{"id":8147,"date":"2021-03-06T09:25:55","date_gmt":"2021-03-06T09:25:55","guid":{"rendered":"https:\/\/zeepedia.com\/?p=8147"},"modified":"2021-04-30T10:05:40","modified_gmt":"2021-04-30T10:05:40","slug":"enbrel","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/enbrel\/","title":{"rendered":"Enbrel &#8211; Etanercept uses, dose and side effects"},"content":{"rendered":"\n<p> 25 mg\u00a0injection\u00a0solution in a prefilled\u00a0pen\u00a0<br>Etanercept<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">1. What Enbrel is and what it is used for<\/h2>\n\n\n\n<p>Enbrel 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), Enbrel can be used for moderate or severe&nbsp;<strong>rheumatoid arthritis<\/strong>,&nbsp;psoriatic arthritis, severe&nbsp;axial&nbsp;spondylarthritis&nbsp;including&nbsp;ankylosing spondylitis, and moderate or severe&nbsp;<strong>psoriasis<\/strong>&nbsp;&#8211; usually when other commonly used treatments have not worked well enough or are inappropriate for you.<br><\/p>\n\n\n\n<p>Enbrel is usually used in combination with methotrexate to treat&nbsp;rheumatoid arthritis, but it can also be used as the only medicine if treatment with methotrexate is unsuitable for you.&nbsp;Whether Enbrel is used as a single medicine or in combination with methotrexate, Enbrel 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 psoriatic arthritis, Enbrel may increase the ability to perform daily activities.&nbsp;For patients with multiple symmetrical aching or swollen joints (eg hands, ankles, and feet), Enbrel may delay the breakdown of joint surfaces.<br><\/p>\n\n\n\n<p>Enbrel 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:<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.<\/li><li>Arthritis is associated with the skin disease&nbsp;psoriasis&nbsp;(psoriatic arthritis) in patients from 12 years of age.<\/li><\/ul><\/li><li>For patients from the age of 12 with musculoskeletal and tendonitis (enthesitis-related&nbsp;arthritis&nbsp;) when other standard treatments have not given sufficient results or are not suitable.<\/li><li>Severe&nbsp;psoriasis&nbsp;in children and adolescents from 6 years of age who have had an insufficient effect of (or who cannot be treated with) light therapy or other systemic treatments (drugs that affect the whole body).<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">2. What you need to know before you use Enbrel<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Do not use Enbrel<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>if you or your child are hypersensitive (allergic) to etanercept or any of the other ingredients of Enbrel (listed in section 6).&nbsp;If you or your child have allergic reactions, such as shortness of breath, wheezing, dizziness, or rash, stop injecting Enbrel and contact your doctor immediately.<\/li><li>if you or your child have, or are at risk of developing, a serious&nbsp;infection&nbsp;in the blood called sepsis.&nbsp;If you are not sure, contact your or your child&#8217;s doctor.<\/li><li>if you or your child have an&nbsp;infection&nbsp;of any kind.&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 Enbrel.<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 Enbrel and contact your or your child&#8217;s doctor immediately.<\/li><li>Infections\/operations:&nbsp;If you or your child develops a new&nbsp;infection&nbsp;or is facing a major operation.&nbsp;Your doctor may then want to monitor your treatment with Enbrel.<\/li><li>Infections \/ Diabetes:&nbsp;Tell your or your child&#8217;s doctor if you or your child has had a recurrent&nbsp;infection&nbsp;or has&nbsp;diabetes&nbsp;or any other condition that increases the risk of&nbsp;infection.<\/li><li>Infections\/follow-up:&nbsp;Tell your or your child&#8217;s doctor if you or your child 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 for the presence of&nbsp;infection&nbsp;after you or your child has stopped taking Enbrel.<\/li><li>Tuberculosis:&nbsp;As cases of&nbsp;tuberculosis&nbsp;have been reported in patients treated with Enbrel, your doctor will examine to see if there are any signs of&nbsp;tuberculosis&nbsp;before starting treatment with Enbrel.