Etanercept, sold under the brand name Enbrel, is a biopharmaceutical. It acts as a TNF inhibitor and has five FDA approved uses. Each of its uses is related to overactive immune systems. This article contains information answering the most common questions asked by patients who have been prescribed Enbrel.
- What is Enbrel (etanercept) used for?
- How does Enbrel work?
- How much does Enbrel Cost?
- What are the side effects of Enbrel?
- How do you inject Enbrel?
- What is the difference between Enbrel and Humira?
- What should I avoid while taking Enbrel?
- Which Enbrel dosage is right for me?
1. What is Enbrel (etanercept) used for?
Enbrel is used to treat rheumatoid arthritis, polyarticular juvenile idiopathic arthritis (JIA), ankylosing spondylitis, psoriatic arthritis, and plaque psoriasis. The common link between all these diseases is that they are related to an overactive immune system, which Enbrel works to reduce. In turn, the symptoms of these diseases, such as joint pain, can be treated.
2. How does Enbrel work?
TNF is a protein that helps the immune system fight infections, but people with certain autoimmune diseases have so much TNF that it attacks their healthy cells. Enbrel is a TNF, or tumor necrosis factor (TNF), blocker that has the form of a TNF receptor. By binding to TNF in the body, Enbrel decreases the activity of TNF. Enbrel is not a cure for the conditions it’s approved to treat but it does treat symptoms. It may also be able to prevent further damage to joints in patients with arthritis.
3. How much does Enbrel Cost?
The cost of Enbrel will vary greatly based on the insurance coverage and location of individual patients. The list price of Enbrel is $1,389.24 per 50mg dose. The recommended dose for most adults is 50mg weekly. This makes the average monthly price of Enbrel $5,556.96. However, patients with plaque psoriasis may be prescribed 50mg twice weekly for the first three months before being reduced to the normal dose.
4. What are the side effects of Enbrel?
Enbrel may cause side effects ranging from mild to severe. The following lists include some of the most reported side effects but are not complete. Mild side effects typically subside within a few days or weeks of consistent medication-taking. However, if they persist or worsen you should speak to your doctor.
Common side effects:
- Redness at the injection site
- Itchy skin
- Cold-like symptoms
- Mild fever
Serious side effects:
- Heart failure
- Extreme fatigue
- Persistent or worsening fever
- Pale skin
- Worsening symptoms
- Multiple sclerosis
- Potentially fatal skin conditions like Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN)
If you experience any of these serious side effects, you should speak with your doctor as they may be a sign of a serious reaction. Seek immediate medical attention if it is an emergency.
In some rare cases, patients can experience allergic reactions. Seek emergency medical care if you experience any of the following symptoms after taking Enbrel.
- Skin rash
- Tightness in the throat or chest
- Difficulty talking or breathing
- Swelling of the face, lips, tongue, or throat
5. How do you inject Enbrel?
Patients often wonder how to inject Enbrel themselves. However, it is important to note that you should not attempt to give any injections without first speaking with your doctor. If your doctor has decided that at-home injections are the best route, then the following video from John Hopkins Rheumatology provides helpful step by step instructions and demonstration.
6. What is the difference between Enbrel and Humira?
It is common for patients to wonder if they should be taking Enbrel or Humira given that they both have very similar use cases. In truth, they are equally effective as well. However, some slight differences may mean one is right for you over the other. One example is that Humira can be taken twice or four times monthly, whereas Enbrel can only be taken four times monthly. They also have slightly different applicators which may be a concern for patients giving self-injections. The best thing to do is to speak with your doctor so you can learn which differences are relevant to you and can make the best decision regarding your treatment together.
7. What should I avoid while taking Enbrel?
While taking Enbrel, the most important thing to avoid while on anakinra, as with other immunosuppressants, it is important to avoid live vaccines. You should also avoid getting a live vaccine up to three months before starting treatment. Not all vaccines are considered “live vaccines,” so be sure to speak with your healthcare provider about any vaccines you are scheduled to receive before receiving them if you take anakinra. Aside from live vaccinations, patients should take extra care to avoid infections as their bodies may not be able to fight them off effectively.
Patients should also avoid injecting Enbrel in the same location every time. While this is not necessarily critical, rotating injection sites may be able to reduce discomfort and pain/redness after the injection. Keeping a log of injections with a journal or an injection site tracker may make this easier.
8. Which Enbrel dosage is right for me?
The proper dosage of Enbrel will vary between patients and is based on several factors. You should always follow your doctor’s instructions or the directions on the label. The information below refers to typical doses of Enbrel. If these doses are not consistent with your prescription, follow your prescription. The dosage patients are typically prescribed will be based on the condition it’s being used to treat, your age, the form of Enbrel you’re taking, and any other medical conditions you are affected by. Enbrel is available as a prefilled syringe, autoinjector, powder, and prefilled cartridge. The following are standard doses:
- Rheumatoid arthritis – 50 mg once weekly
- Psoriatic arthritis – Weekly 50mg doses
- Ankylosing spondylitis – 50 mg once weekly
- Plaque psoriasis – 50 mg twice weekly for three months, followed by 50 mg once weekly
- Polyarticular juvenile idiopathic arthritis – Dosage is determined based on weight
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