Enbrel is an injectable prescription medication. It's used to treat multiple conditions, including:

Enbrel belongs to a class of medications called biologics. Biologics are medications made from a live organism.

Enbrel works by decreasing inflammation, which can help relieve the symptoms of your condition.

Enbrel is usually given as a once-weekly injection. The medication may be given to you at your doctor's office. In some cases, your doctor can show you how to give the medication to yourself at home. Enbrel comes in the following forms:

  • prefilled syringe (25 mg/0.5 mL or 50 mg/mL)
  • prefilled SureClick or SureClick 2.0 autoinjector (50 mg/mL)
  • powder to be mixed into a solution (25 mg of powder when mixed is 25 mg/mL)
  • Enbrel Mini single-dose prefilled cartridge (50 mg/mL to be used in an AutoTouch reusable autoinjector)

Effectiveness

Clinical trials of Enbrel show that it's effective in treating the conditions it's approved for.

In a clinical study of adults with plaque psoriasis, 32% to 46% of people taking Enbrel had a decrease in symptoms of 75% or more. In adults taking a placebo (a treatment with no active drug), 3% had a decrease in symptoms of 75% or more.

In children ages 4 years and older with plaque psoriasis, 57% of those taking Enbrel showed a decrease in symptoms of 75% or more. Of the children taking a placebo, 11% had a decrease in symptoms of 75% or more.

For information about Enbrel's effectiveness for other conditions, see the "Enbrel uses" section below.

Enbrel is available only as a brand-name medication. It's not currently available in generic form.

Enbrel contains the active ingredient etanercept.

Two drugs are approved as biosimilars to Enbrel: Erelzi and Eticovo. A biosimilar drug is a drug product that's similar to a brand-name medication and contains the same active ingredient. A generic drug, on the other hand, is an exact copy of a brand-name medication.

Biosimilars are based on biologic drugs, which are made from parts of living organisms. Generics are based on regular drugs, which are made from chemicals.

Enbrel can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Enbrel. These lists do not include all possible side effects.

For more information on the possible side effects of Enbrel, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

More common side effects

The more common side effects of Enbrel can include:

  • respiratory infections
  • redness or pain at the injection site
  • rash
  • itchy skin
  • fever
  • diarrhea (see "Side effect details" below)

Most of these side effects may go away within a few days or a couple of weeks. If they're more severe or don't go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Enbrel aren't common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency.

Serious side effects and their symptoms can include:

  • New or worsening neurologic reactions, such as seizures, multiple sclerosis, or optic neuritis (an eye condition). Symptoms can include:
    • confusion
    • memory loss
    • feeling disoriented
    • changes in vision
    • vision loss
    • feeling tired
  • Blood disorders such as pancytopenia (low levels of certain types of blood cells). Symptoms can include:
    • persistent fever that isn't caused by a cold or flu
    • bruising
    • bleeding easier than usual
    • skin that looks paler than usual
  • Autoimmune reactions such as lupus-like syndrome. Symptoms can include:
    • muscle pain
    • joint pain
    • flu-like symptoms (fever, feeling tired)
  • New or worsening psoriasis. Symptoms may include:
    • new scaly patches on skin
    • bumps on skin

Other serious side effects, explained in more detail below in "Side effect details," include:

* Enbrel has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warnings: Serious infections and cancers" at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here's some detail on several of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Enbrel. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Enbrel. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency.

Eye side effects

Swelling inside the eye can occur while taking Enbrel. If the swelling is of the optic nerve, it's called optic neuritis. This condition can lead to vision loss. Symptoms of optic neuritis include:

  • pain in your eye
  • vision loss, usually only in one eye
  • seeing flashing lights (off to the side) in one or both eyes

In clinical trials, optic neuritis and other side effects that impact the nerves were very rare. These side effects occurred in less than 0.1% of people taking Enbrel or another medication like Enbrel.

Talk with your doctor right away if you have any changes in your vision while taking Enbrel.

Serious infections

Taking Enbrel may weaken the immune system. While using Enbrel, it may be harder for your body to fight infections, and you may become sick easier than usual. Enbrel can raise your risk of getting tuberculosis (TB) and other bacterial, viral, and fungal infections.

Enbrel can raise your risk of reactivated (preexisting) TB. It can also cause new TB if you are exposed to it, because your immune system is weakened. Before starting Enbrel, your doctor will test you for TB. If you test positive, you may need to be treated for TB before starting Enbrel.

Throughout the time you're taking Enbrel, your doctor should monitor you for any signs and symptoms of infections. If you develop a serious infection, your doctor may have you stop taking Enbrel until the infection is gone.

In clinical trials, 50% of people taking Enbrel had an infection over a 6-month period. In comparison, 39% of people taking a placebo (a treatment without an active drug) had that same result.

Talk with your doctor if you're concerned about developing an infection while taking Enbrel.

Long-term side effects

Using Enbrel long term can cause you to have side effects. However, the long-term side effects of using the medication are very similar to the short-term side effects. Some side effects include:

  • respiratory infections
  • redness or pain at the injection site
  • rash
  • itchy skin
  • fever
  • diarrhea

Talk with your doctor if you're concerned about the long-term side effects associated with Enbrel.

Cancer risk

People taking Enbrel may have a higher risk of getting certain types of cancer.

In clinical trials, some cancers (including lymphoma, leukemia, and skin cancer such as melanoma) occurred at a higher rate in people taking Enbrel than in people taking placebos.

Lymphoma is a type of cancer of the lymph nodes, which are part of your immune system. Lymphoma occurred in 0.06% of the 3,306 people being treated with Enbrel in a clinical trial. It did not occur in any of the 1,521 people taking a placebo in this study.

Leukemia (a type of blood cancer) is also a serious side effect that can occur in people taking Enbrel. In clinical trials, 0.037% of the 5,445 people taking Enbrel developed leukemia. None of the 2,890 people taking a placebo in this study developed leukemia.

Certain types of skin cancer have also been reported while Enbrel. In clinical trials, there was 0.41 cases of skin cancer per 100 patient years. This means that if 100 people took Enbrel for 2 years, about 1 of them would develop skin cancer. Seeing your doctor for skin exams while you're taking Enbrel can help catch any changes in your skin early on.

An increased risk of cancer was also seen in children taking Enbrel. The most common type of cancer was lymphoma.

