Etanercept, Injection et-a-NER-sept

What are other names for this medicine?

Type of medicine: antirheumatic; disease-modifying antirheumatic drug (DMARD)

Generic and brand names: etanercept, injection; Enbrel

What is this medicine used for?

This medicine is used to treat:

• rheumatoid or psoriatic arthritis when other medicines have not been effective
• ankylosing spondylitis
• plaque psoriasis

This medicine is given as a shot just under the skin. It may be used for other conditions as determined by your healthcare provider. This medicine may be given with methotrexate when methotrexate alone is not effective.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine or to latex
• a blood disorder
• a weakened immune system from diseases such as HIV/AIDS or from cancer chemotherapy, radiation therapy, or steroid medicine
• diabetes
• heart failure
• hepatitis B or other liver problems
• multiple sclerosis, optic neuritis, or any other nerve disorder
• tuberculosis (TB), a positive skin test for TB, or close contact with someone who has TB (your healthcare provider may give you a skin test to check for this).

Tell your healthcare provider if you currently have an infection such as the flu or an open cut or sore, or if you often have infections that come back.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Follow your healthcare provider's directions exactly.

Sometimes you can give yourself these shots or have someone at home give them to you. Be sure you know how and when to have them and how much medicine to use. Use sterile, disposable syringes and needles. Use them only once and dispose of them safely, following your healthcare provider's instructions.

Carefully read and follow the directions that come in the package of medicine for the shots.

Wash your hands before using this medicine. Follow these steps to give yourself the shots:

1. Choose a site on your abdomen (thigh, upper arm, or other sites) around the belly button but not in the belly button. Each day, choose a different spot for the shot to lessen irritation.
2. Use an alcohol swab to clean the skin where you will give yourself the shot.
3. Gently pinch up the skin and insert the needle into the skin at a 45-degree angle. After you insert the needle completely, release your grasp of the skin.
4. After you have given yourself the shot, withdraw the needle and syringe and press the alcohol swab at the spot where the shot was given.
5. Discard the syringe, needle, and drug vial. Use the syringes and needles ONLY ONCE. Throw them away after use. Put used needles in rigid puncture-resistant containers with lids or caps, such as heavy plastic bleach bottles with screw caps. DO NOT throw needles directly into garbage cans or dumpsters.
6. When you repeat the procedure, use a new pack.

If you are not sure of how to give yourself the shots, ask your healthcare provider or pharmacist for help.

What if I miss a dose?

If you miss a dose, use it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and use the next one as directed. Do not use double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

Symptoms of an acute overdose have not been reported.

What should I watch out for?

You may get infections more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections. Contact your healthcare provider right away if you develop a fever or ANY other symptoms of infection. Do not receive shots of this medicine if you have any kind of infection. If you develop signs of infection (fever, pain, or swelling) while receiving this medicine, stop using the medicine and contact your healthcare provider right away. Also, do not have any vaccines without getting your healthcare provider's approval first.

Your healthcare provider will check you regularly to see how this medicine affects you. Keep all appointments.

Rarely, this medicine causes a condition called lupuslike syndrome. Its symptoms include a rash on your face or other parts of your body, chest pain or discomfort that doesn’t go away, new joint pain, shortness of breath, and sensitivity to sunlight. Talk to your healthcare provider about this.

This medicine may increase your risk for certain kinds of cancer. Talk to your healthcare provider about this.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Lupuslike syndrome (new joint pain, rash, sensitivity to sunlight, chest pain), high fever; unexplained bleeding or bruising; unusually pale skin; yellowing of the skin; dark urine; trouble walking, vision changes, stomach pain or cramping; blood in vomit, stool, or urine; unusual muscle or bone weakness; swelling in your ankles or feet, increased shortness of breath; sore throat.

Other: Headache; nausea; vomiting; runny nose; mouth sores; dizziness; throat irritation; itching, redness, or pain at the injection site.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• abatacept (Orencia)
• anakinra (Kineret)
• cyclophosphamide (Cytoxan, Neosar)
• natural remedies such as curcumin, echinacea, and green tea
• sulfasalazine (Azulfidine, Sulfazine)
• vaccines

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine in the refrigerator. Keep the container tightly closed. Protect from heat, high humidity, and bright light. Do not freeze. Do not use this medicine after the expiration date on the package.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.