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Pharmacologic class: Immunomodulator

Therapeutic class: Antiarthritic

Pregnancy risk category B


Reacts with and deactivates free-floating tumor necrosis factor, responsible for inflammation


Powder for injection: 25 mg in multiple-use vial

Prefilled syringe (single-use): 50 mg/ml

Indications and dosages

Moderately to severely active rheumatoid arthritis; ankylosing spondylitis; psoriatric arthritis

Adults: 50 mg subcutaneously q week given as a single injection. Dosages above 50 mg/week are not recommended.

Chronic moderate to severe plaque psoriasis

Adults ages 18 and older: 50 mg subcutaneously twice weekly (given 3 or 4 days apart) for 3 months, followed by reduction to a maintenance dosage of 50 mg weekly

Polyarticular-course juvenile rheumatoid arthritis

Children ages 4 to 17: 0.8 mg/kg subcutaneously q week, to a maximum of 50 mg weekly


• Hypersensitivity to drug or its components
• Sepsis


Use cautiously in:
• immunosuppression, chronic infection, heart failure
• latex allergy (needle cover of diluent syringe contains latex)
• elderly patients
• pregnant or breastfeeding patients
• children younger than age 4.


• Inject subcutaneously into thigh, abdomen, or upper arm.
• For adult, use single-use, 50 mg/ml prefilled syringe.
• For child weighing 63 kg (138 lb) or more, use single-use, 50 mg/ml pre-filled syringe for weekly dose; for child weighing 31 to 62 kg (68 to 137 lb), administer total weekly dose from multipleuse vial as two injections on same day or 3 or 4 days apart; for child weighing less than 31 kg (68 lb), give as a single weekly injection using multipleuse vial.
• Rotate injection sites.

Adverse reactions

CNS: asthenia, headache, depression, dizziness, paresthesia, fatigue, demyelinating disorders (such as multiple sclerosis and myelitis), cerebral hemorrhage, seizures, cerebrovascular accident (CVA)

CV: hypotension, hypertension, chest pain, deep-vein thrombosis, thrombophlebitis, myocardial ischemia, myocardial infarction (MI), heart failure

EENT: ocular inflammation, pharyngitis, rhinitis, sinusitis

GI: nausea, vomiting, diarrhea, abdominal pain, dyspepsia, anorexia, cholecystitis, abdominal abscess, GI hemorrhage, intestinal perforation, pancreatitis

GU: pyelonephritis, membranous glomerulonephropathy

Hematologic: anemia, aplastic anemia, leukopenia, pancytopenia, thrombocytopenia

Metabolic: hypomagnesemia

Musculoskeletal: bursitis, polymyositis, joint pain

Respiratory: cough, congestion, dyspnea, bronchitis, pneumonia, pulmonary embolism, interstitial lung disease

Skin: flushing, cellulitis, pruritus, rash, cutaneous vasculitis, urticaria, alopecia, angioedema

Other: altered taste, weight gain, adenopathy, fever, irritation at injection site, peripheral edema, flulike symptoms, autoantibody formation, lupus-like syndrome, serious infections, malignancies


None significant

Patient monitoring

Watch for signs and symptoms of malignancies, pancytopenia and infection.

Monitor for evidence of GI bleeding, lupus-like syndrome, and serious hypersensitivity reactions. Stop therapy immediately if these occur.
• Monitor CBC and coagulation studies.

Check for signs and symptoms of cardiac compromise and cerebrovascular events.
• Monitor pulmonary function test results periodically to assess lung status.
• Assess patient's ability to self-administer drug.
• Check for irritation at injection site. As needed, apply cool compresses.
• Examine eyes for conjunctival dryness. As needed, apply artificial tears.

Patient teaching

Tell patient to withhold dose and contact prescriber if he develops signs or symptoms of infection or is exposed to anyone with chickenpox.

Tell patient to immediately report hypersensitivity reaction, neurologic or respiratory problems, sudden weight gain, chest pain, or easy bruising or bleeding.
• Teach patient or caregiver how to administer drug and handle and dispose of equipment.
• Caution patient not to get live-virus vaccines.
• Tell female to inform prescriber if she is pregnant or breastfeeding.
• Advise patient to expect redness, swelling, and pain at injection site. Assure him that these problems will diminish over time.
• As appropriate, review all other significant and life-threatening adverse reactions mentioned above.


A trademark for the drug etanercept.


Etanercept Rheumatology A TNF inhibitor that targets the immune system, ↓ M&M of moderately to severely active rheumatoid arthritis in Pts with an inadequate response to one or more disease-modifying antirheumatic drugs–DMARDs; can be used in combination with MTX for nonresponders to MTX alone


A brand name for ETANERCEPT.
References in periodicals archive ?
Drug Enbrel has recently been passed by the National Institute for Clinical Excellence as a treatment for patients.
Enbrel blocks a protein called tumour necrosis factor (TNF) and belongs to a family of drugs collectively called 'Anti-TNF drugs', which have been a fantastic success in the treatment of rheumatoid arthritis.
According to Bruce Strober, co-director of the Psoriasis and Psoriatic Arthritis Center at New York University, 'These results are important because they confirm the safety profile of Enbrel, which is key information in the context of wider discussion about the long-term use of biologics.
Enbrel sales increased 35 percent during the third quarter to $668 million, versus $496 million in the year-ago period.
The company also revised the drug's label, advising doctors not to prescribe Enbrel for patients with infections and to closely monitor all patients taking the drug.
Approval was based on three studies, including a trial of 277 patients in which 60% of those treated with Enbrel achieved at 12 weeks at least a 20% improvement in response criteria (physical function, pain, spinal stiffness and inflammation, and patient's global assessment), vs.
We have information sheets on both Remicade and Enbrel which can be obtained by calling our booklet hotline on 01636 677775.
Comment: Enbrel reduces inflammation by inactivating TNF, a cytokine that plays an important role in the inflammatory cascade that results in RA symptoms and joint damage.
The British Society for Rheumatologists has already urged its members to tackle health authorities and NHS trusts which refuse to fund drugs such as Enbrel because of their high cost per patient.
GlobalData has released its new PharmaPoint Drug Evaluation report, Enbrel (Rheumatoid Arthritis) Forecast and Market Analysis.
Thats when she discovered that her out-of-pocket cost would increase from $10 to $3,800 per month if she continued on Enbrel.