Enbrel: Uses, Side effects, Interactions and Precaution

Overview

What is Enbrel?

Enbrel is the prescription drug trade name to treat autoimmune conditions such as arthritis and plaque psoriasis in adults. An autoimmune disease is when the immune system incorrectly attacks the body’s healthy cells. Plaque psoriasis is a persistent skin condition with itchy skin patches (plaque).

Enbrel is also sometimes used with other medications to treat arthritis.

Enbrel belongs to the tumor necrosis factor (TNF) inhibitor drug class.²Overview| Researched based study from Sciencedirect.com

Facts of Enbrel

• Enbrel is accessible only as the trade name drug
• The biological drug of Enbrel is Etanercept. In 1998, the FDA approved the Etanercept drug.
• The other biosimilar drugs of Enbrel are Eticovo and Erelzi ¹Overview| Researched based study from Nlm.nih.gov .

Mode of action of Enbrel

• Enbrel works by retarding the overactive immune system. It reduces the tumor necrosis factor.
• TNF is a protein created by the immune system to combat infection. In people with autoimmune conditions, the body excessively produces TNF that incorrectly attacks the normal body cells ³Overview| Researched based study from Sciencedirect.com

Uses

Uses of Enbrel

Enbrel is used to treat the following health conditions:

• Treats Polyarticular juvenile idiopathic arthritis
• Helps in the management of Rheumatic arthritis
• Aids in Ankylosing spondylitis Management
• Treats Psoriatic arthritis
• Helps in Plaque psoriasis treatment

Polyarticular juvenile idiopathic arthritis

• It is an autoimmune condition in children that causes painful joints.
• Enbrel prescribed for Polyarticular juvenile idiopathic arthritis children of 2 years and older

Rheumatic arthritis

• It is a condition that causes swelling, pain, and stiffness of the joints of the wrist, elbow, shoulder, hands, hips, and ankles.
• Enbrel is prescribed for Rheumatic arthritis patients of 18 years and older.

Ankylosing spondylitis

• It is a persistent condition that affects the joints of the spine. It causes severe back and hip pain.
• Enbrel is for Ankylosing spondylitis patients of 18 years and older.

Psoriatic arthritis

• It is a chronic condition of joint inflammation and skin disease (psoriasis).
• Enbrel is for Psoriatic arthritis patients over 18 years of age.

Plaque psoriasis

• It is a chronic skin disorder.
• Enbrel is for Plaque psoriasis patients of 4 years and older ⁵Uses| Researched based study from Nlm.nih.gov

Dosage

Dosage of Enbrel

The dose of Enbrel depends on several factors, such as age, medical condition, and the condition for which taken. In young children, the Enbrel dose depends on body mass. Some of the commonly used amounts of Enbrel are as follows:

Adults dose for Rheumatic arthritis, psoriatic arthritis, Ankylosing Arthritis

• 50 mg injection per week

Plaque psoriasis (moderate to severe)

• Starting dose- 50mg (milligram) twice weekly for three months
• Maintenance dose-After three months, 50 mg per week ⁴Dosage| Researched based study from Nlm.nih.gov

However, one must follow the amount as prescribed by the doctor.

Taking Enbrel

Enbrel is a subcutaneous injection. Some tips for using Enbel are as follows:

• One can inject Enbrel into the belly, thigh, and upper arm. To avoid an injection site reaction, one must not inject Enbrel at the exact locations each time.
• Remove the Enbrel injections 30 minutes before using it
• While injecting the Enbrel autoinjector, use the medicine within five minutes of taking off the cap
• Avoid reusing the syringes

Missed dose

• In case of missed doses, take the amount instantly when you remember.
• However, never take two injections simultaneously, which can have rigorous side effects.
• One who needs to be sure of taking or skipping the dose must talk to the healthcare provider.

Formulations

Formulation of Enbrel

Enbrel is available as a solution or in powder form as a mixed-in solution. Doctors give it as an injection under the skin.