&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;You must 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, worsening of the general condition, or mild fever) or any other infection&nbsp;occur 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 B. Your doctor should test for&nbsp;hepatitis&nbsp;B before you or your child start treatment with Enbrel.&nbsp;Treatment with Enbrel may result in the reactivation of&nbsp;hepatitis&nbsp;B in patients who have previously been infected with the&nbsp;hepatitis&nbsp;B&nbsp;virus.&nbsp;If this happens, treatment with Enbrel should be stopped.<\/li><li>Hepatitis&nbsp;C:&nbsp;Tell your doctor if you or your child have&nbsp;hepatitis&nbsp;C. Your doctor may want to check your treatment with Enbrel if the&nbsp;infection&nbsp;worsens.<\/li><li>Blood disorders:&nbsp;Seek immediate medical attention if you or your child have symptoms such as persistent fever, sore throat, bruising, bleeding, and\/or paleness.&nbsp;Such symptoms may indicate a potentially life-threatening disorder of the blood picture, which requires discontinuation of Enbrel.<\/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 Enbrel is the right treatment.<\/li><li>Heart failure:&nbsp;Tell your doctor if you or your child have a history of&nbsp;heart failure, as Enbrel must be used with caution in such circumstances.<\/li><li>Cancer:&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 taking Enbrel.&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 Enbrel may be at greater risk of developing&nbsp;lymphoma&nbsp;or other cancers.&nbsp;Some children and teens who have received Enbrel or other medicines that work in a similar way to Enbrel have developed cancer, including unusual types that sometimes lead to death.&nbsp;Some patients who have received Enbrel 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:&nbsp;Tell your doctor if you or your child have been exposed to chickenpox during treatment with Enbrel.&nbsp;Your doctor will decide if prophylactic treatment for chickenpox needs to be prescribed to you.<\/li><li>Latex: The&nbsp;needle cover on the MYCLIC pen is made of latex (dry natural rubber).&nbsp;Contact your doctor before using Enbrel if the needle guard will be handled by, or Enbrel is given to, someone with a known or possible hypersensitivity (&nbsp;allergy&nbsp;) to latex.<\/li><li>Alcohol abuse:&nbsp;Enbrel should not be used for the treatment of&nbsp;hepatitis-related to alcohol abuse.&nbsp;Tell your doctor if you or your child have a history of alcohol abuse.<\/li><li>Wegener&#8217;s granulomatosis:&nbsp;Enbrel is not recommended for the treatment of&nbsp;Wegener&#8217;s granulomatosis, a rare inflammatory disease.&nbsp;Talk to your or your child&#8217;s doctor if you or your child have&nbsp;Wegener&#8217;s granulomatosis.<\/li><li>Medicines for diabetes:&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 Enbrel.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Children and young people<\/h2>\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 Enbrel.&nbsp;Some vaccines, such as the oral polio vaccine, should not be taken while taking Enbrel.&nbsp;Check with your or your child&#8217;s doctor before you or your child receive any vaccination.<\/li><\/ul>\n\n\n\n<p>Enbrel should not normally be used in children under 2 years of age with polyarthritis or extended oligoarthritis, or children under 12 years of age with encephalitis-related&nbsp;arthritis&nbsp;or psoriatic arthritis, or children under 6 years of age with&nbsp;psoriasis.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other medicines and Enbrel<\/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 anakinra, abatacept, and sulfasalazine), including over-the-counter medicines.&nbsp;Do not use Enbrel at the same time as medicines containing anakinra or abatacept as an active substance.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy, breastfeeding, and fertility<\/h2>\n\n\n\n<p>Enbrel should only be used during pregnancy if clearly necessary.&nbsp;Contact your doctor if you become pregnant, think you may be pregnant, or are planning to have a baby.