Etanercept Drug information

Etanercept can be used for several types of inflammatory arthritis. Etanercept should effectively treat Your doctor may decide your condition, and prevent joint not to prescribe etanercept damage. It has been tested and has if you’ve ever had: helped many people. As with all drugs • repeated or serious infections some people will have side-effects. • multiple sclerosis (MS) • cancer What is etanercept • a serious heart condition and how is it used? • lung fibrosis (scarring In rheumatoid arthritis and some of the lung tissue). other conditions, too much of a Before starting etanercept you’ll protein called TNF is produced causing have a chest x-ray and tests to inflammation, pain and damage to check if you’ve ever been exposed the bones and joints. Anti-TNF drugs to tuberculosis (TB). You may need such as etanercept block the action of treatment for latent (asymptomatic) TNF and so reduce this inflammation. TB before starting etanercept. You’ll Etanercept isn’t a painkiller, but also be checked for previous hepatitis can modify the disease and should infection, as etanercept may increase start to improve your symptoms the risk of hepatitis being reactivated. over a period of 2–12 weeks. You may have further blood Etanercept can be prescribed for: tests while you’re on etanercept to monitor its effects. • rheumatoid arthritis • psoriatic arthritis When and how do I • ankylosing spondylitis • juvenile idiopathic arthritis (JIA). take etanercept? Etanercept can be taken either once National and local guidelines or twice a week, depending on which determine when it can be brand you are using and your dosage. prescribed, according to which It is administered as an injection under condition you have. It’s usually the skin (subcutaneous injection) given along with other disease- using a pre-filled pen-like syringe modifying drugs – for example, – these should be stored in the methotrexate or sulfasalazine. fridge. You, your partner, or another Etanercept won’t be started if: member of your family can learn to give these injections at home. • your arthritis isn’t active • you have an infection Because it’s a long-term treatment, it’s • you haven’t tried other treatments important to keep taking etanercept appropriate for your condition first. (unless you have severe side-effects): • even if it doesn’t seem to be working at first • even when your symptoms start to improve (to help keep the disease under control). Your symptoms Etanercept was originally available should start to only under the brand name Enbrel. improve within More recently, a new version of 12 weeks. etanercept with the brand name Benepali has become available. This new drug is referred to as a ‘bio-similar’ because it’s meant to act in the same way as the original drug. Because this drug is newer, we don’t yet know as much about it in terms of safety and effectiveness in • a mild fever all the situations described in this • headaches leaflet. Benepali is only licensed for • dizziness adults aged 18 and over, whereas • a rash Enbrel can be prescribed to children • stomach pain or indigestion. from the age of 2 years old as Some people may have reactions well as to adults. Some known at the injection site such as redness, risks associated with Enbrel are swelling or pain. Regularly changing thought to apply to Benepali, for the injection site will help reduce example, people taking Benepali the chances of this irritation. are warned that they are more at risk of infectious diseases such as Because etanercept affects the tuberculosis. If you are currently immune system, it can make you being treated with Enbrel and it more likely to pick up infections. It can is proposed that you change to also make them harder to spot. Tell Benepali, we strongly advise you your doctor or rheumatology nurse discuss this with your rheumatology straight away if you develop any signs team before any change is made. of infection such as a sore throat or fever, or have unexplained bruising, Possible risks and side-effects bleeding or paleness, or any other new symptoms that concern you. If The most common side-effects are: any of these symptoms are severe, • a blocked or runny nose you should stop taking etanercept • nausea (feeling sick) and see your doctor straight away. You should also see your doctor if you Taking other medicines develop chickenpox or shingles or come into contact with someone who Etanercept may be prescribed has chickenpox or shingles. These along with other drugs, including illnesses can be more severe if you’re methotrexate. Check with your on etanercept. You may need antiviral doctor before starting any new treatment, and your etanercept may medications, and remember to be stopped until you’re better. mention you’re on etanercept if you’re treated by anyone other than Rarely, people may have an allergic your usual rheumatology team. reaction. Contact your healthcare team if you think this may