There are two methods you can use when injecting with the Multi-use Vial: the Vial Adapter Method or the Free-Hand Method.
For some children, one vial of ENBREL can be used for more than one dose. You should NOT use the Vial Adapter Method if you will be using the vial more than once. If one vial of ENBREL is being used for more than one dose, you must use the Free-Hand Method. Ask your doctor if you have questions about which method to use.
Let’s get started
These demos show only injection highlights. See your health care professional to receive formal injection training. Please see the Instructions for Use for more information.
Do not use this method for children injecting multiple doses from a single vial.
Do not use this method for children injecting multiple doses from a single vial.
Do not use this method for children injecting multiple doses from a single vial.
- Wash your hands with soap and warm water
- Take the ENBREL dose tray out of the refrigerator and place it on a clean, well-lit, flat work surface
- Leave the dose tray at room temperature for 15 to 30 minutes before using for a more comfortable injection
Do not use this method for children injecting multiple doses from a single vial.
- If the expiration date has passed, do NOT use the dose tray
- Contact your pharmacist or call 1-888-4ENBREL (1-888-436-2735)
Do not use this method for children injecting multiple doses from a single vial.
- One prefilled diluent syringe with an attached adapter and twist-off cap
- One plunger
- One ENBREL vial
- One vial adapter
- One 27-gauge ½-inch needle in a hard plastic cover
IMPORTANT: If any of these items are missing or look damaged, call your pharmacist or 1-888-4ENBREL (1-888-436-2735).
Do not use this method for children injecting multiple doses from a single vial.
- With the twist-off cap pointing down, check the amount of liquid in the syringe
- Be sure there is at least 1 mL of liquid inside
IMPORTANT: Do NOT use the syringe if there is less than 1 mL of liquid. Do NOT use the syringe if the twist-off cap is missing or not tightly attached. Call your pharmacist or 1-888-4ENBREL (1-888-4ENBREL).
Do not use this method for children injecting multiple doses from a single vial.
Do not use this method for children injecting multiple doses from a single vial.
- Remove the pink plastic cap from the vial
IMPORTANT: Do NOT remove the gray stopper or silver metal ring around the top of the vial.
Do not use this method for children injecting multiple doses from a single vial.
- Place the vial on your flat work surface or turn your dose tray upside down and place it in the space marked “V”
- Clean the gray stopper on the vial with an alcohol swab
IMPORTANT: Do NOT touch the gray stopper with your hands.
Do not use this method for children injecting multiple doses from a single vial.
- Open the wrappers that hold the needle and vial adapter by peeling apart the tabs
- Set them both aside for later
IMPORTANT: Do NOT touch the vial adapter’s twist-on end or the spike inside.
Do not use this method for children injecting multiple doses from a single vial.
- Slide the plunger into the flange end of the syringe (see figure 1)
- Attach the plunger to the gray rubber stopper in the syringe by turning the plunger clockwise until you feel a slight resistance (see figure 2)
Do not use this method for children injecting multiple doses from a single vial.
- Remove the twist-off cap by turning counterclockwise (you may see a drop of liquid when removing the cap–this is normal)
- Place the cap on your flat work surface
IMPORTANT: Do NOT touch or bump the plunger. Do NOT touch the syringe tip.
Do not use this method for children injecting multiple doses from a single vial.
- Twist the vial adapter onto the syringe, turning clockwise, until you feel slight resistance
IMPORTANT: Do NOT over-tighten.
Do not use this method for children injecting multiple doses from a single vial.
- Hold the vial upright on your flat work surface
- Hold the sides of the vial adapter and put it over the top of the vial
- Insert the adapter into the gray stopper on the vial (the spike should puncture the stopper)
- Be sure the vial adapter fits snugly
IMPORTANT: Do NOT touch or bump the plunger.
Do not use this method for children injecting multiple doses from a single vial.
- Hold the vial upright on your flat work surface
- Push the plunger down until all the liquid from the syringe is in the vial (you may see foaming/bubbles in the vial–this is normal)
Do not use this method for children injecting multiple doses from a single vial.