<br><\/p>\n\n\n\n<p>If you have been given Enbrel 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 Enbrel during pregnancy, compared to mothers who had not received Enbrel or other similar drugs (&nbsp;TNF&nbsp;&#8211;&nbsp;antagonist), but no specific type of malformation was reported.&nbsp;Another study did not show an increased risk of malformations when the mother received Enbrel during pregnancy.&nbsp;Your doctor will help you determine if the benefits of treatment outweigh the potential risks to your child.&nbsp;You must tell your infant&#8217;s physician or another healthcare professional that Enbrel has been used during pregnancy before the infant receives any vaccination (see section 2, \u201cVaccinations\u201d for more information).<br><\/p>\n\n\n\n<p>You should not breast-feed while using Enbrel as Enbrel passes into breast milk.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving and using machines<\/h2>\n\n\n\n<p>The use of Enbrel is not expected to affect your ability to drive or use machines.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Important information about latex<\/h2>\n\n\n\n<p>Contact your doctor before using Enbrel, Enbrel will be handled by, or given to anyone with&nbsp;an allergy&nbsp;to latex, since the needle cover to the MYCLIC&nbsp;pen&nbsp;is made from latex.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">3. How to use Enbrel<\/h2>\n\n\n\n<p>Always use this medicine exactly as your doctor has told&nbsp;you.&nbsp;Check with your doctor or pharmacist if you are not sure.<br><\/p>\n\n\n\n<p>If you have the impression that the effect of Enbrel is too strong or too weak, talk to your doctor or doctor<\/p>\n\n\n\n<p>pharmacy staff.<br><\/p>\n\n\n\n<p>You have been prescribed Enbrel 25 mg.&nbsp;There is also Enbrel 50 mg if you are prescribed a&nbsp;dose&nbsp;of 50 mg.<br><\/p>\n\n\n\n<p><strong>Dosage&nbsp;for adult patients (over 18 years)<\/strong><br><\/p>\n\n\n\n<p><em>Rheumatoid arthritis, psoriatic arthritis, and&nbsp;axial&nbsp;spondylarthritis including&nbsp;ankylosing spondylitis<\/em><\/p>\n\n\n\n<p>The recommended&nbsp;dose&nbsp;is 25 mg twice a week or 50 mg once a week as an&nbsp;injection under the skin.&nbsp;Your doctor may determine a different frequency for your&nbsp;injections.<br><\/p>\n\n\n\n<p><em>Plaque psoriasis<\/em><\/p>\n\n\n\n<p>The recommended&nbsp;dose&nbsp;is 25 mg given twice a week or 50 mg given once a week.<br><\/p>\n\n\n\n<p>Alternatively, 50 mg may be given twice a week for up to 12 weeks followed by 25 mg twice a week or 50 mg once a week.<br><\/p>\n\n\n\n<p>Your doctor will decide how long to take Enbrel and if resuming treatment is needed based on the treatment results.&nbsp;If Enbrel 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<h2 class=\"wp-block-heading\">Use for children and adolescents<\/h2>\n\n\n\n<p>The appropriate&nbsp;dose&nbsp;and how often it should be given to your child or adolescent depends on body weight and illness.&nbsp;Your doctor will determine the correct&nbsp;dose&nbsp;for your child and prescribe Enbrel with the appropriate strength (10 mg, 25 mg, or 50 mg).<br><\/p>\n\n\n\n<p>For patients from 2 years of age with polyarthritis or extended oligoarthritis or patients from 12 years of age with encephalitis-related&nbsp;arthritis&nbsp;or psoriatic arthritis, the usual&nbsp;dose is&nbsp;0.4 mg Enbrel per kilogram body weight (up to a maximum of 25 mg per&nbsp;dose&nbsp;) given two times. times a week, or 0.8 mg Enbrel per kilogram body weight (up to a maximum of 50 mg per&nbsp;dose&nbsp;) given once a week.<br><\/p>\n\n\n\n<p>For patients from 6 years of age with&nbsp;psoriasis, the usual&nbsp;dose is&nbsp;0.8 mg Enbrel per kilogram body weight (up to a maximum of 50 mg per&nbsp;dose&nbsp;) given once a week.&nbsp;If Enbrel 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&nbsp;preparing&nbsp;and measuring the correct&nbsp;dose.<br><\/p>\n\n\n\n<p><strong>Method and route of delivery<\/strong><br><\/p>\n\n\n\n<p>Enbrel is injected under the skin (&nbsp;subcutaneous&nbsp;injection&nbsp;).<br><\/p>\n\n\n\n<p>Enbrel can be taken with or without food or drink.<br><\/p>\n\n\n\n<p><strong>Detailed instructions on how to inject Enbrel are provided in section 7 &#8220;Using MYCLIC&nbsp;pen&nbsp;to inject Enbrel&#8221;.