{"id":5962,"date":"2020-12-29T15:13:55","date_gmt":"2020-12-29T15:13:55","guid":{"rendered":"https:\/\/zeepedia.com\/?p=5962"},"modified":"2021-07-05T07:57:06","modified_gmt":"2021-07-05T07:57:06","slug":"benepali","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/benepali\/","title":{"rendered":"Benepali &#8211; Etanercept uses, dose and side effects"},"content":{"rendered":"\n<p>\n\n50 mg&nbsp;solution for injection&nbsp;in pre-filled&nbsp;pen&nbsp;<br>etanercept<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">1. What Benepali is and what it is used for<\/h2>\n\n\n\n<p>Benepali contains the active substance etanercept.<br><\/p>\n\n\n\n<p>Benepali is a drug made from two human proteins.&nbsp;It binds to another&nbsp;protein&nbsp;that causes&nbsp;inflammation&nbsp;and blocks its activity.&nbsp;This blockage reduces the&nbsp;inflammation associated with the disease.<br><\/p>\n\n\n\n<p>In adults (18 years and older) Benepali can be used for:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>moderate or severe&nbsp;<strong>rheumatoid arthritis<\/strong>&nbsp;;<\/li><li><strong>psoriatic arthritis<\/strong><\/li><li>severe&nbsp;<strong>axial&nbsp;spondylarthritis<\/strong>&nbsp;including&nbsp;<strong>ankylosing spondylitis<\/strong>&nbsp;;<\/li><li>moderate or severe&nbsp;plaque&nbsp;psoriasis.<\/li><\/ul>\n\n\n\n<p>Benepali is most often used when other commonly used treatments have not worked well enough or are unsuitable for you.<br><\/p>\n\n\n\n<p>Benepali is usually used in combination with methotrexate to treat&nbsp;<strong>rheumatoid arthritis<\/strong>, but it can also be used as the only medicine if treatment with methotrexate is unsuitable for you.&nbsp;Whether Benepali is used as a single drug or in combination with methotrexate, Benepali can slow down the damage to your joints caused by&nbsp;rheumatoid arthritis&nbsp;and improve your ability to perform daily activities.<br><\/p>\n\n\n\n<p>For patients who have multiple joints affected by&nbsp;psoriatic arthritis, Benepali can increase the ability to perform daily activities.<br><\/p>\n\n\n\n<p>For patients with&nbsp;<strong>multiple symmetrical aching or swollen joints<\/strong>&nbsp;(eg hands, ankles, and feet), Benepali may delay the breakdown of joint surfaces.<br><\/p>\n\n\n\n<p>Benepali is also used to treat the following diseases in children and adolescents:<br><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>For the following types of childhood rheumatism (&nbsp;juvenile idiopathic arthritis&nbsp;), when treatment with methotrexate has not given sufficient results or is not appropriate:<br><ul><li>Inflammation&nbsp;of many joints (polyarthritis) (rheumatoid factor positive or negative) and&nbsp;inflammation&nbsp;affecting 5 or more joints (enlarged oligoarthritis) in patients from 2 years of age and weighing 62.5 kg or more<br><\/li><li>Arthritis associated with the skin disease&nbsp;psoriasis&nbsp;(psoriatic arthritis) in patients from the age of 12 and weighing 62.5 kg or more<\/li><\/ul><\/li><\/ul>\n\n\n\n<ul class=\"wp-block-list\"><li>For patients from the age of 12 years and weighing 62.5 kg or more with musculoskeletal and tendinitis (enthesitis-related&nbsp;arthritis&nbsp;) when other standard treatments have not given sufficient results or are not suitable<br><\/li><li>Severe plaque psoriasis in patients from 6 years of age weighing 62.5 kg or more who have had the insufficient effect of (or who cannot be treated with) light therapy or other systemic therapies (whole body medicines).<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">2. What you need to know before using Benepali<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Do not use Benepali<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>if you or your child are&nbsp;<strong>allergic to etanercept<\/strong>&nbsp;or any of the other&nbsp;<strong>ingredients of this medicine&nbsp;(listed in section 6).