The risk of getting cancer from using Enbrel is typically low. But if you have questions about your level of risk, talk with your doctor.

Diarrhea

You may have diarrhea while taking Enbrel. In clinical trials, this was a common side effect of people taking Enbrel. About 3% of people taking Enbrel for plaque psoriasis had diarrhea. In comparison, 2% of people taking a placebo had diarrhea.

Talk with your doctor if you're concerned about having diarrhea while taking Enbrel.

Heart failure

If you have congestive heart failure, taking Enbrel may make the condition worse. In very rare cases, you could develop new congestive heart failure from taking Enbrel. In clinical trials, less than 0.1% of people taking Enbrel developed new congestive heart failure when they had no previous heart disease.

Symptoms of congestive heart failure can include:

  • shortness of breath
  • feeling tired
  • cough
  • swelling in your legs and ankles

If you already have heart failure, your doctor should monitor you while you're taking Enbrel to make sure your condition doesn't get worse.

Talk with your doctor if you're concerned about having congestive heart failure while taking Enbrel.

Ulcerative colitis

Enbrel may cause ulcerative colitis (a type of inflammatory bowel disease).

Symptoms of ulcerative colitis can include:

  • abdomen (belly) pain
  • blood in stool
  • weight loss
  • diarrhea

In clinical trials, less than 0.1% of children taking Enbrel for juvenile idiopathic arthritis developed inflammatory bowel disease. This study did not look for ulcerative colitis specifically. Instead, it looked for any type of inflammatory bowel disease.

Also, in studies after Enbrel was approved, about 144 people taking Enbrel developed new ulcerative colitis that was reported to the FDA.

Symptoms of ulcerative colitis may decrease or stop after you stop taking Enbrel.

Talk with your doctor if you're concerned about getting ulcerative colitis while taking Enbrel.

Weight gain (not a side effect)

It's unlikely that taking Enbrel will cause you to gain weight. Weight gain was not a side effect seen in clinical trials. However, weight gain may be caused by congestive heart failure, which is a possible serious side effect of Enbrel. Congestive heart failure can cause your body to hold extra water (water retention) in your legs, ankles, and feet, which can cause you to gain weight.

Talk to your doctor right away if you gain weight or notice swelling in your legs, ankles, or feet while taking Enbrel. This could be a sign of a more serious side effect such as congestive heart failure.

Weight loss (not a side effect)

Weight loss is not a known side effect of Enbrel, and it wasn't a side effect seen in clinical studies. However, weight loss can be a sign of a more serious side effect such as an infection.

Talk with your doctor right away if you have unexpected weight loss. This could be a sign of a bacterial, viral, fungal, or tuberculosis infection, which can become serious if not treated.

Hair loss (not a side effect)

Hair loss was not a side effect found in clinical trials of Enbrel. However, sometimes people with rheumatoid arthritis or psoriatic arthritis take Enbrel along with methotrexate. Methotrexate can cause hair loss in a small percentage of people.

Talk with your doctor if you're concerned about any of your medications causing hair loss.

Headache (not a side effect)

Headache was not a side effect seen in clinical trials of Enbrel. Other medications used to treat similar conditions to those Enbrel treats may cause headaches. For example, headaches are a common side effect of Humira.

Talk with your doctor if you're getting headaches while taking any medications.

Depression (not a side effect)

Enbrel does not generally cause depression, and it wasn't a side effect seen in clinical trials.

Sometimes your condition itself can cause you to feel depressed. Also, some medications used to treat similar conditions to those Enbrel treats can cause or worsen depression. For example, Siliq, a medication used to treat plaque psoriasis, can cause new or worsening depression.

Talk with your doctor if you have concerns about your mental health.

Fatigue (not a side effect)

Enbrel shouldn't cause fatigue (lack of energy). In clinical trials, fatigue was not a side effect in people taking Enbrel.

However, fatigue is a common symptom of inflammatory conditions such as rheumatoid arthritis and ankylosing spondylitis. Often, people with inflammatory conditions experience more fatigue. This is most likely due to the condition itself and not the treatment.

Talk with your doctor if you're concerned about fatigue.

Side effects in children

Side effects in children were very similar to those seen in adults.

As with all medications, the cost of Enbrel can vary. To find current prices for Enbrel in your area, check out GoodRx.com.

The cost you find on GoodRx.com is what you may pay without insurance. The actual price you'll pay depends on your insurance plan, your location, and the pharmacy you use.

Financial and insurance assistance

If you need financial support to pay for Enbrel, or if you need help understanding your insurance coverage, help is available.

Amgen Inc., the manufacturer of Enbrel, offers a copay program that may help lower the cost of Enbrel if you have health insurance coverage. Amgen Inc. also offers a program called Amgen Safety Net Foundation, which may help cover the cost of Enbrel if you don't have health insurance coverage for the drug.

For more information about these programs, and to find out if you're eligible for support, call 888-4ENBREL (888-436-2735) or visit the program website.

Enbrel is a medication that's given as a subcutaneous (under the skin) injection. You'll probably get your first dose of Enbrel in your doctor's office. Then your doctor or pharmacist may show you how to inject Enbrel so you can use the medication at home.

You should take Enbrel according to your doctor or healthcare provider's instructions. The Enbrel website also provides step-by-step instructions and videos on how to use each Enbrel product.

Here are some other tips for using Enbrel:

  • Enbrel can be injected into your thigh, the outer area of your upper arm, or your belly (except for the 2-inch area around your belly button). You should rotate locations each time you inject Enbrel. Do not inject Enbrel into any areas of the skin that are bruised or red, or have psoriasis patches.
  • You should take Enbrel out of the refrigerator at least 30 minutes before using it so it can come to room temperature. Enbrel comes in different forms: a prefilled syringe, a vial, an autoinjector, and a reusable autoinjector.
  • If you're using Enbrel from a vial, the medication will need to be mixed and drawn into a syringe before use. Enbrel vials expire 14 days after mixing the solution and must be refrigerated once they're mixed. Never use Enbrel after it's been mixed for more than 14 days.
  • When injecting Enbrel using the SureClick autoinjector, always use the medication within 5 minutes of taking the syringe cap off. Leaving the cap off for longer can dry out the syringe, and as a result you may not get your full dose of medication.
  • Enbrel also comes as an AutoTouch reusable injector with Enbrel Mini cartridges. If you're using the AutoTouch injector, you only need to replace the cartridge containing the medication with each new injection.
  • The AutoTouch device has light and sound indicators to let you know when your injection has been administered. Make sure you use the medication within 5 minutes of taking the syringe cap off. Leaving it off for longer can dry out the syringe, and as a result you may not get your full dose.
  • Always dispose of used syringes, single-use autoinjectors, or the Enbrel Mini cartridges into a sharps container. Never throw syringes in a regular trash can. Never reuse syringes. For more information about proper sharps disposal, see the FDA's guidelines.

