ENBREL Rheumatology FAQs

Have a question about ENBREL? Call 1-888-4ENBREL (1-888-436-2735) and we'll be happy to help. Live support is available in over 200 languages. You can also find answers to the most frequently asked questions below.

  • Getting Started
  • Insurance Basics
  • Dosing & Injection
  • Safety Information
  • All

Getting Started

How should I store ENBREL?

ENBREL should be kept cool—at 36°F to 46°F (2°C to 8°C; the standard temperature range of most refrigerators). However, the ENBREL syringe, autoinjector, and dose tray for the multi-use vial can be stored at room temperature between 68°F to 77°F (20°C to 25°C) for up to 14 days.

Learn more about traveling with and storing ENBREL.

Should I let ENBREL warm up before I inject it?

You may want to wait 15 to 30 minutes after you take ENBREL from the refrigerator to allow it to reach room temperature. Do NOT remove the needle cover while you wait. Do NOT warm ENBREL in any other way (for example, do NOT warm it in a microwave or in hot water).

Tip: Set your kitchen timer to remind you that 15 minutes has passed.

Learn more about injecting ENBREL.


Insurance Basics

My physician prescribed ENBREL for me. Can you tell me if my health insurance company will cover it?

Yes, we'd be happy to contact your insurance company for you to find out if ENBREL is covered. You can verify your insurance coverage online or call to speak to one of our insurance specialists at 1-888-4ENBREL (1-888-436-2735). Please have your insurance card and information ready when you call us.

Read more about insurance verification and paying for ENBREL.

My health insurance company does not cover ENBREL. Can you help?

Yes, we can help. Our insurance specialists at 1-888-4ENBREL (1-888-436-2735; Monday through Friday, 8 AM to 8 PM Eastern time) will do all they can to help. There are several steps that we can take to help you receive payment from your health insurance company. Once we determine the reason that the health insurance company is not covering ENBREL, we can discuss the next best steps. For example, we have materials to assist you and your doctor in asking for coverage, such as sample advocacy letters, appeal letters, and letters of medical necessity.

Read more about paying for ENBREL.

Does Medicaid cover ENBREL?

We would be happy to find out for you. Each Medicaid agency is different. We can call your agency and ask about your coverage. Just give us a call at 1-888-4ENBREL (1-888-436-2735), and choose option #6. Our specialists are available from 8 AM to 8 PM ET, Monday through Friday.

Read more about government insurance assistance.

Does Medicare cover ENBREL used for ongoing therapy?

Coverage of medications and length of coverage vary for each plan under Medicare. If you receive Medicare, you can sign up for a plan that can help cover the cost of ENBREL.

To learn more about Medicare, please visit Medicare.gov or call 1-888-4ENBREL (1-888-436-2735), and choose option #6. Our Medicare Solutions specialists are available from 8 AM to 8 PM ET, Monday through Friday.

Read more about Medicare Solutions.

Can you help me work through the process of getting prior authorization for ENBREL?

Yes. Insurance specialists can help you and your physician with prior authorization. Please call our insurance specialists at 1-888-4ENBREL (1-888-436-2735) 8 AM to 8 PM Eastern time, Monday through Friday, with your insurance information to get started.

Read more about paying for ENBREL.


Dosing & Injection

How often do I need to take ENBREL?

Your doctor will tell you how often you should use ENBREL. This amount is based on the condition being treated. Do NOT use ENBREL more often than prescribed.

The recommended dose of ENBREL for adult patients with moderately to severely active rheumatoid arthritis or with ankylosing spondylitis or psoriatic arthritis is 50 mg per week. A 50-mg dose can be given as one subcutaneous injection (an injection beneath the skin) using either a 50-mg/mL Enbrel® SureClick® autoinjector or a 50-mg/mL single-use prefilled syringe. A 50-mg dose can also be given as two 25-mg subcutaneous injections using 25-mg/0.5-mL single-use prefilled syringes or 25-mg vials.

How often does my child need to take ENBREL?

The recommended dose of ENBREL for pediatric patients ages 2 to 17 years with moderately to severely active polyarticular juvenile idiopathic arthritis is 0.8 mg/kg per week (up to a maximum of 50 mg per week). For pediatric patients weighing 63 kg (138 pounds) or more, the weekly dose of 50 mg may be given using Enbrel® SureClick® autoinjectors or prefilled syringes. For pediatric patients weighing 31 kg to 62 kg (68 pounds to 136 pounds), the total weekly dose should be given as two subcutaneous (an injection beneath the skin) injections, either on the same day or 3 or 4 days apart. The dose for pediatric patients weighing less than 31 kg (68 pounds) should be given as a single subcutaneous injection once weekly using the correct volume from the 25-mg vial mixed via the free-hand method.

Where on the body should ENBREL be injected?

On the front of the middle thighs or on the stomach, except for the 2-inch area around the belly button. These areas usually have enough tissue for the injection and are easy to reach. If a parent or caregiver is giving the injection, the outer area of the upper arms is another option.

