Immune Modulator

Recently Answered

• QWhat is Enbrel (etanercept)?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

   Enbrel (etanercept) is an injectible drug that is part of the class of drugs called tumor-necrosis factor (TNF) inhibitors. (TNF is a substance the body produces that causes inflammation.) This drug is used to treat several autoimmune disorders (disorders that cause the body’s immune system to attack and damage otherwise healthy tissue). The disorders it treats are:

  •rheumatoid arthritis (a disorder where the body targets its own joints, which leads to inflammation, pain, swelling, and decreased function) •psoriatic arthritis (a disorder that also leads to joint pain and swelling and is characterized by scales on the skin)
  •juvenile idiopathic arthritis (a disorder that appears in children under 16 and involves swelling of the lining of the joints)
  •ankylosing spondylitis (a disorder that attacks spinal joints, leading to pain and joint damage)
  •chronic plaque psoriasis (a skin disorder that causes red, scaly patches to form on the body)

  This drug has also been used to treat active arthritis, reactive arthritis, and inflammatory bowel disease arthritis.

• QWhat should I know about Enbrel (etanercept) before taking it?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  It is possible that use of Enbrel (etanercept) will significantly reduce your body’s ability to fight off infections and raise your risk of developing life-threatening infections such as sepsis. Prior to use of this drug, be sure to tell your doctor if you have any type of infection, including minor cuts or scrapes, recurring infections (like cold sores), or chronic infections. Inform your doctor if you have diabetes or any condition that suppresses your immune system or if you take any drugs that slow down your immune system.

  Do not have any vaccinations while you are on this drug and do not get vaccinations three months before starting use of this drug. If your child is going to be on this drug, be sure their vaccinations are updated prior to starting this medication.

  You will need to take a tuberculosis (TB) test before using this drug, as it can raise the risk of developing TB. Let your doctor know if you have ever had TB, lived in a country where TB is common, or have ever been around anyone with TB or who has tested positive for TB.

  Enbrel (etanercept) may increase your risk of developing autoimmune hepatitis or cause symptoms that resemble lupus symptoms.

• QWhat are the side effects of Enbrel (etanercept)?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Enbrel can cause a wide variety of side effects. If you experience any of the following symptoms for a long period of time or if they are particularly severe, discuss them with your doctor:
  
  •nausea or vomiting
  •headache
  •heartburn
  •cough
  •weakness
  •stomach pain
  •swelling, itching, or pain around the site of the injection
  
  In addition, Enbrel may cause other more serious symptoms, which require immediate medical attention. These include:
  •difficulty breathing
  •bruising or bleeding
  •arm or leg weakness
  •lightheadedness
  •vision problems
  •numbness
  •rash, hives, or blisters on the skin
  •swelling in the face, throat, legs, arms, or other areas of the body
  
  

• QWhat should I avoid while taking Enbrel (etanercept)?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

   Do not get any vaccinations while you are taking Enbrel (etanercept). You also should not have any vaccinations three months prior to the start of taking Enbrel. Stay away from anyone with chickenpox. If you come in contact with someone who has chickenpox, tell your doctor right away.

• QWhere on the body should Enbrel (etanercept) be injected?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Enbrel (etanercept) should be injected in the front of your middle thighs, upper arms, and stomach (except for the navel or two inches around the navel). A medical professional will give you instructions on the proper way to prepare the prefilled syringe, autoinjector, powder, or vial for dosing. To prevent soreness, redness, and rash, choose a different injection site each time. If you are using Enbrel to treat plaque psoriasis, do not inject yourself in areas of skin that are red, scaly, thick, or hard.

• QHow does Enbrel (etanercept) interact with other medications?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Using Enbrel (etanercept) with any of the drugs listed here is not recommended. Sometimes, however, using these drugs together may be necessary. If so, your doctor may need to adjust the dosage and timing of one or both drugs. The vaccines listed may cause dangerous interactions because Enbrel increases risk for infection and it could make the live viruses in these vaccines result in disease:

  •Orencia (abatacept)
  •Kineret (anakinra)
  •Live Bacillus of Calmette and Guerin vaccine
  •Endoxan, Cytoxan, Neosar, Procytox, or Revimmune (cyclophosphamide)
  •Live measles virus vaccine
  •Live mumps virus vaccine
  •Live poliovirus vaccineArkalyst (rilonacept)
  •Live rotavirus vaccine
  •Live rubella virus vaccine
  •Smallpox vaccine
  •Typhoid vaccine
  •Varicella virus vaccine
  •Yellow fever vaccine

• QAre there any risks in taking Enbrel (etanercept)?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  If you take Enbrel (etanercept) you are at increased risk for getting infection, as it lowers your immune system’s ability to fight off infection. In addition, children and teens who take this drug are at risk for developing unusual cancers. Children, teens, and adults all have increased risk for lymphoma and other cancers.

  If you are a carrier of the hepatitis B virus, using this drug may make that virus active.

  Problems may arise with your nervous system; some people develop multiple sclerosis, get inflammation of the nerves of the eyes, or have seizures.

  While on this drug, you are at increased risk for developing heart failure or worsening already present heart failure. The same holds true with psoriasis; if you have it, it may get worse or you may develop a new case of it.

  Some people have autoimmune reactions to this drug. They may develop symptoms that mimic those of lupus or they may get autoimmune hepatitis. It is also possible that you may have a severe allergic reaction to this drug.