When to take

Enbrel is usually given as a once-weekly injection. In some cases, people with moderate to severe plaque psoriasis may get twice-weekly injections for the first 3 months. After that, their dosage may switch to once a week.

You should take Enbrel on the same day each week so you always have the same amount of medication in your body. To help make sure you don't miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

The Enbrel dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you're using Enbrel to treat
  • your age
  • the form of Enbrel you take
  • other medical conditions you may have

Your doctor will ultimately prescribe the smallest dosage that provides the desired effect. The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Enbrel comes in many different forms and strengths, including:

  • prefilled syringe (25 mg/0.5 mL or 50 mg/mL)
  • prefilled SureClick or SureClick 2.0 Autoinjector (50 mg/mL)
  • powder to be mixed into a solution (25 mg of powder equals 25 mg/mL solution when mixed)
  • Enbrel Mini single-dose prefilled cartridge (50 mg/mL to be used in an AutoTouch reusable autoinjector)

Dosage for rheumatoid arthritis

If you have rheumatoid arthritis, the standard dose is one 50-mg injection every week. You may take Enbrel along with methotrexate for rheumatoid arthritis.

Dosage for psoriatic arthritis

The standard dose for psoriatic arthritis is one 50-mg injection every week. You may take Enbrel along with methotrexate for psoriatic arthritis.

Dosage for ankylosing spondylitis

If you have ankylosing spondylitis, the standard dose is one 50-mg injection every week. You may take Enbrel along with methotrexate for ankylosing spondylitis.

Dosage for plaque psoriasis

If you have moderate to severe plaque psoriasis, you may start off using 50 mg of Enbrel twice a week for the first 3 months. This is called a loading dose.

Loading doses are higher doses at the start of treatment. These higher doses help the medication to start working faster in your body.

After the first 3 months, you'll switch to a maintenance dose. The standard maintenance dose is a 50-mg injection once every week.

In some cases, you may start out with 25- or 50-mg injections once per week. In this case, you would not have a loading dose. Depending on factors like how severe your condition is, your age, and other medical conditions, your doctor will determine the best way to start your treatment.

Dosage for polyarticular juvenile idiopathic arthritis

Enbrel can be used in children ages 2 years and older for polyarticular juvenile idiopathic arthritis. Children who weigh 138 pounds (63 kg) or more will receive one 50-mg injection each week.

For children who weigh less than 138 pounds (63 kg), one injection is given each week. The dose is based on weight.

The milligram strength is calculated as 0.8 mg/kg. For example, if a child weighs 42 pounds, that equals about 19 kg. The dose is calculated as 19 kg multiplied by 0.8 mg/kg, resulting in a dose of about 15 mg. Your child's doctor or pharmacist can calculate the correct dosage for you.

Enbrel prefilled syringes and autoinjectors only come in doses of 25 mg or 50 mg. You need to use the powder for a dose other than 25 or 50 mg.

The powder comes as 25 mg/mL and must be mixed before use. Once the powder is mixed, you can draw out the exact amount of medication that you need. So for the example above, you would draw out 0.6 mL of medication for a dose of 15 mg.

Weight-based dosing should never be greater than one 50-mg injection per week.

In juvenile idiopathic arthritis, children may continue taking steroid medications, anti-inflammatory medications, or pain medications that help relieve symptoms.

Pediatric dosage for moderate to severe plaque psoriasis

Enbrel can be used in children ages 4 years and older for moderate to severe plaque psoriasis. Children who weigh 138 pounds (63 kg) or more will receive one 50-mg injection each week.

For children who weigh less than 138 pounds (63 kg), one injection is given each week. The dose is based on weight.

The milligram strength is calculated as 0.8 mg/kg. For example, if a child weighs 42 pounds, that equals about 19 kg. The dose is calculated as 19 kg multiplied by 0.8 mg/kg, resulting in a dose of about 15 mg. Your child's doctor or pharmacist can calculate the correct dosage for you.

What if I miss a dose?

If you miss your doses of medication, take it as soon as you remember. Never take two injections at once, as this can cause very serious side effects. If you're unsure whether to skip a dose or when to take your next dose, talk to your doctor or pharmacist.

To help make sure that you don't miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Enbrel is meant to be used as a long-term treatment. If you and your doctor determine that Enbrel is safe and effective for you, you'll likely take it long term.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you're interested in finding an alternative to Enbrel, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here may be used off-label to treat these specific conditions.

Alternatives for rheumatoid arthritis

Examples of other drugs that may be used to treat rheumatoid arthritis include:

  • adalimumab (Humira)
  • infliximab (Remicade)
  • certolizumab (Cimzia)
  • methotrexate (Rheumatrex)
  • abatacept (Orencia)
  • anakinra (Kineret)
  • golimumab (Simponi)
  • rituximab (Rituxan)
  • tocilizumab (Actemra)
  • tofacitinib (Xeljanz)

Alternatives for psoriatic arthritis

Examples of other drugs that may be used to treat psoriatic arthritis include:

  • adalimumab (Humira)
  • infliximab (Remicade)
  • apremilast (Otezla)
  • ustekinumab (Stelara)
  • ixekizumab (Taltz)
  • certolizumab (Cimzia)
  • methotrexate (Rheumatrex)
  • secukinumab (Cosentyx)

Alternatives for ankylosing spondylitis

Examples of other drugs that may be used to treat ankylosing spondylitis include:

  • adalimumab (Humira)
  • infliximab (Remicade)
  • certolizumab (Cimzia)
  • methotrexate (Rheumatrex)
  • secukinumab (Cosentyx)

Alternatives for plaque psoriasis

Examples of other drugs that may be used to treat plaque psoriasis include:

  • adalimumab (Humira)
  • infliximab (Remicade)
  • apremilast (Otezla)
  • guselkumab (Tremfya)
  • ustekinumab (Stelara)
  • ixekizumab (Taltz)
  • brodalumab (Siliq)
  • certolizumab (Cimzia)
  • methotrexate (Rheumatrex)
  • secukinumab (Cosentyx)

Alternatives for polyarticular juvenile idiopathic arthritis

Examples of other drugs that may be used to treat polyarticular juvenile idiopathic arthritis include:

  • methotrexate (Rheumatrex)
  • adalimumab (Humira)
  • abatacept (Orencia)
  • tocilizumab (Actemra)

You may wonder how Enbrel compares to other medications that are prescribed for similar uses. Here we look at how Enbrel and Humira are alike and different.