- Gently swirl the vial in a circular motion to dissolve the powder
- If you used the dose tray to hold the vial, take the vial out (with the vial adapter and syringe still attached)
- Wait until all the powder dissolves (usually less than 10 minutes)
- The solution should be clear and colorless (there may still be foam/bubbles)
IMPORTANT: Do NOT shake. Do NOT inject the solution if it is discolored or contains lumps, flakes, or particles. If all of the powder in the vial is not dissolved or there are still particles after 10 minutes, call 1-888-4ENBREL (1-888-436-2735).
Do not use this method for children injecting multiple doses from a single vial.
Do not use this method for children injecting multiple doses from a single vial.
- Turn the vial upside down
- Hold the syringe at eye level
- Slowly pull the plunger down to the markings on the syringe that match your prescribed dose
- Be careful not to pull the plunger completely out of the syringe
- Some white foam may remain in the vial—this is normal
Do not use this method for children injecting multiple doses from a single vial.
- Gently tap the syringe to make any bubbles rise to the top
- Slowly push the plunger up to remove the air bubbles
- If you push some solution back into the vial, slowly pull back on the plunger to fill it back up to your prescribed dose
Do not use this method for children injecting multiple doses from a single vial.
- Hold the vial adapter with one hand
- Turn the syringe counterclockwise with your other hand
- Place the vial with the vial adapter on your flat work surface
IMPORTANT: Do NOT touch or bump the plunger.
Do not use this method for children injecting multiple doses from a single vial.
- Continue to hold the barrel of the syringe
- Twist the 27-gauge needle onto the tip of the syringe with your free hand until it fits snugly
- Place the syringe on your flat work surface until you are ready to inject ENBREL
IMPORTANT: Do NOT remove the needle cover from the syringe yet.
Do not use this method for children injecting multiple doses from a single vial.
Do not use this method for children injecting multiple doses from a single vial.
There are three recommended injection sites for ENBREL:
- The front of the middle thighs
- The outer area of the upper arms
- The stomach (except for the two-inch area right around the navel)
Do not use this method for children injecting multiple doses from a single vial.
- Alternate your injection sites each time you inject ENBREL
- Avoid areas with scars or stretch marks
IMPORTANT: Do NOT inject into areas where the skin is tender, bruised, red, or hard. If you have psoriasis, do NOT inject into any raised, thick, red, or scaly skin patches or lesions.
Do not use this method for children injecting multiple doses from a single vial.
- Wipe your injection site with a new alcohol swab
IMPORTANT: Do NOT touch this area again before giving the injection.
Do not use this method for children injecting multiple doses from a single vial.
- When you are ready to inject, pick up the syringe from your flat work surface
- Hold the barrel of the syringe with one hand, and pull the needle cover straight off (There may be a drop of liquid at the end of the needle. This is normal.)
IMPORTANT: Do NOT twist or bend the needle cover while you are removing it. Do NOT try to put the needle cover back onto the syringe. Do NOT touch the needle or allow it to touch any surface. Do NOT touch or bump the plunger.
Do not use this method for children injecting multiple doses from a single vial.
- With one hand, gently pinch the cleaned area of skin and hold it firmly
- With the other hand, hold the syringe like a pencil, at a 45-degree angle to the skin
- Push the needle into the skin with a quick, dart-like motion
Do not use this method for children injecting multiple doses from a single vial.
- When the needle is completely in the skin, let go of the skin
- With your free hand, hold the syringe near its base to stabilize it
- Slowly push the plunger to inject all of the ENBREL solution at a steady rate
Do not use this method for children injecting multiple doses from a single vial.
- When the syringe is empty, pull the needle out of the skin, being careful to keep it at the same angle
- If there is a little bleeding, you can press a cotton ball over the injection site for 10 seconds, or cover the injection site with a bandage
IMPORTANT: Do NOT rub the injection site. Injection site reactions, such as redness, rash, swelling, itching, or bruising, may occur. These symptoms usually go away within 3 to 5 days. If you experience these reactions and they don’t go away or get worse, call your doctor.
Do not use this method for children injecting multiple doses from a single vial.
- If your doctor instructed you to take two ENBREL injections on the same day, repeat the steps to give yourself another injection of ENBREL, using a different vial and vial adapter
- Choose and prepare a new injection site for the second injection
Do not use this method for children injecting multiple doses from a single vial.