&nbsp;<\/strong>Do not mix the Enbrel 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 Enbrel should be taken.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you take more Enbrel than you should<\/h2>\n\n\n\n<p>If you have injected more Enbrel than your doctor has prescribed (either by injecting too much at one time or taking one&nbsp;dose&nbsp;too much) you should contact your doctor or pharmacist immediately.<\/p>\n\n\n\n<p>Always carry the labeled outer packaging of the medicine, even if it is empty.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you forget to use Enbrel<\/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.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you stop using Enbrel<\/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,&nbsp;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 more Enbrel, but contact your doctor or your doctor immediately or the emergency department at the nearest hospital.<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 rash,&nbsp;itching,&nbsp;or hives (red spots or pale skin that often itches)<\/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 Enbrel, 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<\/strong>, such as a high fever that may be associated with coughing, difficulty breathing, feeling weak, or a hot, red, and tense surface in the skin or at a joint.<\/li><li>Symptoms of any&nbsp;blood disease, such as bleeding, bruising,g or pallor.<\/li><li>Symptoms of any&nbsp;neurological disease, such as loss of sensation and a stinging sensation, vision changes, or muscle weakness in the arms or legs.<\/li><li>Symptoms of&nbsp;heart failure&nbsp;or&nbsp;worsening&nbsp;heart failure, such as fatigue or difficulty breathing exertion, swollen ankles, a feeling of swollen neck and abdomen, difficulty breathing at night, cough or bluish color on nails or lips.<\/li><li>Symptoms&nbsp;of cancer: 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;autoimmune reactions&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;inflammatory&nbsp;bowel disease&nbsp;(lupus) or lupus-like syndromes such as weight change, persistent rash, fever, joint or muscle aches, or fatigue.<\/li><li>Symptoms of&nbsp;inflammation&nbsp;of the blood vessels&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 unusual&nbsp;side effects, but serious (some of them can be fatal).&nbsp;If any of the above symptoms occur, contact your or your child&#8217;s physician or the emergency department at the nearest hospital immediately.<br><\/p>\n\n\n\n<p>Known&nbsp;side effects&nbsp;of Enbrel are the following, divided into groups according to decreasing frequency:<br><\/p>\n\n\n\n<p>\u2022&nbsp;<strong>Very common<\/strong>&nbsp;(may affect more than 1 user in 10):<\/p>\n\n\n\n<p>Infections&nbsp;(including upper respiratory tract infections,&nbsp;bronchitis, urinary tract infections, skin infections), injection site reactions (such as bleeding, bruising,&nbsp;redness,&nbsp;itching, pain, swelling) (these often subside after the first month of treatment, some patients develop a reaction at an injection site that has recently used) and headache.<br><\/p>\n\n\n\n<p>\u2022&nbsp;<strong>Common<\/strong>&nbsp;(may affect up to 1 in 10):<\/p>\n\n\n\n<p>Allergic reactions, fever, rash,&nbsp;itching,&nbsp;antibody&nbsp;are directed against normal&nbsp;tissue(autoantibody formation).<br><\/p>\n\n\n\n<p>\u2022&nbsp;<strong>Uncommon<\/strong>&nbsp;(may affect up to 1 in 100 people):<\/p>\n\n\n\n<p>Severe&nbsp;infections&nbsp;(including&nbsp;pneumonia, deep skin infections, joint infections, sepsis, and&nbsp;infections&nbsp;in various places), worsening&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 number&nbsp;platelets, skin cancer (excluding&nbsp;melanoma&nbsp;), local swelling of the skin (&nbsp;angioedema&nbsp;), hives (red spots or pale skin that often itches), eye inflammation,&nbsp;psoriasis&nbsp;(new onset or worsening),&nbsp;inflammation&nbsp;in the blood vessels that can affect several organs, elevated liver values \u200b\u200bin blood tests (in patients who also receive methotrexate, the frequency of elevated liver values \u200b\u200bis &#8220;normal&#8221;), cramps and pain in the stomach, diarrhea, weight loss or blood in the stool (signs of intestinal disease).