Uses

Enbrel and Humira are both brand-name medications that are approved to treat:

Humira is approved for some other conditions as well, including:

Drug forms and administration

Enbrel and Humira are available in different forms. Both drugs are given as subcutaneous (under the skin) injections.

For Enbrel

Enbrel is available in the following forms:

  • prefilled syringe (25 mg/0.5 mL or 50 mg/mL)
  • prefilled SureClick autoinjector (50 mg/mL)
  • powder to be mixed into a solution (25 mg of powder equals 25 mg/mL solution when mixed)
  • Enbrel Mini single-dose prefilled cartridge (50 mg/mL to be used in an AutoTouch reusable autoinjector)

Enbrel is given as a subcutaneous injection, usually once a week. If you have rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis, the standard Enbrel dose is one 50-mg injection every week.

For adults with plaque psoriasis, you may start out with a dose of 50 mg twice per week for the first 3 months. After that, you'll likely reduce your dose to one 50-mg dose a week.

For children with either plaque psoriasis or juvenile idiopathic arthritis, the dosage is usually based on weight. Children who weigh 138 pounds (63 kg) or more will receive one 50-mg injection each week.

Children who weigh less than 138 pounds (63 kg) also receive one injection each week. The dose is based on weight. The milligram strength is calculated as 0.8 mg/kg.

For example, if a child weighs 42 pounds, that equals about 19 kg. The dose is calculated as 19 kg multiplied by 0.8 mg/kg, resulting in a dose of about 15 mg. Your child's doctor or pharmacist can calculate the correct dosage for you.

For Humira

Humira is available in the following forms:

  • single-use prefilled syringe (10 mg, 20 mg, 40 mg, or 80 mg)
  • single-use prefilled pen (40 mg or 80 mg)
  • single-use 40-mg vial (for use by healthcare professionals only)

Humira is given as a subcutaneous injection, usually every 2 weeks. For rheumatoid arthritis, you would get one 40-mg injection every other week. In some cases, your dose may be one 40-mg injection every week.

If you have plaque psoriasis, the standard dose is an 80-mg injection the first week, and then one 40-mg injection every 2 weeks after that.

If you have either psoriatic arthritis or ankylosing spondylitis, the standard dose is one 40-mg injection every 2 weeks.

Much like Enbrel, the pediatric dose of Humira for polyarticular JIA is based on the child's weight:

  • 22 to 32 pounds (10 to <15 kg) = one 10-mg injection every other week
  • 33 to 66 pounds (15 to <30 kg) = one 20-mg injection every other week
  • more than 66 pounds (30 kg) = one 40-mg injection every other week

Side effects and risks

Enbrel and Humira are in the same class of medications, called tissue necrosis factor (TNF) blockers. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Enbrel, with Humira, or with both drugs (when taken individually).

  • Can occur with Enbrel:
    • itchy skin
    • fever
  • Can occur with Humira:
    • headache
    • nausea
    • abdomen (belly) pain
  • Can occur with both Enbrel and Humira:
    • respiratory infections
    • injection site reactions
    • diarrhea
    • rash

Serious side effects

This list contains examples of serious side effects that can occur with both Enbrel and Humira (when taken individually).

* Enbrel and Humira both have a boxed warning from the Food and Drug Administration (FDA) for serious infections. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous.

Effectiveness

Studies have found both Enbrel and Humira to be effective for treating rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis. However, no studies have directly compared these drugs for these uses.

Costs

Enbrel and Humira are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Enbrel and Humira generally cost about the same. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

You may wonder how Enbrel compares to other medications that are prescribed for similar uses. Here we look at how Enbrel and Remicade are alike and different.

Uses

Enbrel and Remicade are both brand-name prescription medications that are approved to treat the following conditions:

In addition, Remicade is also approved to treat:

Enbrel is additionally approved to treat:

Drug forms and administration

Enbrel and Remicade are available in different forms and administered in different ways.

For Enbrel

Enbrel is available in the following forms:

  • prefilled syringe (25 mg/0.5 mL or 50 mg/mL)
  • prefilled SureClick autoinjector (50 mg/mL)
  • powder to be mixed (25 mg of powder equals 25 mg/mL solution when mixed)
  • Enbrel Mini single-dose prefilled cartridge (50 mg/mL to be used in an AutoTouch reusable autoinjector)

Enbrel is given as a subcutaneous (under the skin) injection, usually once a week. If you have rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis, the standard Enbrel dose is one 50-mg injection every week.

For adults with plaque psoriasis, you may start out with a dose of 50 mg twice per week for the first 3 months. After that, you'll likely reduce your dose to one 50-mg dose a week.

In children with either plaque psoriasis or juvenile idiopathic arthritis, dosing is usually based on weight. If the child weighs 138 pounds or more, they get one injection of 50 mg each week. If they weigh less than 138 pounds, their dose would be calculated by their doctor or pharmacist to be a once-weekly dose of 0.8 mg/kg.

For Remicade

Remicade is also an injectable prescription medication. It's only available as a 100-mg vial of powder solution that's mixed to form a solution.

Remicade is given as an intravenous (IV) infusion. Unlike Enbrel, Remicade must be given at your doctor's office. However, Remicade is usually only given once every 4 to 8 weeks, depending on what condition is being treated.

Remicade dosages are always based on body weight. If you have rheumatoid arthritis, your dose would be 3 mg/kg. You would be given medication at weeks 0, 2, and 6 to start your treatment. After week 6, you would only need one infusion every 8 weeks.

Your doctor may adjust your dose based on how well you're responding to Remicade. Your dosage could go as high as 10 mg/kg, and you may get infusions every 4 weeks instead of every 8 weeks to get the most benefit.

