can help reduce symptoms of autoimmune joint problems. This can include joint pain, swelling, and stiffness. It can also help with skin redness and scaling related to plaque psoriasis.
When does Enbrel (etanercept) start working?Time passed since treatment started:
Drug facts
| Common Brands | Enbrel, Enbrel Mini, Enbrel SureClick |
|---|---|
| Drug Class | TNF blocker |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
More on Enbrel (etanercept) essentials
Side effects of Enbrel (etanercept)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Infection (27%)
- Injection site reaction (15%)
Less Common Side Effects
- Diarrhea
- Rash
- Hives
- Itchiness
Note: Side effects were from adults taking Enbrel (etanercept) for plaque psoriasis. Side effects might differ for treating other conditions or for children.
Enbrel (etanercept) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious infections: fever, chills, trouble breathing, cough that won't go away, night sweats, body aches, confusion
- Allergic reactions: trouble breathing, tightness in the throat, face swelling, fast heartbeat, severe rash
More on Enbrel (etanercept) side effects
The following Enbrel (etanercept) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Congestion in the chest
fast heartbeat
frequent or painful urination
itching, pain, redness, or swelling on the skin
joint or muscle stiffness, tightness, or rigidity
stomach discomfort or pain
Incidence not known
Bladder pain
blistering, peeling, or loosening of the skin
bloody, black, or tarry stools
blue-yellow color blindness
blurred vision
chest discomfort or pain
cloudy or bloody urine
confusion
dark urine
decreased urine output
decreased vision
difficult, irregular, troubled, or labored breathing (or difficulty with breathing gets worse)
difficulty with moving
dilated neck veins
double vision
extreme fatigue
feeling sad or empty
fruit-like breath odor
general feeling of discomfort, illness, or weakness
generalized pain
inability to move the arms, legs, or facial muscles
indigestion
irregular heartbeat
joint or muscle pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
lightheadedness
loss of consciousness
muscle tenderness
pain or discomfort in the arms, jaw, back, or neck
pain, redness, or swelling in the arm or leg
problems with bowel or bladder function
red skin lesions, often with a purple center
red, scaling, or crusted skin
seizures
severe and continuing nausea
severe numbness, especially on one side of the face or body
sores, ulcers, or white spots on the lips or in the mouth
swelling of the face, fingers, feet, or lower legs
tenderness
tightness in the chest
trouble concentrating
trouble sleeping
unexplained weight loss
unusual bleeding or bruising
unusual tiredness or weakness
vomiting of blood or material that looks like coffee grounds
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Loss of energy or weakness
pain or burning in the throat
redness or itching, pain, or swelling at the injection site (under the skin)
runny or stuffy nose
stomach pain
vomiting
Less common
Bumps below the skin
hair loss or thinning
irritation or soreness of the mouth
itching, redness, or tearing of the eye
skin rash
Incidence not known
Altered sense of taste
burning, crawling, itching, numb, prickling, “pins and needles”, or tingling feelings
feeling faint, dizzy, or lightheaded
feeling of warmth or heat
flushing or redness of the skin, especially on the face and neck
loss of appetite
sweating
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Enbrel (etanercept)
Pros
- Available in many options for at-home injections (e.g., prefilled syringes, autoinjectors)
- Can be used for children age 2 and older with certain kinds of juvenile arthritis
- Can be used for both adults and children 4 years and up for plaque psoriasis
Cons
- Must be given as an injection under the skin
- Must give injection every week
- Raises the risk of serious infections
Pharmacist tips for Enbrel (etanercept)
- Make sure you get injection training before using Enbrel (etanercept). Don’t give yourself an injection before you know how to do it safely. Read the Instructions for Use that came with your prescription. If you need help, contact your clinic or call 1-888-4Enbrel.
- Take Enbrel (etanercept) exactly as prescribed. Most people use it once a week. Adults with plaque psoriasis start with twice-weekly injections for a few months, then switch to once a week. Try to give the injection on the same day each week. You can use a calendar reminder to help you remember.
- If you miss a dose of Enbrel (etanercept), inject your dose as soon as you remember. Then, take your usual dose at your next regular time. Don't inject Enbrel (etanercept) more often than prescribed. Taking extra doses can raise your risk of side effects.
- It's possible have redness, itching, pain, or swelling where you inject Enbrel (etanercept). These reactions usually get better within a few days. Try using a cool compress after the injection to help with discomfort. Tell your care team if the reaction is severe or doesn't go away.
- Enbrel (etanercept) can make it easier for you to get sick. Watch for signs of infection, such as fever, chills, a cough that won't go away, trouble breathing, or feeling very tired. Call your care team right away if you notice any of these symptoms. They can check for an infection and give you the care you need.
- Before getting any vaccines, tell the healthcare professional that you're taking Enbrel (etanercept). It's safe to get most vaccines like the regular flu shot during treatment. But you should avoid getting live vaccines, such as FluMist (the nasal spray flu vaccine). It's not clear if live vaccines are safe with Enbrel (etanercept). The healthcare professional can make sure the vaccine is safe for you.
