ETANERCEPT (Enbrel®) INFORMATION SHEET

Developed by Andy Thompson MD FRCPC

What is Etanercept?

Etanercept is a biologic agent specifically engineered to treat inflammation. It is used for the treatment of Rheumatoid arthritis, Psoriatic arthritis, Ankylosing spondylitis, Juvenile inflammatory arthritis, and other types of arthritis.

How does Etanercept work?

In some people with arthritis, a protein called Tumour Necrosis Factor (TNF) is present in the blood and joints in excessive amounts where it increases inflammation (pain & swelling). Etanercept is another type of protein called a TNF blocker which blocks the action of TNF. By blocking TNF, Etanercept works by suppressing the body’s immune system. Although this suppression can make it slightly harder for you to fight off infections, it also helps to stabilize an overactive immune system.

Why am I taking Etanercept?

Your doctor has prescribed this medicine to help with the following:

1. Reduce the pain and swelling (inflammation) in your joints.
2. Improve your day to day function.
3. Prevent any long-term damage from the joint inflammation.

What is the usual dose of Etanercept?

• Etanercept is taken by injection under the skin ONCE TO TWICE PER WEEK.
• The standard dose of each injection is 25 mg.

How often do I take Etanercept?

• Etanercept is taken ONCE TO TWICE A WEEK.

Who should NOT take Etanercept?

• Patients who have had a previous serious allergic reaction to Etanercept.
• Women who are pregnant, planning on becoming pregnant in the near future, or currently breast feeding.
• Possibly patients who have cancer or have had a past history of certain cancers.
• Patients who have severe or uncontrolled congestive heart failure.
• Patients who have multiple sclerosis.
• Patients with active infections (such as tuberculosis).

When will I start to feel the effects of Etanercept?

Etanercept will take about 2 weeks before you start to feel the effects. It may take 4 to 12 weeks before you feel the maximum effect.

What should I AVOID while taking Etanercept?

• You should discuss all vaccinations with your doctor as some vaccines are not advisable while you are taking Etanercept.
• If you are scheduled for surgery, please tell your doctor.

When should I NOT TAKE my Etanercept?

You should contact your doctor before missing a dose of Etanercept. However, in the following situations, it would be advisable to stop the Etanercept:

• If you have a fever.
• If you have or think you have an infection.
• If you think you are pregnant.

Which Medications are safe to take with Etanercept?

Your rheumatologist may decide to add other medications to treat your arthritis. Most medications may be taken safely with Etanercept. For example, some of the other medications which may be safely added to Etanercept include: Acetaminophen (Tylenol), Prednisone, and Other DMARDs (i.e. Methotrexate)

What are the side-effects of Etanercept?

MORE COMMON side-effects include:

• Mild skin reaction at the injection site (itchiness, redness, and mild swelling).
• Headaches
• Upper respiratory tract infections (such as sinusitis).

RARE side-effects include:

• Blood Counts – Etanercept can cause a drop in the numbers of white blood cells (which are needed to fight infection) or red blood cells (which carry oxygen). This is very rare and it is unusual for this to be a serious problem.
• Infection – There have been serious infections associated with the use of Etanercept. Any infections or fevers should be taken very seriously and reviewed by your doctor.
• Nervous System – There have been rare reports of some patients developing disorders that affect the nervous system (multiple sclerosis, seizures, or inflammation of the nerves of the eye) while taking Etanercept. Fortunately, these reports are exceedingly rare.
• Heart – Inform your doctor if you have congestive heart failure as Etanercept may make it worse.
• Malignancy – When used for long periods of time, Etanercept may be associated with a small increased risk of lymphoma.

How can I help to minimize the side-effects of Etanercept?

• Take your Etanercept as prescribed by your doctor.

Do I need to have regular blood tests while taking Etanercept?

Blood tests are not routinely required while you are taking Etanercept. However, your doctor will likely order periodic blood tests to check your blood counts and follow the activity of your arthritis.

How do I stop the Etanercept?

You do not need to wean yourself off the Etanercept. It can simply be stopped. However, your arthritis will likely “flare” after you stop the medicine.

Is Etanercept Safe in Pregancy & Breastfeeding?

• Etanercept is a new medication and it is unknown if it is safe to use in pregnancy. Therefore, you should AVOID PREGNANCY while on Etanercept.
• All women of child bearing potential taking Etanercept must use reliable contraception.
• If you become pregnant while taking Etanercept NOTIFY YOUR DOCTOR IMMEDIATELY.
• You should not breast feed while taking Etanercept.