Etanercept Benepali, Enbrel, Erelzi
Etanercept is given by an injection under your skin. Carefully follow the directions you have been given for using the injections, and ask your doctor if you are unsure about anything.
Carry your Patient Alert Card with you and show it to anyone who is treating you to make sure they know you are receiving etanercept.
If you develop signs of an infection such as a high temperature (fever) or a sore throat, or if you have any unexplained bruising or bleeding, let your doctor know straightaway.
|Type of medicine||A cytokine modulator biological medicine|
|Used for||Rheumatoid arthritis; ankylosing spondylitis; psoriatic arthritis; juvenile idiopathic arthritis (a type of arthritis in children); plaque psoriasis|
|Also called||Benapali®; Enbrel®; Erelzi®|
|Available as||Subcutaneous injection|
Etanercept is a biological medicine used to ease the symptoms of rheumatoid arthritis and some other forms of arthritis such as psoriatic arthritis, juvenile idiopathic arthritis and ankylosing spondylitis. It is also used to treat plaque psoriasis, which is a chronic inflammatory skin disease. A biological medicine is a medicine which is made by living organisms. The medicines mimic substances produced by your body. Biological medicines like etanercept are sometimes called cytokine modulators, or monoclonal antibodies.
Arthritis simply means inflammation of joints. Biological medicines work in arthritis by blocking chemicals in your body that are involved in inflammation. Etanercept blocks a protein called tumour necrosis factor alpha (TNF-alpha). This protein plays an important role in causing inflammation. By blocking it, etanercept reduces damage to your joints.
Etanercept is usually prescribed when other treatments have not worked sufficiently, or if other treatments are not suitable for you. If you are being treated for rheumatoid arthritis, it may be used alongside another medicine such as methotrexate. Etanercept will be prescribed for you by a specialist doctor in a hospital. It cannot be taken as a tablet, as it does not work when swallowed. Instead, it is given by an injection under your skin. You can either learn to inject yourself, or a nurse in the hospital will do it for you.
Before having etanercept
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you (or your child if appropriate) start having etanercept, it is important that your doctor or nurse knows:
- If you are pregnant or breastfeeding.
- If you have an infection, or if you think that you may be at risk of an infection. It is particularly important that you tell your doctor if you have ever had tuberculosis (TB).
- If you have a heart condition.
- If you have diabetes (diabetes mellitus).
- If you have ever had a blood disorder or cancer.
- If you have multiple sclerosis, an eye condition called optic neuritis, or a spinal condition called transverse myelitis.
- If you have had any liver infection or been told you have inflammation of your liver due to drinking alcohol.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How etanercept is given
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about etanercept and a full list of side-effects which you may experience from having it.
- Etanercept is given as an injection under your skin. It is usually given once or twice a week. You may be given the injections by a nurse in your hospital clinic, or you may be taught how to give the injections to yourself. Your doctor or nurse will discuss these options with you.
- If you are given the injections to store at home, keep them in a fridge. You can take your dose out of the fridge about 15-30 minutes before your injection is due, to allow it to reach room temperature before it is given.
- If you are giving your own injections, always check that the solution is clear, not cloudy, and that it does not contain any bits or large particles before you administer it. So that you know exactly how the solution should look, read the description given in the manufacturer's leaflet that comes with your medicine.
- You should try to remember to use etanercept on the same day(s) each week. Make a note in your diary of which days your dose is due so that you do not forget.
- If you do forget a dose, have the injection as soon as you remember and then continue on your usual days. Always refer to the manufacturer's instructions provided with your medicine. As a guide, if you do not remember until your next dose is nearly due (for example, if it is due the following day), you should skip the missed dose but remember your next dose when it is due. Do not have two doses on the same day to make up for a missed dose.
Getting the most from your treatment
- You will be given a Patient Alert Card when you start this treatment. This contains some important safety information for you to read and keep. Carry the card with you, and if ever you need any medical treatment, it is important you show it to anyone who is treating you.
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. Your doctor may want you to have some tests and X-rays from time to time to make sure the treatment is working for you.
- While you are on etanercept, tell your doctor if you come into contact with anyone who has chickenpox or shingles. This is because you may need to have treatment to protect you from these infections.
- If you need to have any vaccinations, speak with your clinic first, as some vaccines are not suitable for you while you are being treated with etanercept.
- If you have diabetes you may need to check your blood glucose levels more regularly, as this preparation can affect the levels of sugar in your blood. Your doctor will advise you about this.
- Initially, etanercept is usually prescribed for about 3-6 months. If the treatment helps you, your doctor may then decide to continue it for longer. The decision to continue or stop your treatment will depend upon your symptoms and what you and your specialist feel is best for you.
- If you need to buy any medicines, check with a pharmacist that they are suitable for you to take alongside etanercept.
Can etanercept cause problems?
Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. The table below lists some of the most common ones associated with etanercept. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve after the first few weeks of having the injections, but speak with your doctor if any of the following side-effects continue or become troublesome.
|Common etanercept side-effects||What can I do if I experience this?|
|Headache||Drink plenty of water and ask a pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know|
|Increased risk of infection||Let your doctor know if you develop a high temperature (fever) or a sore throat, or any other sign of an infection|
|A reaction at the site of the injection (such as bleeding, bruising, redness, itching, pain, and swelling)||These can be common during the first few weeks of treatment but occur less frequently after the first month|
|Allergic-type reactions, such as an itchy skin rash||Let your doctor know about this|
Important: your doctor will discuss with you the possibility of rare but serious side-effects, such as a blood disorder. Contact your doctor straightaway if you develop a high temperature, sore throat, or any unexplained bruising or bleeding.
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store etanercept
- Keep all medicines out of the reach and sight of children.
- Store in a refrigerator. Do not freeze.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you might have had an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Enbrel® 25 mg solution for injection in pre-filled syringe; Pfizer Ltd, The electronic Medicines Compendium. Dated May 2021.
Manufacturer's PIL, Enbrel® 50 mg solution for injection in pre-filled pen; Pfizer Ltd, The electronic Medicines Compendium. Dated May 2021.
Manufacturer's PIL, Benepali® 50 mg solution for injection in pre-filled pen; Biogen Biosimilars, The electronic Medicines Compendium. Dated November 2021.
Medicines Complete BNF 84th Edition; British Medical Association and Royal Pharmaceutical Society of Great Britain, London