Use a different site from those used the last couple of times. DO NOT inject into areas where the skin is tender, bruised, red, or hard. Avoid areas with scars or stretch marks.

If you have plaque psoriasis, you should try not to inject directly into any raised, thick, red, or scaly skin patches or lesions.

View injection demonstrations.

Sometimes the skin around the injection site becomes red and itchy. Is this normal?

Yes, sometimes this can happen. In medical studies, some patients experienced mild to moderate injection site reactions, usually within the first month. Most reactions healed and patients could keep taking ENBREL. If you have any concerns, talk to your doctor.

Read more about potential side effects.

When using the 25-mg vial (where mixing the liquid and powder is required), after mixing the liquid and the powder, the solution appeared cloudy. Does this matter?

It's important to make sure the solution is clear before injecting. Before mixing, the powder should be white. After you add the liquid (diluent), the powder usually dissolves in about 10 minutes. The mixed solution should be clear and colorless. (A small amount of foam or bubbles may be present; this is normal.) Do NOT inject the solution if it is discolored, or if it contains lumps, flakes, or colored particles. If all the powder in the ENBREL vial is not dissolved or there are particles present after 10 minutes, call 1-888-4ENBREL (1-888-436-2735).

What should I do with my needles, syringes, or autoinjectors after I inject?

You should not throw used needles or syringes into a regular garbage can or recycling bin. Immediately after each injection, you should discard them in a puncture-resistant container, often called a sharps disposal container, specifically designed for their disposal. These safe containers can be purchased at your local pharmacy or are available through ENBREL Support™. NEVER recap or reuse a needle, syringe, or an autoinjector. Keep all materials and sharps disposal containers out of the reach of children.

What should I do with my needle disposal container once it's full?

Once you've filled your sharps disposal container with used needles, syringes, or autoinjectors, you need to throw it out using the directions from your health care professional. For public safety reasons, containers generally require special disposal. State and local laws for disposing of needles vary from town to town. For information in your area, call 1-888-4ENBREL (1-888-436-2735).

Important: Do NOT recycle the sharps disposal container. Never put your sharps disposal container in the trash with other plastic recyclables (unless your local laws permit this). Never empty the contents of your sharps disposal container in order to reuse it.

You can also sign up for the ENBREL Sharps Mail-Back Program, which gives you a safe convenient way to dispose of your sharps materials at no cost to you. Call 1-888-4ENBREL (1-888-436-2735) to enroll.

Can I still use ENBREL if I take it out of the refrigerator but don't use it right away?

ENBREL can stay at room temperature (between 68°F to 77°F) for up to 14 days. However, it's important to remember that once ENBREL reaches room temperature, you cannot put it back in the refrigerator.

Throw away ENBREL that has been stored at room temperature after 14 days. Mixed ENBREL powder should be used right away or kept in the refrigerator at 36°F to 46°F (2°C to 8°C) for up to 14 days.

If you have any questions about storing and using ENBREL, call us toll-free at 1-888-4ENBREL (1-888-436-2735).

Learn more about traveling with and storing ENBREL.

What should I do if the needle is bent or the autoinjector is damaged?

If a needle or an autoinjector is damaged in any way, don't try to fix it or use it. If a syringe or an autoinjector is damaged, please do NOT throw it away. Call 1-888-4ENBREL for further instructions and we will help you.

Remember to review the proper techniques for preparing ENBREL that come in each carton of ENBREL.

How should I travel with ENBREL?

There are several options for traveling with ENBREL. 1) Keep ENBREL at room temperature (between 68°F to 77°F) for up to 14 days. But remember that once ENBREL reaches room temperature, you cannot put it back in the refrigerator. Or, 2) Keep ENBREL cool—at 36°F to 46°F (2°C to 8°C). Transport ENBREL in its original packaging, wrap it in bubble wrap, and place it in your travel cooler provided by ENBREL Support™.

  • Do NOT store ENBREL in extreme heat or cold. For example, avoid storing ENBREL in your vehicle's glove box or trunk.
  • Do NOT freeze.
  • Do NOT shake.
  • Store ENBREL in the original carton to protect from light or physical damage.
  • Keep ENBREL and all medicines out of the reach of children.

Then, pack it with ice. Put a thermometer in the cooler and check it every few hours. Add ice as necessary to keep the temperature at 36°F to 46°F (2°C to 8°C). Some hotels may have small refrigerators. Check with the hotel before your arrival. If you're traveling by air, please call the airline ahead of time. You can call 1-888-4ENBREL (1-888-436-2735) to get a free ENBREL travel pack.

Learn more about traveling with and storing ENBREL.

Can I travel by air with my ENBREL needles, syringes, or autoinjectors?

Check with your airline before you travel. They will be able to tell you whether you may carry needles, syringes, or autoinjectors onto the airplane.

It is also a good idea to carry medical documentation to present to airport security. Notify the screener if you are carrying a sharps disposal container in your carry-on baggage.