For ankylosing spondylitis, Remicade is given as a dose of 5mg/kg on weeks 0, 2, and 6. After that, you'd only need to receive Remicade once every 6 weeks.

For psoriatic arthritis or plaque psoriasis treatment, Remicade is also given as a dose of 5 mg/kg on weeks 0, 2 and 6. After that, you'd only need to receive Remicade once every 8 weeks to maintain your treatment.

Side effects and risks

Enbrel and Remicade are in the same class of medications, called tumor necrosis factor (TNF) blockers. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Enbrel, with Remicade, or with both drugs (when taken individually).

  • Can occur with Enbrel:
    • itchy skin
  • Can occur with Remicade:
    • fatigue
    • headache
    • abdominal (belly) pain
  • Can occur with both Enbrel and Remicade:
    • injection or infusion site reactions
    • respiratory infections
    • diarrhea
    • rash
    • fever

Serious side effects

These lists contain examples of serious side effects that can occur with Enbrel, with Remicade, or with both drugs (when taken individually).

  • Can occur with Enbrel:
    • leukemia (a type of blood cancer)
  • Can occur with Remicade:
    • severe liver injury
    • stroke
    • heart attack
    • certain types of liver cancer
  • Can occur with both Enbrel and Remicade:
    • serious infections* such as tuberculosis or sepsis
    • certain types of cancer such as lymphoma and skin cancer
    • congestive heart failure
    • serious allergic reactions
    • new or worsening nerve conditions such as optic neuritis (an eye condition)
    • decreases in certain blood cells such as white blood cells
    • reactivation of hepatitis B
    • lupus-like syndrome
* Enbrel and Remicade both have a boxed warning from the Food and Drug Administration (FDA) for serious infections and sepsis. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous.

Effectiveness

Enbrel and Remicade are both FDA-approved to treat the following conditions:

  • plaque psoriasis in adults
  • psoriatic arthritis
  • rheumatoid arthritis
  • ankylosing spondylitis

See "Uses" above for the other conditions Remicade is approved to treat.

Enbrel and Remicade haven't been directly compared in clinical studies. However, studies have found both Enbrel and Remicade to be effective for treating adults with plaque psoriasis, psoriatic arthritis, rheumatoid arthritis, and ankylosing spondylitis.

Costs

Enbrel and Remicade are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Remicade is generally less expensive than Enbrel. This is because Enbrel is usually given each week, while Remicade is often only used once every 4 to 8 weeks. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

The Food and Drug Administration (FDA) approves prescription drugs such as Enbrel to treat certain conditions. Enbrel may also be used off-label for other conditions. Off-label use is when a drug that's approved to treat one condition is used to treat a different condition.

Enbrel for plaque psoriasis

Enbrel is approved for use in adults and children ages 4 years and older with moderate to severe plaque psoriasis. Plaque psoriasis is the most common type of psoriasis.

Psoriasis symptoms include raised patches of red, often itchy skin. The patches may have a white or silver lining. Plaque psoriasis patches often appear on the knees, elbows, and scalp, but they can affect any part on your body. If you have psoriasis, your immune system builds up skin cells too quickly, which causes the patches to form.

Enbrel works by targeting your immune system and slowing down the rate that skin cells are formed. This helps reduce the patches of irritated skin.

In clinical trials, 46% of adults taking 50 mg of Enbrel twice per week for 3 months had a 75% or more decrease in plaque psoriasis symptoms. In adults taking a placebo (a treatment without an active drug), 3% showed a 75% or more decrease in symptoms.

In children ages 4 years and older, 57% showed a decrease in symptoms of 75% or more when taking Enbrel once per week for plaque psoriasis. In comparison, 11% of children taking a placebo showed a 75% or more decrease in symptoms.

Enbrel for psoriatic arthritis

Enbrel is approved to treat psoriatic arthritis in adults. Enbrel was shown in clinical trials to be an effective treatment for this condition.

Psoriatic arthritis is a type of arthritis that affects people with the skin condition psoriasis. About 30% of people with psoriasis also have psoriatic arthritis. Psoriatic arthritis is caused by your immune system making too many proteins that cause swelling in your joints.

Enbrel can be used alone or with methotrexate to treat psoriatic arthritis.

Enbrel works by slowing down your immune system so your body makes less proteins that cause inflammation. Decreasing the inflammation in your joints helps you have less pain when you move.

In clinical trials, after 6 months of treatment, 50% of people with psoriatic arthritis who took Enbrel had at least a 20% decrease in their symptoms. In comparison, 13% of people who took a placebo had at least a 20% decrease in their symptoms.

Enbrel for rheumatoid arthritis

Enbrel is approved for use in adults with moderate to severe rheumatoid arthritis. If you have rheumatoid arthritis, your immune system attacks your joints. This can cause your joints to become swollen and stiff, making it hard to move.

Some of the joints commonly affected by rheumatoid arthritis include the fingers, hands, feet, wrists, and ankles. However, it can affect other joints as well.

Enbrel works on your immune system to reduce the swelling in your joints. This can help you move easier.

Enbrel can be used alone or along with methotrexate to treat rheumatoid arthritis.

Enbrel can relieve symptoms, help improve physical ability, and slow down joint damage caused by rheumatoid arthritis. In clinical trials, 62% of people taking Enbrel had a 20% decrease in joint swelling and more mobility after 3 months of use. In comparison, 23% of people taking a placebo had a 20% decrease in joint swelling and more mobility after 3 months.

Enbrel for ankylosing spondylitis

Enbrel is approved to treat ankylosing spondylitis in adults. This is a type of arthritis that affects your spine. If you have ankylosing spondylitis, your body makes too much of a certain protein. This causes severe swelling and pain in your spine. Ankylosing spondylitis can also cause pain and stiffness in other parts of your body, including your knees, shoulders, and hips.

Enbrel can be an effective treatment for ankylosing spondylitis because it targets the extra proteins in your spine that cause the swelling. In clinical trials of adults with ankylosing spondylitis, about 60% of people had at least a 20% decrease in their symptoms after 12 weeks of treatment with Enbrel. In comparison, 27% of people treated with a placebo had a 20% decrease in symptoms after 12 weeks.

