Enbrel (etanercept)

Etanercept (Enbrel) is an engineered biologic medication approved for the treatment of RA.1

Enbrel is an combination (fusion) protein made of two different components that block the action of tumor necrosis factors α and β (TNF-α and TNF-β) in the body. TNFs are normal 2

All biologic medicines approved for use against RA improve the symptoms of arthritis, reduce joint damage, improve functional ability, and increase the quality of life patients with RA.2

Enbrel is not available in generic forms.

What are the ingredients in Enbrel?

The active ingredient in Enbrel is etanercept.1

How does Enbrel work?

Enbrel is an engineered protein consisting of two components that bind to TNF-α and TNF-β, both important immune system signaling factors (called a cytokines) that play a key role in swelling and inflammation. Blocking these factors prevents them from interacting with their receptors, which helps tamp down the damage caused by the dysfunction of the immune system that is characteristic of RA.1,2

What are the possible side effects of Enbrel?

Common side effects with Enbrel include3,4:

  • redness, itching, pain, or swelling at the site of injection
  • headache
  • nausea
  • vomiting
  • heartburn
  • stomach pain
  • weakness
  • cough
  • upper respiratory infection

In some patients, Enbrel can cause more harmful side effects. Patients who take Enbrel are at increased risk for serious infections, including tuberculosis, invasive fungal infections, viral infections, bacterial infections, and other opportunistic infections (infection caused by a microorganism that does not normally cause infection in humans, typically due to an abnormally functioning immune system).3

Children and adolescents taking Enbrel are also at slightly higher risk for lymphoma and other cancers. Other rare but serious side effects include heart failure, Hepatitis B reactivation, nerve diseases like multiple sclerosis, certain blood disorders, and lupus-type symptoms.4

This is not an exhaustive list of all potential side effects of Enbrel. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects, contact your doctor or healthcare provider immediately.

Things to note about Enbrel

Before taking Enbrel, tell your doctor if you1:

  • Have a current infection or are prone to recurring infections, including open cuts
  • Have HIV, diabetes, or a weakened immune system
  • Have tested positive for TB or have been in close contact with someone who has TB
  • Live in areas of the US where known for fungal infections, including the Ohio and Mississippi Valley and the southwest
  • Have any nervous system problems like multiple sclerosis or Guillain-Barré syndrome
  • Have or have had congestive heart failure
  • Are scheduled to have surgery
  • Are scheduled to receive a vaccine
  • Have or have had Hepatitis B
  • Are pregnant or plan to become pregnant or are breastfeeding

Enbrel should not be taken if you have sepsis (a condition in which harmful bacteria or other toxins are present in tissues, usually due to an infected wound).4

With Enbrel, there is an increased risk for serious infections. This is because Enbrel can decrease the ability of the immune system to fight infections. If an infection develops while you are taking Enbrel, or if you have a severe allergic reaction, contact your doctor immediately.4

Patients taking this medication should not receive live vaccines. Tell your doctor about any medications or supplements you are taking while on Enbrel, because certain medicines don’t mix well with this medication. It is important for doctors to test you for TB before you take Enbrel and to monitor for heart problems, infection, and nerve damage while you are on the medication.4

Dosing information

Enbrel is taken as a subcutaneous (under the skin) injection of 50 mg once a week. It comes as a liquid in a prefilled syringe, in an automatic injection device, and as a powder that gets mixed with a provided liquid. You will receive your first injection of Enbrel at a medical office. After that, you can inject the medication at home.3

Some preparations of the medication come in vials that hold more than one dose. You should refrigerate any medicine remaining in your vial. Before injecting Enbrel, bring the medicine to room temperature for 15 to 20 minutes before use.3

If you are administering Enbrel to yourself, make sure you have been fully instructed on how to measure and administer the correct dose. See the “Instructions for Use” booklet that comes with the medication or call your doctor if you have questions.3

Written by: Sara Finkelstein | Last reviewed: June 2018.
View References
  1. Medication Guide Enbrel. Amgen, Thousand Oaks, CA. Revised November 2016. https://www.enbrel.com/-/media/project/enbrel/discussion-guides/enbrel_mg.ashx Accessed May 27, 2018.
  2. Carolina Negrei, Violeta Bojinca, Andra Balanescu, et. al., Management of rheumatoid arthritis: Impact and risks of various therapeutic approaches. Exp Ther Med. 2016 Apr; 11(4): 1177–1183. Published online 2016 Feb 2. doi: 10.3892/etm.2016.3045 Accessed May 26, 2018.
  3. Etanercept Injection. MedlinePlus. US National Library of Medicine. Bethesda, MD. Revised August 15, 2017. https://medlineplus.gov/druginfo/meds/a602013.html Accessed May 27, 2018.
  4. Prescribing Information. Enbrel. Amgen and Pfizer, Thousand Oaks, CA. Revised November 2012. https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/103795s5503lbl.pdf Accessed May 27, 2018.