Etanercept (Subcutaneous)

Etanercept is a medicine that is used for the treatment of active arthritis, rheumatoid arthritis and psoriatic arthritis. This includes reducing tiredness, joint swelling, duration of stiffness in the morning and pain.

Overview

Etanercept is an injection type of medicine. It is used to reduce the signs and symptoms of certain types of arthritis, as well as helping to slow the damage progression of these diseases. Also, this medicine is used to treat conditions such as ankylosing spondylitis and plaque psoriasis.

This medication is often prescribed for conditions including rheumatoid arthritis, psoriatic arthritis, active arthritis. It may help to slow degradation in both active and rheumatoid forms of arthritis. Also, this medicine is also used for children older than two years, for the treatment of juvenile idiopathic arthritis.

Etanercept is solely available from a doctor or medical professional and should be prescribed as such, though it can be used in a home environment once prescribed.

Conditions Treated

  • Active arthritis
  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Juvenile Idiopathic Arthritis

Type Of Medicine

  • Powder for Solution
  • Solution

Side Effects

The required effects of Etanercept include reduction of pain, reduced joint swelling and fewer symptoms of arthritis. However, in addition to these required effects, patients who take this medication may experience other, less wanted and less regular effects of this treatment. It is very unlikely that all of these side effects or conditions will occur during taking Etanercept. If these side effects are present, and active, during the time you are taking this drug, it's important to inform a doctor as soon as you can.

Should any of the listed side effects occur while you are taking Etanercept, check with a doctor or medical professional immediately:

  • Yellow tone of the eyes or skin
  • Worsened, difficult, irregular, troubled, or labored breathing
  • Weight loss
  • Unusual tiredness or weakness
  • Unusual bleeding or bruising
  • Unexplained weight loss
  • Trouble sleeping
  • Trouble concentrating
  • Tightness in the chest
  • Tenderness
  • Swelling of the fingers, face, feet, or lower legs
  • Sudden vomiting of blood, or of items that looks like coffee grounds
  • Stomach discomfort or pain
  • Stiffness, tightness, or rigidity in the muscles and joints
  • Sore throat
  • Sore throat
  • Sneezing
  • Shortness of breath
  • Severe numbness experienced on one side of the face or body
  • Severe and constant nausea
  • Red, scaling or crusted dry skin
  • Red skin lesions (often with a purple center)
  • Painful sores, white spots or ulcers in or around the lips or the mouth
  • Pain or swelling in the arm or leg
  • Pain in the arms, jaw, back or neck
  • Muscle tenderness
  • Loss of consciousness
  • Lightheadedness
  • Less common
  • Large, hive-like swellings to the face, eyes, lips, mouth, throat, hands, feet, legs or sexual organs
  • Joint or muscle pain
  • Itching, redness, or swelling of the skin that is painful
  • Issues with bowel or bladder function
  • Irregular heartbeat
  • High blood pressure
  • Heartburn or indigestion
  • Generalized pain
  • General feeling of illness or weakness
  • Fruit-like breath odor
  • Frequent or painful urination
  • Fever
  • Feeling sad or empty
  • Fast heartbeat
  • Eye pain
  • Extreme fatigue
  • Double vision
  • Dilated neck veins
  • Difficulty with moving
  • Diarrhea
  • Depression
  • Decreased vision
  • Decreased urine output
  • Darkened urine
  • Cough
  • Convulsions
  • Congestion in the chest
  • Confusion
  • Cloudy or bloody urine
  • Chills
  • Chest discomfort or pain
  • Blurred vision
  • Blue-yellow color blindness
  • Bloody, black, or tarry stools
  • Blistering, peeling, or loosening of the skin
  • Bladder pain
  • Being unable to move the arms, legs or facial muscles

In addition to the side effects and conditions that may occur during treatment with Etanercept that require urgent medical support or attention, this drug can also result in, or cause, side effects that do not need any critical medical help or care.

The effects are less likely to be harmful to the patient. If any of the listed conditions become uncomfortable or continue over an extended period, especially if side effects continue beyond treatment, your doctor may be able to support you to prevent these side effects. If they continue to occur, a review of your current medications may be required.