Enbrel for polyarticular juvenile idiopathic arthritis

Enbrel is also approved to treat moderate to severe polyarticular juvenile idiopathic arthritis (JIA) in children ages 2 years and older.

Polyarticular JIA is a type of arthritis that occurs in people younger than 18 years old. It causes swelling and pain in five or more joints. It's not known what causes polyarticular JIA.

Although polyarticular JIA may cause pain in any joint, the most commonly affected areas are small joints in the fingers and hands.

Enbrel works by decreasing the swelling in joints. This helps make it easier and less painful for children with polyarticular JIA to move their affected joints.

In clinical trials of children ages 2 to 17 years old with polyarticular JIA, 74% saw a decrease in symptoms after 3 months of taking Enbrel. After 3 months, children were split into two groups: those who continued to take Enbrel and those who started taking a placebo (a drug with no active treatment).

In the second part of the trial, about 77% of children taking a placebo had an arthritis flare-up. In comparison, 24% of children taking Enbrel had a flare-up. Children taking Enbrel didn't have their first flare-up of symptoms until at least 116 days after starting treatment. Children taking a placebo had their first flare-up 28 days after starting treatment.

Enbrel for other conditions

In addition to the uses listed above, Enbrel may be used off-label to treat other conditions. Off-label drug use is when a drug that's approved for one use is used for a different one that's not approved.

Enbrel for eczema

Eczema is a skin condition that causes redness and itchy skin. It's not known exactly what causes eczema, but it's believed to be a combination of genetics, an overactive immune system, and exposure to certain triggers.

There is very little information on the effectiveness of Enbrel to treat eczema. Some very small studies have shown improvement in people with eczema taking Enbrel. However, more studies are needed to determine if Enbrel is effective for treating eczema.

Enbrel for osteoarthritis (not an appropriate use)

Enbrel is approved for the treatment of rheumatoid arthritis, which is a condition affecting your immune system. However, osteoarthritis is a different type of arthritis. It's caused by injury to the joint, overuse of the joint, or a lot of weight put on the joint. Osteoarthritis often occurs in your hips, knees, or spine.

Enbrel targets inflammation in your joints caused by an overactive immune system. Osteoarthritis isn't caused by an overactive immune system, so Enbrel isn't an effective treatment for osteoarthritis.

Enbrel for stroke (not an appropriate use)

Enbrel is not an appropriate treatment for disabilities that occur after a stroke. There are a few studies that show Enbrel may decrease the inflammation that happens after a stroke. However, this has not been well studied yet. Enbrel is not currently recommended for use after a stroke.

Enbrel for children

Enbrel is approved for use in children ages 2 years and older with moderate to severe polyarticular juvenile idiopathic arthritis. Enbrel is also approved for use in children ages 4 years and older with moderate to severe plaque psoriasis.

If you're currently taking any of the following medications, you may continue taking them while taking Enbrel. These medications combined with Enbrel may help make your symptoms even less severe.

  • methotrexate (Rheumatrex)
  • steroids such as prednisone (Deltasone)
  • anti-inflammatory medications such as celecoxib (Celebrex)
  • pain medications such as ibuprofen (Advil)

Enbrel and methotrexate

Methotrexate can be used along with Enbrel in the treatment of rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis. Methotrexate is a medication often used for rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. It affects your immune system and helps relieve pain, swelling, and stiffness in your joints.

Enbrel and steroids

Enbrel can be used with steroid medications such as prednisone to treat rheumatoid arthritis, polyarticular JIA, and ankylosing spondylitis. Steroids help reduce the inflammation that makes your joints stiff, swollen, and painful. They can also help prevent flare-ups of your symptoms.

Enbrel and anti-inflammatory medications

With some conditions such as psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, and polyarticular JIA, joints may swell and cause you severe pain. In these cases, Enbrel can be used along with anti-inflammatory medications.

Examples of these medications include ibuprofen (Advil, Motrin), meloxicam (Mobic), and celecoxib (Celebrex). These medications can help decrease the swelling in your joints and relieve the pain.

Enbrel and pain medications

Enbrel may be used along with certain pain medications to help ease your symptoms. Sometimes conditions such as rheumatoid arthritis, ankylosing spondylitis, polyarticular JIA, and psoriatic arthritis may cause severe joint pain.

Examples of pain medications that may be used include tramadol (Ultram) and oxycodone (Roxicodone). Combining Enbrel with these medications can help relieve pain.

There are no known interactions between Enbrel and alcohol. However, certain other medications you may take along with Enbrel for your condition, such as methotrexate, shouldn't be taken with alcohol. Drinking alcohol while taking methotrexate can lead to liver problems and other serious side effects.

If you're concerned about avoiding alcohol while taking methotrexate or other medications, talk with your doctor.

Enbrel can interact with several other medications. It's not known to interact with supplements or foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Enbrel and other medications

Below is a list of medications that can interact with Enbrel. This list does not contain all drugs that may interact with Enbrel.

Before taking Enbrel, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Enbrel and Orencia

While you're taking Enbrel, don't also take abatacept (Orencia). These medications should not be taken together because doing so increases the risk of developing a serious infection. In clinical studies, using Enbrel and Orencia together didn't show any additional benefits. Combining the drugs raised people's risk of side effects such as infections.

Enbrel and cyclophosphamide

Enbrel should not be used in people with granulomatosis with polyangiitis (GPA) who are also taking cyclophosphamide (Cytoxan). GPA was formerly referred to as Wegener's granulomatosis. With GPA, swelling occurs in your blood vessels. It can often affect your nose, lungs, and kidneys.

In a study, using Enbrel and cyclophosphamide together caused an increase in certain types of cancer such as lung or breast cancer. There was also no benefit in using Enbrel along with cyclophosphamide compared to using cyclophosphamide alone to treat GPA.

Enbrel and Kineret

Enbrel should not be taken with anakinra (Kineret). Using these two medications together increases the risk of serious infections such as pneumonia or cellulitis. In a study of people with rheumatoid arthritis taking both Enbrel and Kineret, a higher rate of serious infections occurred, along with one death.

Enbrel and sulfasalazine

Taking Enbrel and sulfasalazine (Azulfidine) together may cause a decrease in a type of white blood cell called neutrophils. In clinical studies of people taking Enbrel and sulfasalazine together, there was a decrease in neutrophils compared to people taking either drug alone.