&nbsp;If you or your child have allergic reactions, such as shortness of breath, wheezing, dizziness,<\/strong> or rash, stop injecting Benepali and contact your doctor immediately.<\/li><li>if you or your child have or are at risk of developing a&nbsp;<strong>serious&nbsp;blood&nbsp;infection called sepsis.&nbsp;If you are not sure, talk to your doctor.<\/strong><\/li><li><strong>if you or your child have an&nbsp;infection&nbsp;of any kind<\/strong>.&nbsp;If you are not sure, talk to your doctor.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings and cautions<\/h2>\n\n\n\n<p>Talk to your doctor before using Benepali.<br><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Allergic reactions:<\/strong>&nbsp;If you or your child have allergic reactions, such as shortness of breath, wheezing, dizziness, or rash, stop injecting Benepali and contact your doctor immediately.<\/li><li>Infections\/surgeries<strong>:<\/strong>&nbsp;If you or your child develop a new&nbsp;infection&nbsp;or are facing a major operation, your doctor may want to monitor your treatment with Benepali.<\/li><li><strong>Infections \/ Diabetes:&nbsp;Tell your doctor if you or your child have had a recurring&nbsp;infection&nbsp;or have&nbsp;diabetes&nbsp;or any other condition that increases the risk of&nbsp;infection.<\/strong><\/li><li><strong>Infections\/follow-up:<\/strong>&nbsp;Tell your doctor if you have recently been traveling outside of Europe.&nbsp;If you or your child develops symptoms of an&nbsp;infection&nbsp;such as fever, chills, or cough, consult a doctor immediately.&nbsp;Your doctor may want to continue to monitor you or your child for the presence of&nbsp;infection&nbsp;after you have stopped treatment with Benepali.<\/li><li><strong>Tuberculosis:<\/strong>&nbsp;As cases of&nbsp;tuberculosis&nbsp;have been reported in patients treated with Benepali, your doctor will perform an examination to see if there are any signs of&nbsp;tuberculosis&nbsp;before starting treatment with Benepali.&nbsp;This may include a thorough review of your medical history, a chest x-ray, and a tuberculin test.&nbsp;The results of these examinations must be entered on the patient card.&nbsp;It is important that you tell your doctor if you or your child have ever had&nbsp;tuberculosis&nbsp;or had close contact with a person who has had&nbsp;tuberculosis.&nbsp;If symptoms of&nbsp;tuberculosis&nbsp;(eg persistent cough, weight loss, general deterioration, or mild fever) or any other infection&nbsp;occurs during treatment, contact your doctor immediately.<\/li><li>Hepatitis&nbsp;B:&nbsp;Tell your doctor if you or your child have or have ever had&nbsp;hepatitis. Your doctor should take a test for&nbsp;hepatitis&nbsp;B before you or your child start treatment with Benepali.&nbsp;Treatment with Benepali may result in the reactivation of hepatitis&nbsp;B in patients who have previously been infected with the&nbsp;hepatitis&nbsp;B&nbsp;virus.&nbsp;If this happens, treatment with Benepali should be stopped.<\/li><li><strong>Hepatitis&nbsp;C:<\/strong>&nbsp;Tell your doctor if you or your child have&nbsp;hepatitis&nbsp;C. Your doctor may want to check your treatment with Benepali if the&nbsp;infection&nbsp;worsens.<\/li><li>Blood disorders: Seek immediate medical attention if you or your child have symptoms such as persistent fever, sore throat, bruising, bleeding, or pallor.&nbsp;Such symptoms may indicate a potentially life-threatening blood disorder, which requires treatment with Benepali to be discontinued.<\/li><li>Nervous system and eye diseases:&nbsp;Tell your doctor if you or your child have&nbsp;multiple sclerosis,&nbsp;optic&nbsp;neuritis&nbsp;(&nbsp;inflammation&nbsp;of the nerves in the eye), or transverse&nbsp;myelitis&nbsp;(&nbsp;inflammation&nbsp;of the spinal cord).&nbsp;Your doctor will decide if Benepali is the right treatment.<\/li><li><strong>Heart failure: Tell your doctor if you or your child have a history of&nbsp;heart failure<\/strong>, as Benepali must be used with caution in such circumstances.