Learn more about storing and traveling with ENBREL.

Is there any latex content in the Enbrel® (etanercept) SureClick® autoinjector or the prefilled syringes and their components?

Yes, the needle cover on the Enbrel® SureClick® autoinjector and the prefilled syringes is composed of dry natural rubber (derivative of latex), which should not be handled by persons sensitive to latex.

What should I do if I'm not getting the results I expected?

It's important to talk to your doctor about your results and expectations for your treatment.


Safety Information

What are the most common side effects of ENBREL?

The most common side effects of ENBREL are infections and injection site reactions. Infections caused by viruses, fungi, or bacteria have happened in patients taking ENBREL and include the common cold, sinusitis, and the flu. Injection site reactions are mild to moderate (redness, itching, pain, swelling, bleeding, and bruising) and usually go away within 3 to 5 days. If you have pain, redness, or swelling around the injection site that doesn't go away or gets worse, call your doctor.

Review common side effects for ENBREL and important safety information.

What should I do if I get a fever or an infection while taking ENBREL?

If you get an infection, especially one with a fever, you need to contact your doctor right away.

Because they work on the immune system, medicines like ENBREL may affect the body's ability to defend itself against infection while ENBREL is being taken. ENBREL works against one of the body's natural defenses against infection.

Read more about how ENBREL works.

I mistakenly missed a dose. What should I do?

If you forget to take ENBREL when you are supposed to, contact your doctor to find out when to take your next dose of ENBREL.

Now that I'm seeing results with ENBREL, why can't I decrease my dose or skip a dose every now and then?

You should follow your doctor's instructions on how to take ENBREL. Please call your doctor if you have any questions.

I'm having surgery, and my doctor said I will temporarily have to stop taking ENBREL. Why?

Sometimes surgery increases your chance of getting an infection. Because ENBREL increases your risk of getting an infection, your doctor may have you stop ENBREL for a period of time before and after your operation. Ask your doctor when you can go back to taking ENBREL.

Note: Medical studies show that if you have responded to therapy with ENBREL and your doctor does recommend that you temporarily stop your treatments, it is likely you will experience the same benefits when you begin using it again.

Can I take ENBREL if I am pregnant or thinking of having a baby?

Before starting ENBREL, you should tell your doctor if you are pregnant or planning to become pregnant. It is not known if ENBREL will harm your unborn baby. If you took ENBREL during pregnancy, talk to your doctor prior to administration of live vaccines to your infant.

Should I take ENBREL if I'm nursing?

Nursing mothers should know that ENBREL can pass into breast milk, and because of the potential for serious adverse reactions in nursing infants from ENBREL, a decision should be made whether to discontinue nursing or to discontinue the drug.

Are there immunization considerations for JIA patients using ENBREL?

Patients receiving ENBREL may receive concurrent vaccinations, except for live vaccines. No data are available on the secondary transmission of infection by live vaccines in patients receiving ENBREL.

It is recommended that JIA patients, if possible, be brought up-to-date with all immunizations in agreement with current immunization guidelines prior to initiating ENBREL therapy. Patients with a significant exposure to varicella virus should temporarily discontinue ENBREL therapy and be considered for prophylactic treatment with Varicella Zoster Immune Globulin.

What should I do if my child with juvenile idiopathic arthritis has contact with someone who has chicken pox?

It is important to tell your doctor right away if your child has contact with someone who has the varicella (chicken pox) virus. If your child is exposed to the chicken pox virus, he or she may need to stop taking ENBREL until directed by your health care provider.

Please see Prescribing Information, Important Safety Information, and Medication Guide for complete details about ENBREL.

Prescription ENBREL is taken by injection.


Moderate to Severe Rheumatoid Arthritis (RA)
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with moderate to severe rheumatoid arthritis. ENBREL can be taken with methotrexate or used alone.

Moderately to Severely Active Polyarticular Juvenile Idiopathic Arthritis (JIA)
ENBREL is indicated for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis (JIA) in children ages 2 years and older.

Ankylosing Spondylitis (AS)
ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.

Supportive data
Moderate to Severe Rheumatoid Arthritis (RA)
  • In medical studies, ENBREL was shown to be clinically effective in about 2 out of 3 adults with moderate to severe RA at 3 months. ENBREL has been shown to begin working in as few as 2 weeks, and most patients who benefit will do so within 3 months. In another medical study, 55% of patients who were evaluated 5 years after beginning ENBREL therapy had no further progression of joint damage.
Moderately to Severely Active Polyarticular Juvenile Idiopathic Arthritis (JIA)
  • In a clinical study, ENBREL was shown to be effective in about 3 out of 4 children with JIA who used it at 3 months. ENBREL has been shown to begin working in as few as 2 to 4 weeks.
Ankylosing Spondylitis (AS)
  • ENBREL was shown to be effective in about 3 out of 5 adults at 6 months. Clinical responses were seen at 2 weeks in 46% of patients, with 59% of patients receiving benefit within 8 weeks.