Enbrel and vaccines

You shouldn't get any live vaccines while taking Enbrel. For live vaccines, you're injected with a small amount of a virus so your body can learn to fight it. You shouldn't get these vaccines while using Enbrel because the drug may weaken your immune system. If this happens, your body won't be able to properly fight the vaccine, and it may make you sick.

Talk to your doctor or pharmacist about what vaccines you may need. It's best to get any needed vaccines before starting Enbrel.

Examples of live vaccines to avoid while taking Enbrel are:

  • measles, mumps, rubella (MMR)
  • intranasal flu
  • smallpox
  • chickenpox
  • rotavirus
  • yellow fever
  • typhoid

Enbrel and herbs and supplements

There aren't any herbs or supplements that have been specifically reported to interact with Enbrel. However, you should still check with your doctor or pharmacist before using any of these products while taking Enbrel.

Studies of pregnant animals taking Enbrel have not shown a risk of birth defects. There are conflicting studies on human pregnancies. Most studies do not show an increase in major birth defects. However, more data is needed to confirm this.

There is a pregnancy registry for women with rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, or ankylosing spondylitis who take Enbrel. The purpose of the pregnancy registry is to collect data on pregnant women who have taken Enbrel.

It's not known if Enbrel is safe to take during pregnancy. If you're sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you're using Enbrel.

Enbrel may pass from mother to baby through breast milk in very small amounts. However, there is no current data on children exposed to Enbrel through breast milk. Talk with your doctor about the risks and benefits of breastfeeding while taking Enbrel.

Here are answers to some frequently asked questions about Enbrel.

Will I have withdrawal symptoms if I stop using Enbrel?

No, you will not have withdrawal symptoms from stopping Enbrel. However, because you're no longer being treated for your condition, your symptoms may worsen when stopping Enbrel.

Is Enbrel an NSAID (nonsteroidal anti-inflammatory drug)?

No, Enbrel is not an NSAID. Enbrel belongs to a class of medications called tumor necrosis factor (TNF) blockers. TNF can cause inflammation (swelling) in your body. Enbrel works by blocking this inflammation, which can help your condition improve. Enbrel can be taken along with NSAIDs for added benefit. Examples of NSAIDs include ibuprofen (Advil, Motrin) and naproxen (Aleve). Talk with your doctor if you're interested in taking an NSAID with Enbrel.

Is Enbrel a corticosteroid drug?

Enbrel is not a corticosteroid drug. Enbrel is in a group of medications called tumor necrosis factor (TNF) blockers. These medications work by decreasing inflammation that causes your arthritis or psoriasis symptoms.

Enbrel may be used along with corticosteroid medications such as prednisone to help relieve symptoms even more. Talk with your doctor if you're interested in taking a corticosteroid with Enbrel.

Can I get vaccines while I'm taking Enbrel?

You shouldn't get any live vaccines while taking Enbrel. For live vaccines, you're injected with a small amount of a weakened virus so your body can learn to fight it. You shouldn't get these vaccines while using Enbrel because the drug may weaken your immune system. If this happens, your body won't be able to properly fight the vaccine, and it may make you sick.

Examples of live vaccines that you should avoid while taking Enbrel include:

  • measles, mumps, rubella (MMR)
  • intranasal flu
  • smallpox
  • chickenpox
  • rotavirus
  • yellow fever
  • typhoid

There are other types of vaccines called inactivated vaccines. These vaccines use a killed version of the bacteria or virus that causes a disease. It is safe to get inactivated vaccine injections while taking Enbrel.

Examples of inactivated vaccines are:

Before starting Enbrel, talk to your doctor or pharmacist about what vaccines you may need. It's best to get any needed vaccines before starting Enbrel.

Can I take Enbrel if I have diabetes?

Yes, you can take Enbrel as long as your diabetes is well controlled. If your blood sugar levels are too high, taking Enbrel can increase your risk of serious infections.

Sometimes people with diabetes who take Enbrel can develop hypoglycemia (low blood sugar). This can lead to sweating, confusion, and dizziness and can be dangerous. It's important to monitor your blood sugar levels while taking Enbrel. Your doctor may need to lower the dose of your diabetes medications if your glucose drops too low while taking Enbrel.

Enbrel belongs to a class of medications called tumor necrosis factor (TNF) blockers. TNF is a naturally occurring protein in your body that can cause inflammation. For people with rheumatoid arthritis, psoriatic arthritis, juvenile idiopathic arthritis, and ankylosing spondylitis, TNF is part of the inflammation in their joints.

In addition, TNF plays a role in inflammation associated with plaque psoriasis in children and adults.

By blocking TNF, Enbrel lowers the amount of inflammation in your body and can help relieve your symptoms.

How long does it take to work?

Enbrel can start working in as little as 1 to 2 weeks. In clinical trials, people taking Enbrel for rheumatoid arthritis had less pain and stiffness in 1 to 2 weeks. By 3 months, Enbrel had started working in about 62% of people taking it.

Using much more than the recommended dosage of Enbrel may lead to serious side effects. In clinical studies where twice the recommended dose of Enbrel was given, no toxic side effects were reported. However, you should not take more medication than prescribed by your doctor. Taking more than twice the recommended dose may cause serious side effects.

What to do in case of overdose

If you think you've taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

  • Serious infections: Enbrel may weaken your immune system. People being treated with Enbrel have a higher risk of developing serious infections including fungal, bacterial, viral, and tuberculosis infections. In some cases, these infections can lead to hospitalization or even death. See your doctor right away if you develop any symptoms of a serious infection, including a fever, nausea, vomiting, and diarrhea. Before starting Enbrel, your doctor will test you for tuberculosis (TB). If you test positive for TB, your doctor may start you on treatment for the condition before you start taking Enbrel. Throughout treatment with Enbrel, your doctor will monitor you for signs and symptoms of serious infections. Your doctor may have you stop taking Enbrel if you develop a serious infection.
  • Cancers: Certain types of cancers, such as lymphoma, have been reported in children and young adults taking Enbrel. In these reports, people with very severe rheumatoid arthritis or psoriasis were at a higher risk of developing cancer.