<\/li><li><strong>Cancer:<\/strong>&nbsp;Tell your doctor if you have or have ever had&nbsp;lymphoma&nbsp;(a type of blood cancer) or any other type of cancer before you get Benepali.&nbsp;Patients with severe&nbsp;rheumatoid arthritis&nbsp;who have had the disease for a long time may have a higher-than-average risk of developing&nbsp;lymphoma.&nbsp;Children and adults who use Benepali may be at greater risk of developing&nbsp;lymphoma other types of cancer.&nbsp;Some children and teens who have been given Benepali or other drugs that work similarly to Benepali have developed cancer, including unusual types that sometimes led to death.&nbsp;Some patients who have received Benepali have developed skin cancer.&nbsp;Tell your doctor if you or your child develops any type of skin change or growth on the skin.<\/li><li>Chickenpox: Tell your doctor if you or your child have been exposed to chickenpox during treatment with Benepali.&nbsp;Your doctor will decide if you need to be prescribed preventative treatment for chickenpox.<\/li><li>Alcohol abuse: Benepali should not be used to treat&nbsp;hepatitis&nbsp;related to alcohol abuse.&nbsp;Tell your doctor if you or your child have a history of alcohol abuse.<\/li><li><strong>Wegener&#8217;s granulomatosis:<\/strong>&nbsp;Benepali is not recommended for the treatment of&nbsp;Wegener&#8217;s granulomatosis, a rare inflammatory disease.&nbsp;Talk to your doctor if you or your child have&nbsp;Wegener&#8217;s granulomatosis.<\/li><li><strong>Medicines for diabetes:<\/strong>&nbsp;Tell your doctor if you or your child have&nbsp;diabetes&nbsp;or are taking medicines to treat&nbsp;diabetes.&nbsp;Your doctor will decide if you or your child needs a smaller&nbsp;dose&nbsp;of the drug for&nbsp;diabetes&nbsp;during treatment with Benepali.<\/li><li>Vaccinations: Some vaccines, e.g.&nbsp;oral polio vaccine, should not be given during treatment with Benepali.&nbsp;Contact a doctor before you or your child receive any vaccines.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Children and young people<\/h2>\n\n\n\n<p>Benepali is not intended for children and adolescents weighing less than 62.5 kg.<br><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Vaccinations:<\/strong>&nbsp;If possible, children should have received all vaccinations according to the vaccination program before starting treatment with Benepali.&nbsp;Some vaccines, such as the oral polio vaccine, should not be taken at the same time as Benepali treatment.&nbsp;Check with your or your child&#8217;s doctor before you or your child receive any vaccination.<\/li><li><strong>Inflammatory&nbsp;bowel disease (IBD):<\/strong>&nbsp;There have been cases of IBD in patients with&nbsp;juvenile idiopathic arthritis&nbsp;(JIA) treated with etanercept.&nbsp;Tell your child&#8217;s doctor if your child has abdominal pain or abdominal cramps, diarrhea, weight loss, or blood in the stool.<br><\/li><\/ul>\n\n\n\n<p>Benepali should not normally be used in children under 2 years of age or weighing less than 62.5 kg with polyarthritis or extended oligoarthritis, or in children under 12 years of age or weighing less than 62.5 kg with enthesitis-related&nbsp;arthritis&nbsp;or psoriatic arthritis, or for children under 6 years of age or weighing less than 62.5 kg with&nbsp;psoriasis.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other medicines and Benepali<\/h2>\n\n\n\n<p>Tell your doctor or pharmacist if you or your child are taking, have recently taken, or might take any other medicines (including sulfasalazine).<br><\/p>\n\n\n\n<p>You or your child should&nbsp;<strong>not use<\/strong>&nbsp;&nbsp;Benepali with other medicines that contain the active substances anakinra or abatacept.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy and breastfeeding<\/h2>\n\n\n\n<p>If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.