- Tell your care team about all the medications you take. Enbrel (etanercept) can interact with some medications and raise your risk of side effects. For example, taking it with other medications that weaken the immune system can raise your risk of serious infection. Your care team can make sure your medications are safe to take together. They can make adjustments to keep you safe if needed.
How to store Enbrel (etanercept):
- Keep Enbrel (etanercept) in the refrigerator at 36°F to 46°F until you're ready to use it. Don't let the medication freeze.
- If you're traveling or don't have access to a fridge, Enbrel (etanercept) can stay at room temperature (68ºF to 77ºF) for up to 30 days. The exception is the multi-dose vials, which can be at room temperature for up to 14 days. Don't leave it in extreme heat. Also don't put the medication back in the fridge after it's been left at room temperature.
- If you're using the AutoTouch reusable autoinjector, keep the device at room temperature. Don't store the AutoTouch autoinjector in the refrigerator with the Enbrel Mini cartridge.
How to use Enbrel (etanercept):
- Be sure you know how to use the Enbrel (etanercept) device you have. The vials, prefilled syringes, Enbrel SureClick autoinjectors, and Enbrel Mini cartridges each have different instructions. Ask your care team or call 1-888-4Enbrel if you're not sure how to use your device.
- Before each Enbrel (etanercept) injection: Take your Enbrel SureClick pen, syringe, Enbrel Mini cartridge, or vial out of the fridge about 30 minutes before your injection. Place it on a flat surface and wait for it to reach room temperature. This is helpful because injecting cold medication can cause more discomfort. Don't warm it up by heating with hot water, a microwave, or direct sunlight. Always check that the solution is clear and colorless. Don't use if it's cloudy, discolored, or has particles.
- Prepare for your Enbrel (etanercept) injection: Wash your hands before giving the injection. Also, clean your injection site with an alcohol swab. This helps prevent infections.
- Where to inject Enbrel (etanercept): Inject the medication under the skin into the thigh or stomach (at least 2 inches away from the belly button). Someone can also help inject it into the outer area of your upper arm. Don’t inject into red, sore, hard, thick, scaly, or bruised skin. Choose a different area for the injection each time to prevent skin irritation or damage.
- After each Enbrel (etanercept) injection: Throw away used pens, syringes, cartridges, vials, or needles in a sharps container. You can also use a heavy-duty plastic container, like an empty laundry detergent bottle. This helps protect you and others from needle sticks. Follow the rules in your local area for how to safely throw the sharps container out when it’s full.
Risks and warnings for Enbrel (etanercept)
Enbrel (etanercept) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of serious infections
- Risk factors: Active, chronic, or recurrent infection | Older adults | Medical conditions that could raise the risk of infection (e.g., poorly controlled diabetes) | Exposed to tuberculosis | Have lived in or traveled to places that have high likelihood of certain infections | Taking other medications that weaken the immune system
Enbrel (etanercept) can raise your risk of serious infections. Some can be severe enough to need hospital care or become life-threatening. In rare cases, certain infections you had in the past, like tuberculosis (TB) or hepatitis, can come back.
Before starting Enbrel (etanercept), tell your prescriber about your medical history. This includes any current infections or past TB or hepatitis B. Also make sure they know about all the medications you take. The risk of serious infections might be higher in older adults and people with certain health conditions. The risk can also be higher if you take other medications that weaken the immune system. Your prescriber can check your risk before treatment and make sure it's safe for you. You shouldn't start Enbrel (etanercept) if you have an active infection.
While taking Enbrel (etanercept), watch for signs of infection. This includes fever, chills, trouble breathing, a cough that won't go away, night sweats, or confusion. If you think you have any signs of an infection, contact your care team right away.
Risk of cancers
- Risk factors: Taking other immunosuppressants at the same time as Enbrel (etanercept)
In studies, a small number of people taking Enbrel (etanercept) developed certain cancers. This included lymphoma. Other cancers reported in adults were leukemia and skin cancers such as melanoma.
Talk with your prescriber if you have concerns about this risk before starting Enbrel (etanercept). Your prescriber will review your risk and monitor you during treatment.
Problems with the nervous system
- Risk factors: History of a neurologic condition
Rare cases of nerve problems have happened in some people taking Enbrel (etanercept). This has included new or worsening multiple sclerosis, Guillain-Barré syndrome, or seizures.
If you currently have a nerve condition, let your prescriber know. They'll want to monitor you more closely during treatment.
Tell your prescriber right away if you feel confused, notice changes in your behavior, or have vision problems. Also let them know if you have numbness, tingling, or weakness in your arms or legs. These can be signs of nerve problems. It's possible that they might become serious or permanent, so it's important to get evaluated.
Heart failure
In rare cases, people taking Enbrel (etanercept) have developed new or worsening heart failure. Tell your prescriber if you currently have heart failure. They can weigh the benefits and risks to help decide if Enbrel (etanercept) is right for you. If you take the medication, they'll help to monitor you closely.