If any of the below side effects become bothersome while you're taking Etanercept, check with your doctor:

  • Weight gain
  • Sweating
  • Skin rash
  • Runny or stuffy nose
  • Pain and swelling under the skin at the injection site
  • Pain or burning in the throat
  • Nausea and vomiting
  • Loss of energy or weakness
  • Loss of appetite
  • Itching, redness, or tearing of the eye
  • Irritation or soreness of the mouth
  • Heartburn
  • Hair loss or thinning
  • Redness or flushing of the skin, particularly on the face and neck
  • Feeling of warmth or heat
  • Feeling faint, dizzy, or lightheaded
  • Dry mouth
  • Dry eyes
  • Depression
  • A feeling of 'pins and needles' on the skin
  • Bumps below the skin
  • Altered sense of taste
  • Abdominal or stomach pain

In addition to the side effects listed above, there is a possibility that you will experience differing conditions or feelings to those listed. Though the list above does include cases with a relatively high incidence, other side effects may not currently be known or listed.

Should you experience any side effects that you believe are caused by your medicine, you can report these directly to your doctor for medical advice and treatment. If you would like to report your side effects to the FDA directly, you can call them on 1-800-FDA-1088.

Dosage

Etanercept is administered as an injection shot under the skin. Though this injection is often given in a medical, clinical environment, it can also be provided in a home environment to patients who are not required to be in a hospital for treatment. It can be administered by a patient or their carers, or especially when given to a child.

If this medication is administered at home, a trained medical professional, such as a doctor or nurse, will be able to teach you how to administer the injection properly, how to disinfect the area and how exactly to use the medicine. Etanercept comes with a complete medication guide as well as patient instructions, and it's important to read the instructions and follow them carefully. If you have any questions or worries, your doctor will be able to offer you help and advice.

Should you choose to administer Etanercept at home, you will be instructed as to the method and locations that this medication should be injected. It's important also to keep a record or track of each shot that you take and where you take it, to help prevent any possible skin problems as a result of repeated injecting.

Etanercept is available in three different forms of administration. These are a prefilled syringe, a prefilled SureClick autoinjector or a glass vial. You can discuss with your doctor the best possible solution for your personal treatment.

Both the cap of the needle on the syringe and autoinjector contains an amount of dry natural rubber, a derivative form of latex. In certain people, this may cause an allergic reaction, if they are sensitive to latex. If either yourself or your child has an allergy to latex, you should notify a relevant medical professional before you begin taking Etanercept as a treatment.

When using the autoinjector or syringe forms of Etanercept, follow these steps:

  • Disinfect your hands with water and soap both prior to and following using Etanercept
  • Remove the container with the required syringe or injector from the fridge, place on a clean cloth and allow at least 30 minutes to warm up to the correct room temperature. While allowing Etanercept to reach room temperature, keep the needle cap in place. Once your medication has reached room temperature, you can then remove the cap immediately prior to use.
  • Prior to administration, check the liquid within the syringe or autoinjector. The contained liquid should be colorless, clear and may contain small, white particles. This is normal for this medication.
  • Check the liquid within the syringe, ensuring that the level of medicine falls in between two purple level indicators as determined on the syringe itself. If the syringe does not appear to have the right amount of liquid, do not use it, and consult a doctor regarding the next step for this medicine.
  • Choose an injection site on the body, for example, the abdomen, stomach area, upper arm or thigh. This injection site should be different each time, to avoid both skin issues and soreness. Do not inject into skin areas that are red, bruised, hard or tender.
  • Ensure the injection site is disinfected and clean with a fresh alcohol wipe, and allow it to dry before continuing
  • When you are ready to inject your medication, you can then remove the needle cover or cap from the medication and prepare to inject.
  • When you have injected, dispose of your medication in the correct manner. A puncture-resistant, hard and closed container that needles can not poke through is a requirement. This container will most likely be provided by your doctor or pharmacist when you begin treatment.

When using a vial for injecting Etanercept, follow these steps:

  • Disinfect your hands with water and soap both before and following using Etanercept
  • Mix the vial of powder with the liquid that is provided in your dose kit; do not shake this medication. Use a clean needle to draw the syringe.
  • Prior to administration, check the liquid within the syringe. The contained liquid should be colorless, clear and may contain small, white particles. This is normal for this medication.
  • Check the liquid within the syringe, ensuring that the level of medicine falls in between two purple level indicators as determined on the syringe itself. If the syringe does not appear to have the right amount of liquid, do not use it, and consult a doctor regarding the next step for this medicine.
  • Choose an injection site on the body, for example, the abdomen, stomach area, upper arm or thigh. This injection site should be different each time, to avoid both skin issues and soreness. Do not inject into skin areas that are red, bruised, hard or tender.
  • Ensure the injection site is disinfected and clean with a fresh alcohol wipe, and allow it to dry before continuing
  • When you are ready to inject your medication, you can then remove the needle cover or cap from the medication and prepare to inject.
  • When you have injected, dispose of your medication in the correct manner. A puncture-resistant, hard and closed container that needles can not poke through is a requirement. This container will most likely be provided by your doctor or pharmacist when you begin treatment.