<br><\/p>\n\n\n\n<p>Women of childbearing potential should be advised to use appropriate contraception to avoid becoming pregnant during treatment with Benepali and for three weeks after stopping treatment.<br><\/p>\n\n\n\n<p>Benepali should only be used during pregnancy if absolutely necessary.<br><\/p>\n\n\n\n<p>If you have had Benepali during pregnancy, your baby may be at greater risk of getting an&nbsp;infection.&nbsp;One study also found more malformations when the mother had received etanercept during pregnancy, compared with mothers who had not received etanercept or other similar drugs (&nbsp;TNF&nbsp;&#8211;&nbsp;antagonistic), but no specific type of malformation was reported.&nbsp;Another study did not show an increased risk of malformations when the mother received etanercept during pregnancy.&nbsp;Your doctor will help you determine if the benefits of the treatment outweigh the potential risk to your child.&nbsp;It is important that you tell your baby&#8217;s doctor or another healthcare professional if Benepali has been used during pregnancy before vaccinating your baby (for more information, see section 2, \u201cVaccinations\u201d).<br><\/p>\n\n\n\n<p>You should not breast-feed while using Benepali as Benepali passes into breast milk.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving and using machines<\/h2>\n\n\n\n<p>There is no information that the use of Benepali affects the ability to drive or use machines.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Benepali contains sodium<\/h2>\n\n\n\n<p>Benepali contains less than 1 mmol&nbsp;sodium&nbsp;(23 mg), ie essentially &#8216;sodium-free&#8217;.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">3. How to use Benepali<\/h2>\n\n\n\n<p>Always use this medicine exactly as your doctor has told you.&nbsp;Ask your doctor or pharmacist if you are unsure.<br><\/p>\n\n\n\n<p>If you have the impression that the effect of Benepali is too strong or too weak, talk to your doctor or pharmacist.<br><\/p>\n\n\n\n<p><strong>Use in adult patients (over 18 years of age)<\/strong><\/p>\n\n\n\n<p><strong><em>Rheumatoid arthritis, psoriatic arthritis, and&nbsp;axial&nbsp;spondylarthritis including&nbsp;ankylosing spondylitis<\/em><\/strong><\/p>\n\n\n\n<p>The recommended&nbsp;dose&nbsp;is 50 mg once a week in the form of an&nbsp;injection&nbsp;under the skin.<\/p>\n\n\n\n<p>Your doctor may decide on a different frequency for injecting Benepali.<br><\/p>\n\n\n\n<p><strong><em>Plaque psoriasis<\/em><\/strong><\/p>\n\n\n\n<p>The recommended&nbsp;dose&nbsp;is 50 mg given once a week.<br><\/p>\n\n\n\n<p>Alternatively, 50 mg can be given twice a week for up to 12 weeks followed by 50 mg once a week.<br><\/p>\n\n\n\n<p>Your doctor will decide how long you should use Benepali and if resuming treatment is needed based on the treatment results.&nbsp;If Benepali has not had any effect on your condition after 12 weeks, your doctor may ask you to stop treatment.<br><\/p>\n\n\n\n<p><strong>Use for children and adolescents<\/strong><\/p>\n\n\n\n<p>Dose&nbsp;one and how often it should be given to the child or adolescent depends on body weight and illness.&nbsp;The doctor determines the correct&nbsp;dose&nbsp;for the child and prescribes etanercept with appropriate strength.&nbsp;Pediatric patients&nbsp;weighing 62.5 kg or more may be given 25 mg twice a week or 50 mg once a week with a pre-filled&nbsp;syringe&nbsp;or pre-filled pen at a set&nbsp;dose.<br><\/p>\n\n\n\n<p>There are other medicines with etanercept in suitable dosage form available for children.<br><\/p>\n\n\n\n<p>For patients from 2 years of age and weighing 62.5 kg or more with polyarthritis or extended oligoarthritis, or for patients from 12 years of age and weighing 62.5 kg or more with encephalitis-related&nbsp;arthritis&nbsp;or psoriatic arthritis, the usual&nbsp;dose is&nbsp;25 mg twice a week or 50 mg once a week.<br><\/p>\n\n\n\n<p>For patients from 6 years of age who weigh 62.5 kg or more with&nbsp;psoriasis, the usual&nbsp;dose is&nbsp;50 mg given once a week.