Enbrel injections are available in the following forms:

Single-use vials

• Power (strength)-25mg/0.5 mL(milliliter)

Multiple-dose vials

• Power (strength)-25 mg(milligram)

Single-dose prefilled syringes

• Power (strength)-25 mg(milligram) per 0.5 mL;50 mg/mL

Single-dose prefilled reusable autoinjectors

• Power (strength)- 50 mg/mL

Single dose single-use prefilled autoinjectors

• Power (strength) – 50 mg/mL

Overdose

Overdose toxicity

• One must take Enbrel as the physician directs, as high doses can lead to serious side effects.
• However, in case of accidental excessive drug intake, one must dial the emergency medical number based on the geographical site or rush to the nearest emergency medical room ⁷Overdose| Researched based study from Dailymed.nlm.nih.gov

Side effects

Side effects of Enbrel

Common side effects

• Pain and redness on the injection site
• Itchiness
• Skin rash
• Diarrhea
• Bleeding
• Fever
• Respiratory infections viz, sinus infection

Serious side effects

• Eye problem
• New scaly patches on the skin
• Weakness in arms and legs
• Persistent fever
• Muscle pain
• Joint pain
• Persistent fever
• Memory loss
• Extreme tiredness
• Confusion
• Bacterial or fungal infection
• Heart failure
• Inflammatory bowel disease(digestive disorder)
• Cancer (lymphoma) ⁶Side effects| Researched based study from Nlm.nih.gov

Long-term side effects

• Skin rash
• Itchiness
• Infections
• Skin problem at the injected site
• Fever ⁹Side effects| Researched based study from Nlm.nih.gov

Contraindications

Contraindications of Enbrel

Enbrel might not be suitable for persons with the following health conditions:

• Allergic reaction to Enbrel or any of the ingredients of the drug
• Diabetes (high blood sugar)
• Tuberculosis (a bacterial infection that impacts the lungs)
• Active infections such as flu
• Heart problem
• Weakened immune system
• Alcoholic hepatitis (alcoholic liver disease)
• Sepsis (the body’s extreme immune response to infection)
• Nervous system disorder
• Fungal infection ⁹Contraindications| Researched based study from Nlm.nih.gov
• Pregnant and nursing women should avoid using Enbrel due to the lack of information on the safety and efficiency of these groups ⁸Contraindications| Researched based study from Nlm.nih.gov

Interactions

Interactions of Enbrel

Cyclophosphamide (Cancer medication)

• Taking Enbrel and cancer medication together might increase the risk of abnormal cell growth.

Orencia (biologic medication)

• Taking Enbrel and biological medication together might increase the risk of severe infections.

Live vaccines

• The live vaccine contains the germ in its weakened form.
• Enbrel weakens the immune system.
• Taking Enbrel and live vaccines together might activate the germ and make the person ill instead of protecting against the disease for which taken.

Enbrel might also interact with several types of medications. Some of them are as follows:

• Rilonacept(recurrent pericarditis medication)
• Sulfasalazine(ulcerative colitis medication)
• Belimumab (lupus medication)
• Anakinra(rheumatic arthritis medication)
• Infliximab(arthritis medication) ¹⁰Interactions| Researched based study from Nlm.nih.gov

Storage

Storage & Disposal of Enbrel

Storage

• One can keep Enbrel in the refrigerator between 2 to 8 degrees centigrade. Once removed from the fridge, one should use it within two weeks.
• For up to two weeks, one can keep Enbrel prefilled syringes at room temperatures between 20 to 25 degrees centigrade while one can keep Enbrel reusable syringes at room temperatures.

Disposal

• Dispose of unused medicine in a disposal container to prevent accidental overdose or death of animals or pets.
• Discard the medication whose expiry date has crossed

Cost of Enbrel

• The cost of Enbrel depends on several conditions, such as geographical site, health store in use, and insurance coverage.
• One without insurance coverage can avail of financial assistance from Enbrel manufacturer’s programs such as Amgen Safety Net Foundation.

Takeaway

Key Takeaways

• Enbrel is an FDA-approved prescription for managing autoimmune conditions like arthritis and plaque psoriasis.
• People with a medical condition must inform the doctor before taking Enbrel to avoid unwanted side effects.
• Enbrel has probable warnings and side effects. So, one must follow the accurate doses as approved by the doctor.