Enbrel (etanercept) is a biologic medicine that targets a protein called TNF-alpha (tumour necrosis factor alpha), which plays a key role in driving inflammation. By blocking TNF-alpha, Enbrel reduces the inflammation thzat causes pain, swelling, and tissue damage in several chronic conditions.

Enbrel is used to treat:

• Rheumatoid arthritis (RA): Moderate to severe RA in adults, alone or with methotrexate
• Psoriatic arthritis: Joint inflammation associated with psoriasis
• Ankylosing spondylitis: Inflammatory arthritis affecting the spine
• Plaque psoriasis: Moderate to severe plaques on the skin in adults and children
• Juvenile idiopathic arthritis (JIA): Certain types of JIA in children aged 2 years and over

How it works:

TNF-alpha is a chemical messenger that the immune system uses to trigger inflammation. In conditions like RA and psoriasis, TNF-alpha is overproduced, causing sustained and damaging inflammation. Enbrel acts as a decoy receptor, binding to TNF-alpha and neutralising it before it can trigger an inflammatory response.

Your dose:

For adults with RA or ankylosing spondylitis: 50mg once weekly, or 25mg twice weekly. For plaque psoriasis: 50mg twice weekly for the first 12 weeks, then 50mg once weekly. Your doctor will confirm the right dose for your condition.

Before you start:

• You will be screened for tuberculosis (TB) and hepatitis B before starting Enbrel
• Tell your doctor about all medicines, vitamins, and supplements you take
• Let your doctor know about any history of infections, heart failure, nerve conditions (such as MS or optic neuritis), or previous cancer
• Tell your doctor if you are pregnant or planning to become pregnant

How it's given:

• Enbrel is injected under the skin (subcutaneously), usually into the thigh, abdomen, or upper arm
• Your nurse will train you or your carer to self-inject at home
• Allow the syringe or pen to reach room temperature for 15 to 30 minutes before injecting
• Rotate injection sites to avoid skin reactions

• If you use it once weekly: inject as soon as you remember, then continue on your usual weekly day
• If you use it twice weekly: inject the missed dose as soon as you remember, then continue on your original schedule
• If it is nearly time for your next dose: skip the missed one and carry on as normal
• Never inject a double dose

If you think you have injected more than prescribed, contact your doctor or go to your nearest emergency department. Bring your medicine packaging.

• Store in the fridge at 2°C to 8°C
• Do not freeze. If frozen, do not use
• Keep in the original packaging to protect from light
• For short trips, Enbrel can be stored at room temperature up to 25°C for up to 4 weeks. Once removed from the fridge, do not put it back, and discard if not used within 4 weeks
• Keep out of reach of children and pets

Like all biologic medicines, Enbrel can cause side effects.

The most important ones to know about are:

• Infections: Blocking TNF-alpha reduces your immune defences. Seek medical attention promptly if you develop a fever, chills, cough, or feel generally unwell
• Injection site reactions: Redness, bruising, itching, or pain at the injection site are common, especially at first. Rotating sites helps
• Reactivation of TB or hepatitis B: This is why screening is done before starting
• Heart failure: Enbrel should not be used in people with moderate to severe heart failure. Tell your doctor if you notice increasing breathlessness or leg swelling
• Neurological problems: Rare cases of nerve conditions (such as optic neuritis or MS-like symptoms) have been reported. Tell your doctor immediately if you notice visual disturbances, numbness, or weakness
• Blood disorders: Rarely, serious decreases in blood cell counts can occur. Seek medical help if you notice unusual bruising or persistent fever

Contact your doctor or pharmacist if any side effect concerns you.

Tell your doctor and pharmacist everything you are taking.

Key interactions include:

• Other biologics: Combining Enbrel with other biologic medicines significantly increases infection risk and is not recommended
• Anakinra: Do not use Enbrel alongside anakinra (an IL-1 blocker). This combination carries a high risk of serious infection
• Live vaccines: Avoid live vaccines during treatment. Discuss any vaccinations with your doctor
• Methotrexate: Commonly used with Enbrel for RA. Both affect the immune system, so regular monitoring is needed

Never start, stop, or change any medicine without speaking to your doctor first.

How long before Enbrel works?

Many people notice some improvement within the first few weeks of treatment. For skin conditions like psoriasis, significant clearing is often seen within 12 weeks. For joint conditions, full benefit may take 3 to 6 months. Your doctor will assess your response at regular intervals.

Can I have surgery while on Enbrel?

Because Enbrel affects the immune system, your surgeon and rheumatologist will usually advise pausing it before elective surgery to reduce the risk of infection or delayed wound healing. The timing depends on the procedure. Always tell your surgical team you are on Enbrel before any planned operation.

Ace provides accurate and independent information medically reviewed on prescription medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.