&nbsp;If Benepali does not show any effect after 12 weeks, your doctor may ask you to stop treatment with this medicine.<br><\/p>\n\n\n\n<p>Your doctor will provide you with detailed instructions for the&nbsp;preparation&nbsp;and measurement of the correct&nbsp;dose.<br><\/p>\n\n\n\n<p><strong>Method and route of delivery<\/strong><\/p>\n\n\n\n<p>Benepali is injected under the skin (&nbsp;subcutaneous&nbsp;use).<br><\/p>\n\n\n\n<p><strong>Detailed instructions on how to inject Benepali can be found in section 7 &#8220;Instructions for use&#8221;.&nbsp;<\/strong>Do not mix the Benepali solution with any other medicine.<br><\/p>\n\n\n\n<p>To make it easier for you to remember, it can be helpful to write in a calendar which days of the week Benepali should be taken.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you have used too much Benepali<\/h2>\n\n\n\n<p>If you have injected more Benepali than your doctor has prescribed (either by injecting too much at one time or taking one&nbsp;dose&nbsp;too much)&nbsp;<strong>you should contact either your doctor or pharmacist immediately<\/strong>.&nbsp;Always carry the labeled outer packaging of the medicine, even if it is empty.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you forget to use Benepali<\/h2>\n\n\n\n<p>If you miss a&nbsp;dose, you should&nbsp;inject&nbsp;one as soon as you remember, unless the next scheduled&nbsp;dose is&nbsp;to be taken the next day, then skip the missed&nbsp;dose.&nbsp;Then continue to inject the medicine on the usual scheduled day.&nbsp;If you do not remember a&nbsp;dose&nbsp;until the day of the&nbsp;usual injection, do not take a double&nbsp;dose&nbsp;(two&nbsp;doses&nbsp;on the same day) to make up for&nbsp;a forgotten&nbsp;dose.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you stop using Benepali<\/h2>\n\n\n\n<p>Your symptoms may return if treatment is stopped.<br><\/p>\n\n\n\n<p>If you have any further questions on the use of this product, ask your doctor or pharmacist.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">4. Possible side effects<\/h2>\n\n\n\n<p>Like all medicines, this medicine can cause&nbsp;side effects, although not everybody gets them.<br><\/p>\n\n\n\n<p><strong>Allergic reactions<\/strong><\/p>\n\n\n\n<p>If any of the following symptoms occur, do not inject Benepali&nbsp;<b>anymore<\/b><strong>,&nbsp;but contact your doctor immediately or the emergency department at the nearest hospital<\/strong>.<br><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Difficulty swallowing or breathing.<\/li><li>Swelling of the face, neck, hands, or feet.<\/li><li>Feeling of nervousness or anxiety, throbbing sensation, sudden&nbsp;redness&nbsp;of the skin with or without feeling hot.<\/li><li>Severe skin rash,&nbsp;itching,&nbsp;or hives (red spots or pale skin that often itches).<br><\/li><\/ul>\n\n\n\n<p>Severe allergic reactions are rare, but one or more of the above symptoms may indicate an&nbsp;allergic reaction&nbsp;caused by Benepali and medical attention should be sought immediately.<br><\/p>\n\n\n\n<p><strong>Serious&nbsp;side effects&nbsp;are<\/strong><\/p>\n\n\n\n<p>If you or your child observes any of the following symptoms, seek medical attention immediately.<br><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Symptoms of a&nbsp;<strong>serious&nbsp;infection&nbsp;<\/strong>(including&nbsp;pneumonia, deep skin infections, joint infections, and sepsis),&nbsp;such as high fever which may be associated with coughing, difficulty breathing, chills, feeling weak, or a hot, red, and tense surface in the skin or at a joint.<\/li><li>Symptoms of any&nbsp;<strong>blodsj&nbsp;u&nbsp;KDOM<\/strong>&nbsp;, such as bleeding, bruising, or pallor.<\/li><li>Symptoms of any&nbsp;<strong>neurological disease, such as loss of sensation and a stinging sensation, changes in vision, eye pain,<\/strong> or muscle weakness in the arms or legs.