be • You can carry on taking non- happening. If the reaction is severe steroidal anti-inflammatory the drug will have to be stopped. drugs (NSAIDs) or painkillers Anti-TNF drugs have been if needed, unless your doctor associated with some types of advises otherwise. skin cancer – these can be readily • Don’t take over-the-counter or treated when diagnosed early. herbal remedies without discussing Research so far hasn’t confirmed this first with your healthcare team. an increased risk of other cancers. It’s recommended that you Very rarely, etanercept may cause carry a biological therapy alert a condition called drug-induced card so anyone treating you will lupus, which can be diagnosed by a know that you’re on etanercept blood test. Symptoms include a rash, – you can get a card from your fever and increased joint pain. If you rheumatology department. develop these symptoms you should contact your rheumatology team. This Vaccinations condition is generally mild and usually clears up if etanercept is stopped. It’s best to discuss vaccinations with your healthcare team Reducing the risk of infection before starting etanercept. It’s usually recommended that people • Try to avoid close contact with on etanercept avoid live vaccines such people with severe active infections. as yellow fever. However, sometimes • For advice on avoiding infection a live vaccine may be necessary – from food, visit: http://www.nhs. for example, rubella immunisation uk/Conditions/Food-poisoning/ in women of childbearing age. Pages/Prevention.aspx If you’re offered shingles vaccination (Zostavax) it’s best if you can have this before starting etanercept. Shingles thinking of breastfeeding we suggest vaccination isn’t recommended for you discuss your medications people who are already on etanercept. with your rheumatologist. Pneumococcal vaccine (which Current guidelines state that protects against the most common etanercept can be used during cause of pneumonia) and yearly flu pregnancy and in men trying to vaccines are safe and recommended. father a child. If it’s used during If possible, children should have pregnancy it will usually be stopped the standard immunisations before after about six months. If it’s used starting etanercept. Measles, mumps after this, then it’s possible (though and rubella (MMR) immunisation not proven) that it may increase the may need to be delayed in children risk of infection in the newborn baby. being treated with etanercept. However, if there’s concern that your arthritis may flare up if etanercept Having an operation is stopped then you can continue with it throughout your pregnancy Talk this over with your specialists. – in this case, your baby should not It’s likely you’ll be advised to have any live vaccines (such as BCG) stop etanercept for a time until they’re seven months old. before and after surgery. Women who are also on methotrexate should stop taking it Alcohol and use contraception for at least There’s no known interaction three months before trying for a baby. between etanercept and alcohol. The guidelines state that there’s no However, if you’re also taking need for men to stop methotrexate methotrexate, you should keep well when trying to father a baby. within the recommended limits of There’s only limited information no more than 14 units of alcohol per about the use of etanercept while week for adults because methotrexate breastfeeding, but we have no and alcohol can interact and affect your liver. In some circumstances evidence that it’s harmful. If you were your doctor may advise lower limits. also taking methotrexate before your pregnancy this should not be re- started until you stop breastfeeding. Fertility, pregnancy and breastfeeding If you’re planning to try for a baby, if you become pregnant, or if you’re Arthritis Research UK Thank you for supporting Arthritis works to improve the Research UK. 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We’re dedicated to funding research into We would like to thank the team of people the cause, treatment and cure of arthritis who contributed to the development of this so that people can live pain-free lives. booklet. It was written by Dr Elizabeth Rankin and updated by Drs Alison Jordan and Ian Giles. For more expert information visit our An Arthritis Research UK medical advisor, website or if you would like to tell us Dr Neil Snowden, is responsible for the what you think about our booklets email content overall. [email protected] or write to the address below. Please note: we have made every effort to ensure that this content is correct at time of Arthritis Research UK publication, but remember that information about drugs may change. This information Copeman House sheet is for general education only and does St Mary’s Gate not list all the uses and side-effects associated Chesterfield with this drug. S41 7TD 0300 790 0400 www.arthritisresearchuk.org

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