Do not use this method for children injecting multiple doses from a single vial.
- The syringe, needles, and vial adapters should never be reused
- Never recap a needle
- Never throw the needle or syringe in the household trash or recycling
- Place the used needle and syringe in a hard plastic needle disposal container with a screw-on cap (you can also use a metal container with a plastic lid, such as a coffee can)
- Always keep the container out of the reach of children
IMPORTANT: Do NOT use glass or clear plastic containers.
Do not use this method for children injecting multiple doses from a single vial.
- When the container is full, tape around the cap or lid to make sure the cap or lid does not come off
- You should always check first with your doctor for instructions on how to properly get rid of a filled disposal container
- There may be special state and local laws for getting rid of used needles and syringes
IMPORTANT: Do NOT throw the disposal container in the household trash or recycling.
Do not use this method for children injecting multiple doses from a single vial.
- The ENBREL vial, vial adapter, and used alcohol swabs should be placed in the trash
- The dose tray and cover may be recycled
Do not use this method for children injecting multiple doses from a single vial.
In general, ENBREL should be kept at 36°F to 46°F (2°C to 8°C; the standard temperature range of most refrigerators).
However, if needed, the ENBREL syringe and dose tray can be stored at room temperature between 68°F to 77°F (20°C to 25°C) for up to 14 days.
Do not use this method for children injecting multiple doses from a single vial.
- ENBREL should be stored in the refrigerator
- Throw away ENBREL that has been at room temperature for more than 14 days
- Keep ENBREL in the original box to protect it from light or physical damage
- Keep ENBREL and all medicines away from children
- Do NOT put ENBREL back in the fridge after it reaches room temperature
- Do NOT store ENBREL in extreme heat or cold (for example, in your car)
- Do NOT freeze ENBREL
- Do NOT shake ENBREL
- Wash your hands with soap and warm water
- Take the ENBREL dose tray out of the refrigerator and place it on a clean, well-lit, flat work surface
- Leave the dose tray at room temperature for 15 to 30 minutes before using for a more comfortable injection
- If the expiration date has passed, do NOT use the dose tray
- One prefilled diluent syringe with an attached adapter and twist-off cap
- One plunger
- One ENBREL vial
- One vial adapter
- One 27-gauge ½-inch needle in a hard plastic cover
You will need an additional 25-gauge needle that is not provided in this kit. Your doctor can provide you with this needle.
IMPORTANT: If any of these items are missing or look damaged, call your pharmacist or 1-888-4ENBREL (1-888-436-2735).
- With the twist-off cap pointing down, check the amount of liquid in the syringe
- Be sure there is at least 1 mL of liquid inside
- Remove the pink plastic cap from the vial
IMPORTANT: Do NOT remove the gray stopper or silver metal ring around the top of the vial.
- Place the vial on your flat work surface or turn your dose tray upside down and place it in the space marked “V”
- Clean the gray stopper on the vial with an alcohol swab
The 25-gauge needle will be used to mix the liquid with the powder and to withdraw ENBREL from the vial.
- Open the wrapper that holds the 25-gauge needle (available from your doctor) by peeling apart the tabs
- Set the needle aside for later use
- Slide the plunger into the flange end of the syringe (see figure 1)
- Attach the plunger to the gray rubber stopper in the syringe by turning the plunger clockwise until you feel a slight resistance (see figure 2)
- Remove the twist-off cap by turning counterclockwise (you may see a drop of liquid when removing the cap–this is normal)
- Place the cap on your flat work surface
IMPORTANT: Do NOT touch or bump the plunger. Do NOT touch the syringe tip.
- Hold the barrel of the syringe
- Twist the 25-gauge needle onto the tip of the syringe until it fits snugly
- Place the syringe on your flat work surface
The 27-gauge needle is for injecting ENBREL.