<\/li><li>Symptoms of&nbsp;<strong>heart failure<\/strong>&nbsp;or&nbsp;<strong>worsening&nbsp;heart failure,&nbsp;such as fatigue or difficulty breathing during exertion, swollen ankles, a feeling of swollen neck and abdomen, difficulty breathing at night, coughing,<\/strong> or bluish color on nails or lips.<\/li><li>Symptoms of&nbsp;<strong>cancer:<\/strong>&nbsp;Cancer can affect all parts of the body, including the skin and blood, and the symptoms depend on the type of cancer and its location.&nbsp;These symptoms may include weight loss, fever, swelling (with or without pain), persistent cough, lumps, or growths on the skin.<\/li><li>Symptoms of&nbsp;<strong>autoimmune reactions<\/strong>&nbsp;(when&nbsp;antibodies&nbsp;are formed that can damage the body&#8217;s normal&nbsp;tissues&nbsp;) such as pain,&nbsp;itching, weakness, abnormal breathing, thoughts, sensations, or vision.<\/li><li>Symptoms of&nbsp;<strong>inflammatory&nbsp;bowel disease<\/strong>&nbsp;(lupus) or lupus-like syndromes such as weight change, persistent rash, fever, joint or muscle aches, or fatigue.<\/li><li>Symptoms of&nbsp;<strong>inflammation&nbsp;of the blood vessels<\/strong>&nbsp;such as pain, fever,&nbsp;redness,&nbsp;or feeling of warmth in the skin or&nbsp;itching.<\/li><\/ul>\n\n\n\n<p>These are rare or uncommon&nbsp;side effects, but serious (some of them can be fatal).&nbsp;If any of the above occur, contact your doctor or emergency department immediately at the nearest hospital.<br><\/p>\n\n\n\n<p><em>Other&nbsp;side effects&nbsp;ar<\/em><\/p>\n\n\n\n<p>Known&nbsp;side effects&nbsp;of Benepali are as follows, divided into groups according to decreasing frequency:<br><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Very common<\/strong>&nbsp;(may affect more than 1 user in 10)Infections&nbsp;(including colds, sinusitis,&nbsp;bronchitis, urinary tract infections, skin infections);&nbsp;injection site reactions (including bleeding, bruising,&nbsp;redness,&nbsp;itching, pain, swelling).Injection site reactions (these often subside after the first month of treatment). Some patients develop a reaction at an injection site that has been used before.<br><\/li><li><strong>Common<\/strong>&nbsp;(may affect up to 1 in 10 people)Allergic reactions;&nbsp;fever;&nbsp;rash;&nbsp;itching;&nbsp;antibodies&nbsp;are directed against normal&nbsp;tissue&nbsp;(autoantibody formation).<br><\/li><li>Uncommon&nbsp;(may affect up to 1 in 100 people)Serious&nbsp;infections, including&nbsp;pneumonia, deep skin infections, joint infections, sepsis and&nbsp;infection&nbsp;in various places, aggravated&nbsp;chronic&nbsp;heart failure, low&nbsp;red blood cell count, low&nbsp;white blood cell count, low&nbsp;neutrophil count&nbsp;(a type of&nbsp;white blood cell count&nbsp;), low platelet count;&nbsp;skin cancer (excluding&nbsp;melanoma&nbsp;);&nbsp;local swelling of the skin (&nbsp;angioedema&nbsp;);&nbsp;hives (red spots or pale skin that often itches);&nbsp;eye inflammation;&nbsp;psoriasis&nbsp;(new onset or worsening);&nbsp;inflammation the blood vessels that can affect several organs;&nbsp;elevated liver values \u200b\u200bin blood tests (in patients also receiving methotrexate, the frequency of elevated liver values \u200b\u200bis \u201cnormal\u201d);&nbsp;cramps and pain in the abdomen, diarrhea, weight loss or blood in the stool (signs of intestinal disease).<br><\/li><li><strong>Rare<\/strong>&nbsp;(may affect up to 1 in 1,000 people)Severe allergic reactions (including severe local swelling of the skin and wheezing);&nbsp;lymphoma&nbsp;(a type of blood cancer);&nbsp;leukemia (cancer that affects the blood and&nbsp;bone marrow&nbsp;);&nbsp;melanoma&nbsp;(a type of skin cancer);&nbsp;a combination of low&nbsp;platelet counts&nbsp;, red and white blood cells;&nbsp;effects on the nervous system (with severe muscle weakness and signs and symptoms similar to those of&nbsp;multiple sclerosis&nbsp;or&nbsp;inflammation&nbsp;of the nerves or spinal cord of the eye);&nbsp;tuberculosis;&nbsp;newly