Low blood cell counts
- Risk factors: History of very abnormal blood counts
It's rare, but some people have had very low blood cell counts while taking Enbrel (etanercept). This can make you feel very tired, weak, or dizzy. You might also bruise or bleed more easily. In particular, low white blood cells can make it harder for your body to fight infections and make it easier to get sick.
Get medical help if you have signs of low blood cell counts while taking Enbrel (etanercept). This includes a fever that doesn't go away, pale skin, extreme tiredness, easy bruising, or unusual bleeding.
Serious allergic reaction
Although rare, Enbrel (etanercept) can cause a serious allergic reaction. This can include anaphylaxis. Get medical help right away if you have signs of an allergic reaction. Look out for severe hives, swelling in your face or throat, or trouble breathing.
Not recommended for certain people with granulomatosis with polyangiitis (GPA)
- Risk factors: Taking immunosuppressants
Tell your prescriber if you have granulomatosis with polyangiitis (GPA). Enbrel (etanercept) isn't recommended if you have this condition and take other medications that weaken the immune system. In a study, people taking Enbrel (etanercept) with these medications had a higher risk of certain cancers. It also didn't work better than standard treatment alone.
Not recommended with Kineret (anakinra) or Orencia (abatacept)
Tell your prescriber if you take Kineret (anakinra) or Orencia (abatacept). Using these medications with Enbrel (etanercept) isn't recommended. This is because it can raise the risk of serious infections. Your prescriber can decide the safest treatment option for you.
Caution use in people with moderate or severe liver damage from alcohol use
Before starting Enbrel (etanercept), tell your prescriber if you have liver damage from alcohol use. This is called alcoholic hepatitis. In a study, people with moderate or severe alcoholic hepatitis who took the medication had a higher risk of death after 6 months than those who didn't take it. Your prescriber can make sure Enbrel (etanercept) is safe for you.
Enbrel (etanercept) dosage
The average cost for 1 carton of 4 sureclicks of 50mg of Enbrel (etanercept) is $0.00 with a free GoodRx coupon. This is 100.00% off the average retail price of $10,463.30. 
Carton
Carton| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 4 syringes of 50mg | 1 carton | $0.00 | $0.00 |
| 4 sureclicks of 50mg | 1 carton | $0.00 | $0.00 |
| 4 vials of 25mg | 1 carton | $0.00 | $0.00 |
| 4 syringes of 25mg | 2 cartons | $0.00 | $0.00 |
| 1 vial of 25mg | 1 carton | $852.17 | $852.17 |
| 4 mini cartridges of 50mg | 1 carton | $0.00 | $0.00 |
| 1 syringe of 50mg | 4 cartons | $7,933.71 | $1,983.43 |
| 1 mini cartridge of 50mg | 4 cartons | $7,935.51 | $1,983.88 |
Typical dosage for Enbrel (etanercept)
-
Adults
- Rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis: The typical dose is 50 mg injected under the skin once a week.
- Plaque psoriasis: The typical starting dose is 50 mg injected under the skin twice a week for 3 months. Then, you continue with the maintenance dose of 50 mg once per week.
-
Children
- Juvenile psoriatic arthritis, polyarticular juvenile idiopathic arthritis, or plaque psoriasis: The dose will be based on your child's weight.
- 63 kg (138 lbs) or more: The typical dose is 50 mg injected under the skin once per week.
- Less than 63 kg (138 lbs): The typical dose is 0.8 mg/kg injected under the skin once per week. The prescriber will help calculate this dose.
- Juvenile psoriatic arthritis, polyarticular juvenile idiopathic arthritis, or plaque psoriasis: The dose will be based on your child's weight.
More on Enbrel (etanercept) dosage
Interactions between Enbrel (etanercept) and other drugs
Enbrel (etanercept) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Enbrel (etanercept). Please note that only the generic name of each medication is listed below.
More on Enbrel (etanercept) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abatacept
- Adenovirus Vaccine
- Anakinra
- Bacillus of Calmette and Guerin Vaccine, Live
- Cholera Vaccine, Live
- Cyclophosphamide
- Dengue Tetravalent Vaccine, Live
- Infliximab
- Influenza Virus Vaccine, Live
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Poliovirus Vaccine, Live
- Rilonacept
- Rotavirus Vaccine, Live
- Rubella Virus Vaccine, Live
- Smallpox Vaccine
- Tofacitinib
- Typhoid Vaccine, Live
- Varicella Virus Vaccine, Live
- Yellow Fever Vaccine
- Zoster Vaccine, Live
How much does Enbrel (etanercept) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Enbrel (brand)
$0.00
Enbrel (etanercept) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Enbrel (etanercept) will not be safe for you to take.
- Serious and extreme immune response to an infection (sepsis)
- Use near high magnetic or radiation fields, like MRI, CAT, or PET scanners - for AutoTouch Connect autoinjector only
What are alternatives to Enbrel (etanercept)?
There are a number of medications that your doctor can prescribe in place of Enbrel (etanercept). Compare a few possible alternatives below.
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Enbrel Dosages: Your GoodRx Guide
Read on for Enbrel (etanercept) dosage information, including typical dosages, adjustments for health conditions, and what to do if you miss a dose.