Other warnings

Before taking Enbrel, talk with your doctor about your health history. Enbrel may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Sepsis. People with a current sepsis infection should never take Enbrel. Sepsis is a very serious infection that affects your whole body. Because Enbrel may weaken your immune system, it can make sepsis even worse.
  • Diabetes. People with diabetes who take Enbrel may get hypoglycemia (low blood sugar). Hypoglycemia can be very dangerous. If you have diabetes and are taking Enbrel, your doctor may lower your doses of your diabetes medications. This will help prevent your blood sugar levels from getting too low.
  • Tuberculosis. Tuberculosis infections can be reactivated while taking Enbrel. This is because Enbrel may weaken your immune system, which could allow the tuberculosis infection to come back. It's important to be tested for tuberculosis before starting Enbrel. If you test positive, you may be treated for tuberculosis before starting Enbrel.
  • Pregnancy. Currently, studies on Enbrel use during pregnancy have conflicting data. Talk with your doctor if you become pregnant while taking Enbrel or if you plan to become pregnant while taking it. For more information, see the "Enbrel and pregnancy" section above.
  • Active infections. If you have a current infection, Enbrel can make it worse. Do not start taking Enbrel if you have any type of active infection, including a cold, flu, or skin infection. Enbrel may weaken your immune system, and the infection can get worse.
  • Congestive heart failure. Some studies of people with congestive heart failure taking Enbrel have shown that the congestive heart failure symptoms can worsen. If you currently have congestive heart failure and are taking Enbrel, your doctor may monitor you more closely to be sure that your congestive heart failure doesn't get worse.
  • Hepatitis B. If you have had hepatitis B, it can become reactivated while you are taking Enbrel. This is because Enbrel can weaken your immune system, and the hepatitis B virus can become active again. Hepatitis B can cause serious problems with your liver if left untreated. Your doctor will test you for hepatitis B before you begin treatment with Enbrel.
  • Neurological conditions. Certain types of neurological conditions (which affect your nervous system) could become worse while you're taking Enbrel. Examples of these neurological conditions include transverse myelitis, optic neuritis, multiple sclerosis, Guillain-Barré syndrome, and seizure disorders. If you have any of these conditions, talk with your doctor about the risks and benefits of using Enbrel.
  • Fungal infections. If you are at high risk for getting a fungal infection, your doctor may start you on medication to prevent a fungal infection while you're taking Enbrel. Because Enbrel may weaken your immune system, your body won't be able to fight a fungal infection as well as it normally would. If you get a fungal infection while taking Enbrel, you can get very sick.
  • Moderate to severe alcoholic hepatitis. People taking Enbrel who have moderate to severe alcoholic hepatitis (inflammation of the liver caused by drinking alcohol) may have an increased risk of death. If you have alcoholic hepatitis, talk with your doctor about the risks and benefits of using Enbrel.

Note: For more information about the potential negative effects of Enbrel, see the "Enbrel side effects" section above.

When you get Enbrel from the pharmacy, the pharmacist will add an expiration date to the label on the box. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee the medication will be effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Enbrel should be stored in the refrigerator between 36°F to 46°F (2°C to 8°C). It should be stored in its original carton to protect the medication from damage or light. The AutoTouch reusable autoinjector should be stored at room temperature and shouldn't be refrigerated.

Enbrel prefilled syringes, SureClick autoinjectors, and Enbrel Mini cartridges can be stored for a short time at room temperature at 68°F to 77°F (20°C to 25°C) for up to 14 days. Once Enbrel is removed from the refrigerator and comes to room temperature, it should be used within 14 days.

Never put Enbrel back into the refrigerator after it has come to room temperature. If you can't use the medication within the 14-day period, it must be thrown out.

Do not freeze or shake Enbrel.

Enbrel also comes as a lyophilized powder form that you mix before injecting it. The powder and liquid to mix the powder should be stored in the refrigerator between 36°F to 46°F (2°C to 8°C).

Before mixing, Enbrel vials (both the powder and liquid to mix the powder) can be stored at room temperature for up to 14 days. After 14 days, the vials must be mixed and used or thrown out.

Once a vial of Enbrel is mixed, it must be used right away or put back into the refrigerator. If you mix a vial and put back into the refrigerator, you need to use it within 14 days.

Disposal

If you no longer need to take Enbrel and have leftover medication, it's important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

Always discard syringes and autoinjectors into a sharps container. Syringes and autoinjectors should never be thrown into a household trash can. For additional information about proper sharps disposal, see the FDA's guidelines.

The following information is provided for clinicians and other healthcare professionals.

Indications

Enbrel is indicated in treatment of the following conditions:

Enbrel can be used in combination with methotrexate for the treatment of rheumatoid arthritis and psoriatic arthritis. When used for plaque psoriasis, Enbrel should be used only in chronic moderate to severe plaque psoriasis patients who are also candidates for systemic or phototherapy.

Mechanism of action

Enbrel is a tissue necrosis factor (TNF) blocker. TNF is a cytokine that plays a role in the inflammation that occurs in rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis. Enbrel acts as an imitation receptor and binds to TNF molecules so that the TNF does not bind to its receptors and therefore has no effect on the body.

Pharmacokinetics and metabolism

The half-life of Enbrel after a single injection of 25 mg was about 102 hours. Using Enbrel along with methotrexate does not alter the pharmacokinetics. There were no differences observed in pharmacokinetics of Enbrel in different genders or age groups.

Contraindications

Enbrel is contraindicated in patients with sepsis. Because sepsis is a serious infection and Enbrel may weaken the immune system, Enbrel should never be used in patients with active sepsis infections.

Storage

Enbrel should be stored in the refrigerator between 36°F to 46°F (2°C to 8°C). Enbrel should always be stored in its original carton to protect it from light or damage in the refrigerator.

Prefilled syringes, SureClick autoinjectors, and Enbrel Mini cartridges can be stored at room temperature (68°F to 77°F/20°C to 25°C) for up to 14 days. After 14 days, the syringe must be used or thrown out. Once Enbrel comes to room temperature, it should not be put back into the refrigerator. Enbrel should never be frozen.

Enbrel lyophilized vials and diluent should also be refrigerated. The unmixed vial and diluent can also be stored at room temperature for up to 14 days. However, if the medication can't be used within 14 days, it should be discarded. Once the vial is reconstituted, it should be used immediately or refrigerated. A mixed vial can be stored in the refrigerator for up to 14 days.

The AutoTouch reusable autoinjector should remain at room temperature and should not be put in the refrigerator.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.