Any unused medication must be kept and used within the mixing date on the vial, or the use by date on the injector. Any unused medication should be disposed of safely after this date. Your doctor will be able to provide you with details of the correct way to dispose of your medicine.

Interaction:

When it comes to courses of treatments with multiple forms of medication, there are types of medication that should not be used at the same time. Using these medicines together can greatly increase the risk of interaction occurring, which can result in serious complications and even affect the way your medication works.

Depending on what drugs you have been prescribed, your doctor may decide to alter your prescription, change the times you take each drug or even decide not to use certain medications together at all.

The precautions taken to prevent drug interaction are based on the information your doctor has access to in regard to your medical history. Ensure that your doctor is aware of all medications and drugs that you are taking. This should include any and all over-the-counter medications, vitamins and herbal supplements that you're taking.

When you are prescribed Etanercept, it is critical that your healthcare professional is aware if you are taking any of the medications listed below in particular. The listed interactions have been included due to their potential significance and the seriousness of their condition and are not necessarily all-inclusive.

Using Etanercept in tandem with any of the following drugs is generally not recommended, but may be needed depending on the advice of your medical professional or doctor. Should both medicines be prescribed together, your doctor may choose to alter or change the dose, or even change how often that you use one or both of the medicines.

  • Yellow Fever Vaccine
  • Varicella Virus Vaccine
  • Typhoid Vaccine
  • Smallpox Vaccine
  • Rubella Virus Vaccine, Live
  • Rotavirus Vaccine, Live
  • Rilonacept
  • Poliovirus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Measles Virus Vaccine, Live
  • Influenza Virus Vaccine, Live
  • Cyclophosphamide
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Anakinra
  • Adenovirus Vaccine Type 7, Live
  • Adenovirus Vaccine Type 4, Live
  • Abatacept

In addition to the interactions that certain medications may have with other forms of drugs or medicines, some medications may react to foods, alcohol or tobacco. By taking certain drugs around the time of eating food, certain interactions or issues may occur. It's important that you discuss with your doctor or healthcare professional any concerns or issues you have regarding taking Etanercept with alcohol, tobacco or food.

Though no specific food interactions have been recorded for Etanercept, if any issues do occur during your course of treatment, it's important to inform a medical professional.

In addition to the medical interactions that can result in interactions when taken with Etanercept, certain pre-existing medical conditions can affect that way that this medication works, how effective it is, or can even exacerbate the side effects of the medication. Ensure that your doctor is aware of all medical conditions you have, including but not limited to:

  • Wegener's granulomatosis
  • Tuberculosis
  • Sepsis (serious infection in the blood)
  • Psoriasis (skin disease)
  • Optic neuritis (inflammation of the eye nerve)
  • Nervous system problems such as Guillain-Barré syndrome, multiple sclerosis or demyelinating disease
  • Infections, for example, hepatitis B, bacteria, fungus or virus
  • History of seizures
  • History of congestive heart failure
  • History of cancer
  • Diseases of the immune system
  • Diabetes
  • Blood or bone marrow problems such as aplastic anemia or low white blood
  • Alcoholic hepatitis (moderate to severe)

Warnings

When you are under treatment with Etanercept, it is critical that your doctor can check on yours or your child's progress regularly. This is both to ensure that the medication is working appropriately, and also to check that there have been no recent problems or effects as a result of taking this medication.

During the time you are taking Etanercept, your immune system functionality may be reduced. One of the side effects of this medication is a reduced ability to fight infection, and as such it's critical that you seek medical help and support as soon as possible if you find yourself suffering from the symptoms of infection. If you have any of the following symptoms, contact a medical professional as soon as possible:

  • Weakness
  • Side pain
  • Lower back pain
  • Flu-like symptoms
  • Fever
  • Difficult or painful urination
  • Cough
  • Chills

During the time you are being treated with Etanercept, it is important that you do not have any form of immunizations without the explicit consent of your doctor, or a medical professional who is aware of your history. If Etanercept is being used for your child, it's important that they have been given all their vaccines and childhood immunizations before they start their course of medication. Your child's doctor should be able to answer all questions you have regarding your children's immunizations and taking Etanercept.