- Open the wrapper that contains the 27-gauge needle (included in your kit) by peeling apart the tabs
- Set the needle aside for later use
- Pick up the syringe from your flat work surface
- Hold the barrel of the syringe with one hand and pull the needle cover straight off (see figure 1)
- Place the needle cover (open side up) in the round space marked “N” in the ENBREL dose tray (see figure 2)
- Place the vial on your flat work surface
- Hold the syringe with the needle facing up
- Gently pull back on the plunger to pull a small amount of air into the syringe
- Insert the 25-gauge needle straight through the center ring of the gray stopper. You should feel a slight resistance and then a “pop” as the needle goes through the center of the stopper
- Look for the needle tip inside the stopper window
- Push the plunger down VERY SLOWLY until all the liquid from the syringe is in the vial (if you add the liquid too fast, it will cause foaming/bubbles)
- Gently swirl the vial in a circular motion to dissolve the powder
- Wait until all the powder dissolves (usually less than 10 minutes)
- The solution should be clear and colorless (there may still be foam/bubbles)
- With the 25-gauge needle in the vial, turn the vial upside down
- Hold the syringe at eye level
- Slowly pull the plunger down to the markings on the syringe that match your prescribed dose
- Be sure to keep the tip of the needle in the solution
- Some white foam may remain in the vial—this is normal
- With the 25-gauge needle still inside the vial, gently tap the syringe to make any bubbles rise to the top
- Slowly push the plunger up to remove the air bubbles
- If you push some solution back into the vial, slowly pull back on the plunger to fill it back up to your prescribed dose
- Remove syringe and 25-gauge needle from the vial
- Keep the needle attached to the syringe
- Insert the 25-gauge needle straight down into the needle cover in the ENBREL dose tray
- Listen for a “snap” when the needle is secure in the needle cover
- Untwist the 25-gauge needle from the syringe and put it in your needle disposal container
- Twist the 27-gauge needle onto the syringe until it fits snugly
- Place the syringe on your flat work surface until you are ready to inject ENBREL
There area three recommended injection sites for ENBREL:
- The front of the middle thighs
- The outer area of the upper arms
- The stomach (except for the two-inch area right around the navel)
- Alternate your injection sites each time you inject ENBREL
- Avoid areas with scars or stretch marks
- Wipe your injection site with a new alcohol swab
- When you are ready to inject, pick up the syringe from your flat work surface
- Hold the barrel of the syringe with one hand, and pull the 27-gauge needle cover straight off (There may be a drop of liquid at the end of the needle. This is normal.)
- With one hand, gently pinch the cleaned area of skin and hold it firmly
- With the other hand, hold the syringe like a pencil, at a 45-degree angle to the skin
- Push the needle into the skin with a quick, dart-like motion
- When the needle is completely in the skin, let go of the skin
- With your free hand, hold the syringe near its base to stabilize it
- Slowly push the plunger to inject all of the ENBREL solution at a steady rate
- When the syringe is empty, pull the needle out of the skin, being careful to keep it at the same angle
- If there is a little bleeding, you can press a cotton ball over the injection site for 10 seconds, or cover the injection site with a bandage.
IMPORTANT: Do NOT rub the injection site. Injection site reactions such as redness, rash, swelling, itching, or bruising may occur. These symptoms usually go away within 3 to 5 days. If you experience these reactions and they don’t go away or get worse, call your doctor.
- For some children, one vial can be used for more than one dose
- For each additional dose, you will need two new needles (one 25-gauge needle and one 27-gauge needle). Never reuse a syringe or needle
- If your doctor instructed you to take two ENBREL injections on the same day, repeat the steps to give yourself another injection of ENBREL
- Choose and prepare a new injection site for the second injection
- If there is enough solution left in the ENBREL vial for another dose, write the date you mixed the powder and the liquid in the area marked “Mixing Date” on the sticker supplied with these instructions and attach the sticker to the ENBREL vial
- Refrigerate the ENBREL vial (in the dose tray) after use. Otherwise, throw away the ENBREL vial and any remaining solution
- Throw away the refrigerated ENBREL solution if more than 14 days have passed since it was mixed
- Remember: NEVER REUSE A NEEDLE OR SYRINGE
- You will need to get a new 27-guage needle from you doctor for each additional injection taken from a previously mixed vial
- The syringe and needles should never be reused
- Never recap a needle
- Never throw the needle or syringe in the household trash or recycling
- Place the used needle and syringe in a hard plastic needle disposal container with a screw-on cap (you can also use a metal container with a plastic lid, such as a coffee can)
- Always keep the container out of the reach of children
IMPORTANT: Do NOT use glass or clear plastic containers.