debuted heart failure;&nbsp;seizures;&nbsp;lupus or lupus-like symptoms (symptoms include persistent rash, fever, joint pain and fatigue);&nbsp;skin rash that can lead to severe blistering and flaking of the skin;&nbsp;inflammationin the liver caused by the body&#8217;s own immune system (&nbsp;autoimmune&nbsp;hepatitis; in patients who also receive methotrexate, the frequency is \u201cless common\u201d);&nbsp;immune disease that can affect the lungs, skin and lymph nodes (&nbsp;sarcoidosis&nbsp;);&nbsp;inflammation&nbsp;or&nbsp;fibrosis&nbsp;of the lungs (in people who also receive methotrexate, the frequency of&nbsp;inflammationand&nbsp;fibrosis&nbsp;of the lungs is &#8220;less common&#8221;);&nbsp;lichenoid reactions (itchy red-purple rash and \/ or thread-like white-gray lines on mucous membranes);&nbsp;opportunistic&nbsp;infection&nbsp;(which includes&nbsp;tuberculosis&nbsp;and other&nbsp;infections)you arising from a weakened immune system);&nbsp;erythema multiforme (inflammatory skin rash);&nbsp;cutaneous&nbsp;vasculitis&nbsp;(&nbsp;inflammation&nbsp;of the blood vessels in the skin);&nbsp;damage to nerves, including&nbsp;Guillain-Barr\u00e9 syndrome&nbsp;(a serious condition that can affect breathing and damage to body organs).<br><\/li><li><strong>Very rare<\/strong>&nbsp;(may affect up to 1 in 10,000 people)Inability of&nbsp;bone marrow&nbsp;to produce blood cells;&nbsp;toxic epidermal necrolysis&nbsp;(a life-threatening skin disease).<br><\/li><li><strong>No known frequency<\/strong>&nbsp;(cannot be calculated from the available data)Merkel cell cancer (a type of skin cancer);&nbsp;Kaposi&#8217;s Sarcoma&nbsp;(rare cancer associated with&nbsp;infection&nbsp;by human herpes virus 8.&nbsp;Kaposi&#8217;s sarcoma&nbsp;usually occurs as purple spots on the skin);&nbsp;overactivation of&nbsp;white blood cells&nbsp;associated with&nbsp;inflammation&nbsp;(macrophage activation syndrome);&nbsp;reactivation of hepatitis B (a liver infection);&nbsp;worsening of a condition called&nbsp;dermatomyositis&nbsp;(muscle inflammation and weakness accompanied by a rash);&nbsp;listeria (a bacterial&nbsp;infection&nbsp;).<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Side effects in children and adolescents<\/h2>\n\n\n\n<p>The side effects&nbsp;and their frequencies in children and adolescents are the same as in adults, see the description above.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><em>Reporting of side effects<\/em><\/p>\n\n\n\n<p>If you get any side effects, talk to your doctor, pharmacist, or nurse.&nbsp;This includes any possible side effects not listed in this leaflet.&nbsp;You can also report side effects directly to the Medical Products Agency,&nbsp;www.lakemedelsverket.se.&nbsp;By reporting side effects, you can help increase drug safety information.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">5. How to store Benepali<\/h2>\n\n\n\n<p>Keep this medicine out of the sight and reach of children.<br><\/p>\n\n\n\n<p>Do not use this medicine after the expiry date which is stated on the carton and label on the pre-filled pen after EXP.&nbsp;The expiration date is the last day of the specified month.<br><\/p>\n\n\n\n<p>Store in a refrigerator (2 \u00b0 C \u2011 8 \u00b0 C).&nbsp;Do not freeze.<br><\/p>\n\n\n\n<p>Store the pre-filled pens in the outer carton.&nbsp;Sensitive to light.<br><\/p>\n\n\n\n<p>After removing Benepali from the refrigerator,&nbsp;<strong>wait approximately 30 minutes for the Benepali solution in the pen to reach room temperature<\/strong>.<\/p>\n\n\n\n<p>Do not heat Benepali in any other way.&nbsp;Thereafter, immediate use is recommended.<br><\/p>\n\n\n\n<p>Benepali can be stored outside the refrigerator at temperatures up to a maximum of 25 \u00b0 C for a single period of up to four weeks, after which it should not be stored in the refrigerator again.&nbsp;Benepali should be discarded if not used within four weeks of removal from the refrigerator.