As well as potential interactions and side effects, Etanercept can also cause serious allergic reactions and potential issues such as anaphylaxis. This condition can be life-threatening if not treated as soon as possible and requires immediate medical support and attention to treat. Should you find yourself or your child suffering from any of the below symptoms of allergic reaction, call for emergency medical help as soon as you can:

  • Trouble Breathing
  • Swelling (tongue, throat, face)
  • Rash
  • Itching
  • Chest Pain

Prior to starting treatment with Etanercept, you or your child will need to undergo a skin test for tuberculosis. This is because the tuberculosis disease can cause serious interaction and exacerbate the side effects of your medication. A skin test will allow your doctor insight into your health. If you, or anyone in your home, has ever reacted positively to a tuberculosis skin test in the past, inform your doctor prior to starting your course of treatment.

In addition to other symptoms you may experience, Etanercept can increase the risk of you or your child experiencing Lupus-type symptoms. It may also increase your risk of autoimmune hepatitis. It's important that you consult your doctor as soon as you can should you and your child begin to display any of the following symptoms:

  • Yellow eyes/skin
  • Weakness
  • Vomiting
  • Stomach pain
  • Nausea
  • Light-coloured stools
  • Fever
  • Discomfort
  • Chills

As well as the other responses that can be caused by a prescription of Etanercept, serious skin reactions may also occur over the course of treatment. These skin conditions can be dangerous, and you should talk to a doctor as soon as possible if you experience any of the following symptoms:

  • White spots in the mouth or on the lips
  • Unusual tiredness or weakness
  • Ulcers
  • Sore throat
  • Sore
  • Red skin lesions
  • Peeling
  • Loosening of the skin
  • Joint or muscle pain
  • Itching
  • Fever
  • Diarrhea
  • Cough
  • Chills
  • Blistering

When taking Etanercept, it is important that you're aware of all the risks involved in taking this type of medication, as with all drugs that you take. There have been rare reports of this medicine causing serious nervous system problems. These conditions include but are not limited to Guillain-Barré syndrome, demyelinating disease, multiple sclerosis and seizures have occurred extremely rarely in patients who are taking Etanercept. Should you have concerns about this, speak to a medical professional prior to starting treatment with this medication.

A small number of patients, including children and teenagers, have developed certain forms of cancer, such as leukaemia, following treatment with Etanercept. In addition, some patients who have been prescribed this course of treatment have also suffered from lymphoma. If you or your child are experiencing any of the following symptoms, it's important that you seek medical support or attention from your doctor as soon as you can:

  • Weakness
  • Unusual bleeding
  • Unexplained weight loss
  • Underarms
  • Swollen lymph nodes in the neck
  • Red, scaly patches of skin
  • Raised bumps filled with pus
  • Groin
  • Bruising

If you have experienced any of the following symptoms during your treatment with Etanercept, it's important that you talk to your doctor immediately, as these can be the initial warning signs of a heart condition that is called CHF, or congestive heart failure:

  • Trouble breathing
  • Swelling of the fingers, feet, legs or face
  • Sudden weight gain

Do not take any other medications alongside Etanercept, unless you have explicitly discussed your medical history, current medications and current health with a medical professional or doctor. This can include medications such as Abatacept, Anakinra or Cyclophosphamide. Using any of these alongside Etanercept can result in an increased risk of having serious interactions and side effects.

Storage

Etanercept should be kept of out the reach of children and pets at all times, to ensure their safety. As this medication needs to be kept refrigerated, it is important that is it kept in an unreachable place, or in a separate place of refrigeration if possible.

Ensure all used medication and needles are disposed of in a sharps bin to ensure the safety of all others with access to your medication.

Protect this medication from direct sunlight, and ensure that it's stored in its original packaging with all instructions and information included.

Summary

Etanercept is an injection form of medication. It is primarily used as a treatment to reduce the signs and symptoms of specific types of arthritis, as well as helping to slow the damage progression of these diseases. In addition, this medicine is used to treat conditions such as ankylosing spondylitis and plaque psoriasis.

This medication is most commonly prescribed for conditions that include rheumatoid arthritis, psoriatic arthritis and active arthritis. It may help to slow degradation in both active and rheumatoid forms of arthritis. In addition, this medication is used for children older than two years, for the treatment of juvenile idiopathic arthritis.

This medication cannot be taken alongside many forms of vaccines and immunizations, and any other medicines, prescriptions and health conditions should be discussed with a medical professional prior to beginning prescription with this medication.

Etanercept is solely available from a doctor or medical professional and should be prescribed as such. Once prescribed, it can be taken from home and is available in the form of an auto-injector, syringe or vial.