<br><\/p>\n\n\n\n<p>\u2022&nbsp;<strong>Rare<\/strong>&nbsp;(may affect up to 1 in 1,000 people):<\/p>\n\n\n\n<p>Severe allergic reactions (including severe local swelling of the skin and wheezing),&nbsp;lymphoma&nbsp;(a type of blood cancer),&nbsp;leukemia&nbsp;(cancer affecting the blood and&nbsp;bone marrow&nbsp;),&nbsp;melanoma&nbsp;(a type of skin cancer), a combination of low&nbsp;platelet counts&nbsp;, redness and&nbsp;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;, new-onset&nbsp;heart failure, seizures, lupus or lupus-like symptoms (symptoms include persistent rash, fever, joint pain and fatigue), skin rash that may lead to severe blistering and flaking of the skin, lichenoid reactions (itchy red-purple skin rash and \/ or thread-like white-gray lines on mucous membranes ),&nbsp;inflammation&nbsp;of the liver caused by the body&#8217;s own immune system (&nbsp;autoimmune&nbsp;hepatitis&nbsp;, in patients who also receive methotrexate the frequency is &#8220;less common&#8221;), immune disease that can affect the lungs, skin and lymph nodes (&nbsp;sarcoidosis&nbsp;),&nbsp;inflammation&nbsp;or&nbsp;fibrosis&nbsp;in the lungs (in patients who also get methotrexate is the frequency of&nbsp;inflammation&nbsp;or&nbsp;fibrosis&nbsp;in the lungs \u201cless common\u201d).<br><\/p>\n\n\n\n<p>\u2022&nbsp;<strong>Very rare<\/strong>&nbsp;(may affect up to 1 in 10,000 people):<\/p>\n\n\n\n<p>The inability of&nbsp;bone marrow&nbsp;to produce&nbsp;blood cells&nbsp;(&nbsp;aplastic anemia&nbsp;).<br><\/p>\n\n\n\n<p>\u2022&nbsp;<strong>No known frequency<\/strong>&nbsp;(cannot be calculated from the available data):<\/p>\n\n\n\n<p>Merkel cell cancer (a type of skin cancer).&nbsp;Kaposi&#8217;s sarcoma, rare cancer associated with&nbsp;infection&nbsp;with human herpesvirus 8&nbsp;Kaposi sarcoma&nbsp;occurs most often as purple spots on the skin.&nbsp;Overactivation of&nbsp;white blood cells&nbsp;associated with&nbsp;inflammation(macrophage activation syndrome), reactivation of&nbsp;hepatitis&nbsp;B (a liver infection), worsening of a condition called&nbsp;dermatomyositis&nbsp;(muscle inflammation and weakness accompanied by skin rash).<br><\/p>\n\n\n\n<p><strong>Side effects&nbsp;are in children and adolescents<\/strong><\/p>\n\n\n\n<p>Side effects&nbsp;and frequency of side effects in children and adolescents are the same as in adults, see the description above.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">5. How to store Enbrel<\/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 the label 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 &#8211; 8 \u00b0 C).<\/p>\n\n\n\n<p>Do not freeze.<\/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 the Enbrel pre-filled&nbsp;pen&nbsp;from the refrigerator,&nbsp;<strong>wait 15-30 minutes for the Enbrel solution to reach room temperature<\/strong>, do not heat Enbrel in any other way. Immediate use is then recommended.<br><\/p>\n\n\n\n<p>Enbrel can be stored outside the refrigerator at temperatures up to a maximum of 25 \u00baC for a single period of up to four weeks, after which it should not be stored in the refrigerator again.&nbsp;Enbrel should be discarded if not used within four weeks of removal from the refrigerator.&nbsp;It is recommended that you note the date that Enbrel is removed from the refrigerator and the date when Enbrel 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 pre-filled pen by looking through the transparent inspection window.&nbsp;It should be clear or slightly opalescent, colorless to pale yellow or light brown, and may contain small white or almost transparent particles of&nbsp;protein.&nbsp;This appearance is normal for Enbrel.&nbsp;Do not use the solution if it is discolored, cloudy or if particles other than those described above are present.&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<p>The active substance in Enbrel is etanercept.&nbsp;Each MYCLIC prefilled&nbsp;pen&nbsp;contains 25 mg etanercept.<br><\/p>\n\n\n\n<p>Other ingredients are:<\/p>\n\n\n\n<p>Sucrose, sodium chloride, L-arginine hydrochloride, sodium dihydrogen phosphate dihydrate, disodium phosphate dihydrate, and water for&nbsp;injections<\/p>\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>Enbrel is supplied as an&nbsp;injection&nbsp;solution, in a pre-filled&nbsp;pen&nbsp;(MYCLIC) (Solution for&nbsp;injection&nbsp;).