- When the container is full, tape around the cap or lid to make sure the cap or lid does not come off
- You should always check first with your doctor for instructions on how to properly get rid of a filled disposal container
- There may be special state and local laws for getting rid of used needles and syringes
IMPORTANT: Do NOT throw the disposal container in the household trash or recycling.
- The ENBREL vial and used alcohol swabs should be placed in the trash
- The dose tray and cover may be recycled
- ENBREL should be stored in the refrigerator
- Throw away ENBREL that has been at room temperature for more than 14 days
- Keep ENBREL in the original box to protect it from light or physical damage
- Keep ENBREL and all medicines away from children
- Do NOT put ENBREL back in the fridge after it reaches room temperature
- Do NOT store ENBREL in extreme heat or cold (for example, in your car)
- Do NOT freeze ENBREL
- Do NOT shake ENBREL
ENBREL is a medicine that affects your immune system. ENBREL can lower the ability of your immune system to fight infections. Serious infections have happened in patients taking ENBREL. These infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections. Your healthcare provider should test you for TB before you take ENBREL and monitor you closely for TB before, during, and after ENBREL treatment, even if you have tested negative for TB.
There have been some cases of unusual cancers, some resulting in death, reported in children and teenage patients who started using tumor necrosis factor (TNF) blockers before 18 years of age. Also, for children, teenagers, and adults taking TNF blockers, including ENBREL, the chances of getting lymphoma or other cancers may increase. Patients with RA may be more likely to get lymphoma.
- Have any existing medical conditions
- Are taking any medicines, including herbals
- Think you have, are being treated for, have signs of, or are prone to infection. You should not start taking ENBREL if you have any kind of infection, unless your healthcare provider says it is okay
- Have any open cuts or sores
- Have diabetes, HIV, or a weak immune system
- Have TB or have been in close contact with someone who has had TB
- Were born in, lived in, or traveled to countries where there is more risk for getting TB. Ask your healthcare provider if you are not sure
- Live, have lived in, or traveled to certain parts of the country (such as, the Ohio and Mississippi River valleys, or the Southwest) where there is a greater risk for certain kinds of fungal infections, such as histoplasmosis. These infections may develop or become more severe if you take ENBREL. If you don’t know if these infections are common in the areas you’ve been to, ask your healthcare provider
- Have or have had hepatitis B
- Have or have had heart failure
- Develop symptoms such as persistent fever, bruising, bleeding, or paleness while taking ENBREL
- Use the medicine Kineret (anakinra), Orencia (abatacept), or Cytoxan (cyclophosphamide)
- Are taking anti-diabetic medicines
- Have, have had, or develop a serious nervous disorder, seizures, any numbness or tingling, or a disease that affects your nervous system such as multiple sclerosis or Guillain-Barré syndrome
- Are scheduled to have surgery
- Have recently received or are scheduled for any vaccines. All vaccines should be brought up-to-date before starting ENBREL. Patients taking ENBREL should not receive live vaccines.
- Are allergic to rubber or latex
- Are pregnant, planning to become pregnant, or breastfeeding
- Have been around someone with chicken pox
ENBREL can cause serious side effects including: New infections or worsening of infections you already have; hepatitis B can become active if you already have had it; nervous system problems, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes; blood problems (some fatal); new or worsening heart failure; new or worsening psoriasis; allergic reactions; autoimmune reactions, including a lupus-like syndrome and autoimmune hepatitis.
Common side effects include: Injection site reactions and upper respiratory infections (sinus infections).
In general, side effects in children were similar in frequency and type as those seen in adult patients. The types of infections reported were generally mild and similar to those usually seen in children.
These are not all the side effects with ENBREL. Tell your healthcare provider about any side effect that bothers you or does not go away.
If you have any questions about this information, be sure to discuss them with your healthcare provider. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Please see Prescribing Information and Medication Guide.
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with moderately to severely active rheumatoid arthritis. ENBREL can be taken with methotrexate or used alone.
ENBREL is indicated for chronic moderate to severe plaque psoriasis (PsO) in children 4 years and older and adults who may benefit from taking injections or pills (systemic therapy) or phototherapy (ultraviolet light).
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with psoriatic arthritis. ENBREL can be used with or without methotrexate.
ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.