&nbsp;It is recommended that you note the date Benepali is removed from the refrigerator and the date Benepali is to be discarded (no longer than 4 weeks after removal from the refrigerator).<br><\/p>\n\n\n\n<p>Inspect the solution in the pen by looking through the transparent inspection window.&nbsp;It should be clear or slightly opalescent, colorless or pale yellow, and may contain small white or almost transparent particles of&nbsp;protein.&nbsp;This appearance is normal for Benepali.&nbsp;Do not use this medicine if you notice that the solution is discolored, cloudy, or if particles other than those described above occur.&nbsp;If you have any further questions on the use of this solution, ask your pharmacist for help.<br><\/p>\n\n\n\n<p>Medicines should not be disposed of via wastewater or household waste.&nbsp;Ask your pharmacist how to dispose of medicines no longer required.&nbsp;These measures will help to protect the environment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">6. Contents of the packaging and other information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Content declaration<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>The active substance is etanercept.&nbsp;Each pre-filled&nbsp;pen&nbsp;contains 50 mg etanercept.<\/li><li>The other ingredients are sucrose, sodium chloride, sodium dihydrogen phosphate monohydrate, disodium hydrogen phosphate heptahydrate, and water for injections (see section 2 \u201cBenepali contains sodium\u201d).<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">What the medicine looks like and the contents of the pack<\/h2>\n\n\n\n<p>Benepali is supplied in a pre-filled&nbsp;pen.&nbsp;The pen contains a clear to slightly opalescent, colorless, or pale yellow&nbsp;solution for injection&nbsp;(&nbsp;injection&nbsp;).<br><\/p>\n\n\n\n<p>Benepali is available in packs containing 4 pre-filled pens and in multipacks containing 3 cartons, each containing 4 pre-filled pens.&nbsp;Not all pack sizes may be marketed.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorisation Holder<\/h2>\n\n\n\n<p>Samsung Bioepis NL BV<\/p>\n\n\n\n<p>Olof Palmestraat 10<\/p>\n\n\n\n<p>2616 LR Delft<\/p>\n\n\n\n<p>The Netherlands<br><\/p>\n\n\n\n<p><strong>Manufacturer<\/strong><\/p>\n\n\n\n<p>Biogen (Denmark) Manufacturing ApS<\/p>\n\n\n\n<p>Biogen All\u00e9 1<\/p>\n\n\n\n<p>3400 Hiller\u00f8d<\/p>\n\n\n\n<p>Denmark<br><\/p>\n\n\n\n<p>Samsung Bioepis NL BV<\/p>\n\n\n\n<p>Olof Palmestraat 10<\/p>\n\n\n\n<p>2616 LR Delft<\/p>\n\n\n\n<p>Netherlands<br><\/p>\n\n\n\n<p>Contact the representative of the marketing authorization holder to find out more about this medicine:<br><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Benepali is a drug made from two human proteins. It binds to another protein that causes inflammation and blocks its activity. This blockage reduces the inflammation associated with the disease.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2202,2200],"tags":[9120,9124,9122,3941,4256,9119,9123,9118,9121,3942],"class_list":["post-5962","post","type-post","status-publish","format-standard","hentry","category-b","category-medicines","tag-benepali","tag-benepali-injection","tag-benepali-side-effects","tag-etanercept","tag-etanercept-injection","tag-side-effects-of-etanercept","tag-what-benepali-is-used-for","tag-what-etanercept-is-used-for","tag-what-is-benepali","tag-what-is-etanercept"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/5962","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=5962"}],"version-history":[{"count":5,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/5962\/revisions"}],"predecessor-version":[{"id":12104,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/5962\/revisions\/12104"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=5962"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=5962"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=5962"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}