&nbsp;MYCLIC&nbsp;pen&nbsp;contains a clear, colorless to pale yellow or light brown&nbsp;injection.&nbsp;Each pack contains 4, 8, or 24 pre-filled pens and 4, 8, or 24&nbsp;compresses&nbsp;of alcohol for use before&nbsp;injection.<br><\/p>\n\n\n\n<p><em>Not all pack sizes may be marketed.<\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorization Holder and Manufacturer<\/h2>\n\n\n\n<p><em>Marketing Authorisation Holder<\/em><\/p>\n\n\n\n<p>Pfizer Europe MA EEIG<\/p>\n\n\n\n<p>Boulevard de la Plaine 17<\/p>\n\n\n\n<p>1050 Brussels<\/p>\n\n\n\n<p>Belgium<br><\/p>\n\n\n\n<p><em>Manufacturer<\/em><\/p>\n\n\n\n<p>Pfizer Manufacturing Belgium NV<\/p>\n\n\n\n<p>Rijksweg 12,<\/p>\n\n\n\n<p>2870 Puurs<\/p>\n\n\n\n<p>Belgium<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\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><td>Belgium \/ Belgique \/ BelgienLuxembourg \/ LuxemburgPfizer SA \/ NVTel: +32 (0) 2 554 62 11<\/td><td>\u038e\u03c0\u03c1\u03bf\u03c2PFIZER EAA AE (CYPRUS BRANCH).T\u03b7\u03bb: +357 22 817690<\/td><\/tr><\/thead><tbody><tr><td>Czech RepublicPfizer spol.&nbsp;sroTel: + 420-283-004-111<\/td><td>HungaryPfizer Kft.Tel: +36 1 488 3700<\/td><\/tr><tr><td>DenmarkPfizer ApSTel: +45 44 201 100<\/td><td>MaltaVivian Corporation Ltd.Tel: +35621 344610<\/td><\/tr><tr><td>GermanyPfizer Pharma GmbHTel: +49 (0) 30 550055-51000<\/td><td>The NetherlandsPfizer bvTel: +31 (0) 10 406 43 01<\/td><\/tr><tr><td>Bulgaria Pfizer of Luxembourg, Clone of BulgariaTel: +359 2 970 4333<\/td><td>NorwayPfizer ASTel: +47 67 52 61 00<\/td><\/tr><tr><td>EestiPfizer Luxembourg SARL, Estonian branchTel: +372 666 7500<\/td><td>AustriaPfizer Corporation Austria Ges.mbHTel: +43 (0) 1 521 15-0<\/td><\/tr><tr><td>GreecePFIZER E\u039b\u039bA\u03a3 AE.:\u0397\u03bb .: +30 210 6785 800<\/td><td>PolandPfizer Polska Sp.&nbsp;z ooTel .: +48 22 335 61 00<\/td><\/tr><tr><td>SpainPfizer, SLTel: +34 91 490 99 00<\/td><td>PortugalPfizer Laboratories, Lda.Tel: +351 21 423 5500<\/td><\/tr><tr><td>FrancePfizerPhone +33 (0) 1 58 07 34 40<\/td><td>RomaniaPfizer Romania SRLTel: +40 (0) 21 207 28 00<\/td><\/tr><tr><td>CroatiaPfizer Croatia dooTel: +385 1 3908 777<\/td><td>SloveniaPfizer Luxembourg SARL, Pfizer, underwriter for cleaning and pharmaceutical pharmaceuticalsdejavnosti, LjubljanaTel: +386 (0) 1 52 11 400<\/td><\/tr><tr><td>IrelandPfizer Healthcare IrelandTel: +1800 633 363 (toll free)Tel: +44 (0) 1304 616161<\/td><td>Slovak RepublicPfizer Luxembourg SARL, organizerTel: +421 2 3355 5500<\/td><\/tr><tr><td>IcelandIcepharma hf.Tel: +354 540 8000<\/td><td>Finland \/ FinlandPfizer OyPuh \/ Tel: +358 (0) 9 430 040<\/td><\/tr><tr><td>LatviaPfizer Luxembourg SARL subsidiary Latvij\u0101Tel.&nbsp;+371 67035775<\/td><td>United KingdomPfizer LimitedTel: +44 (0) 1304 616161<\/td><\/tr><tr><td>LithuaniaPfizer Luxembourg SARL branches in LithuaniaTel.&nbsp;+3705 2514000<\/td><\/tr><\/tbody><\/table><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Enbrel 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":[2205,2200],"tags":[4258,4261,4260,3941,4257,4256,3943,2215,2213,4259,3942],"class_list":["post-8147","post","type-post","status-publish","format-standard","hentry","category-e","category-medicines","tag-enbrel","tag-enbrel-injection","tag-enbrel-side-effects","tag-etanercept","tag-etanercept-dose","tag-etanercept-injection","tag-etanercept-side-effects","tag-injection","tag-medicines","tag-what-is-enbrel","tag-what-is-etanercept"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/8147","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=8147"}],"version-history":[{"count":4,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/8147\/revisions"}],"predecessor-version":[{"id":10530,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/8147\/revisions\/10530"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=8147"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=8147"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=8147"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}