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.
ENBREL is a medicine that affects your immune system. ENBREL can lower the ability of your immune system to fight infections. Serious infections have happened in patients taking ENBREL. These infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections. Your healthcare provider should test you for TB before you take ENBREL and monitor you closely for TB before, during, and after ENBREL treatment, even if you have tested negative for TB.
There have been some cases of unusual cancers, some resulting in death, reported in children and teenage patients who started using tumor necrosis factor (TNF) blockers before 18 years of age. Also, for children, teenagers, and adults taking TNF blockers, including ENBREL, the chances of getting lymphoma or other cancers may increase. Patients with RA may be more likely to get lymphoma.
- Have any existing medical conditions
- Are taking any medicines, including herbals
- Think you have, are being treated for, have signs of, or are prone to infection. You should not start taking ENBREL if you have any kind of infection, unless your healthcare provider says it is okay
- Have any open cuts or sores
- Have diabetes, HIV, or a weak immune system
- Have TB or have been in close contact with someone who has had TB
- Were born in, lived in, or traveled to countries where there is more risk for getting TB. Ask your healthcare provider if you are not sure
- Live, have lived in, or traveled to certain parts of the country (such as, the Ohio and Mississippi River valleys, or the Southwest) where there is a greater risk for certain kinds of fungal infections, such as histoplasmosis. These infections may develop or become more severe if you take ENBREL. If you don’t know if these infections are common in the areas you’ve been to, ask your healthcare provider
- Have or have had hepatitis B
- Have or have had heart failure
- Develop symptoms such as persistent fever, bruising, bleeding, or paleness while taking ENBREL
- Use the medicine Kineret (anakinra), Orencia (abatacept), or Cytoxan (cyclophosphamide)
- Are taking anti-diabetic medicines
- Have, have had, or develop a serious nervous disorder, seizures, any numbness or tingling, or a disease that affects your nervous system such as multiple sclerosis or Guillain-Barré syndrome
- Are scheduled to have surgery
- Have recently received or are scheduled for any vaccines. All vaccines should be brought up-to-date before starting ENBREL. Patients taking ENBREL should not receive live vaccines.
- Are allergic to rubber or latex
- Are pregnant, planning to become pregnant, or breastfeeding
- Have been around someone with chicken pox
ENBREL can cause serious side effects including: New infections or worsening of infections you already have; hepatitis B can become active if you already have had it; nervous system problems, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes; blood problems (some fatal); new or worsening heart failure; new or worsening psoriasis; allergic reactions; autoimmune reactions, including a lupus-like syndrome and autoimmune hepatitis.
Common side effects include: Injection site reactions and upper respiratory infections (sinus infections).
In general, side effects in children were similar in frequency and type as those seen in adult patients. The types of infections reported were generally mild and similar to those usually seen in children.
These are not all the side effects with ENBREL. Tell your healthcare provider about any side effect that bothers you or does not go away.
If you have any questions about this information, be sure to discuss them with your healthcare provider. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Please see Prescribing Information and Medication Guide.
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with moderately to severely active rheumatoid arthritis. ENBREL can be taken with methotrexate or used alone.
ENBREL is indicated for chronic moderate to severe plaque psoriasis (PsO) in children 4 years and older and adults who may benefit from taking injections or pills (systemic therapy) or phototherapy (ultraviolet light).
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with psoriatic arthritis. ENBREL can be used with or without methotrexate.
ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.
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.
- Close
ENBREL is a medicine that affects your immune system. ENBREL can lower the ability of your immune system to fight infections. Serious infections have happened in patients taking ENBREL. These infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections. Your healthcare provider should test you for TB before you take ENBREL and monitor you closely for TB before, during, and after ENBREL treatment, even if you have tested negative for TB.
There have been some cases of unusual cancers, some resulting in death, reported in children and teenage patients who started using tumor necrosis factor (TNF) blockers before 18 years of age. Also, for children, teenagers, and adults taking TNF blockers, including ENBREL, the chances of getting lymphoma or other cancers may increase. Patients with RA may be more likely to get lymphoma.
- Have any existing medical conditions
- Are taking any medicines, including herbals
- Think you have, are being treated for, have signs of, or are prone to infection. You should not start taking ENBREL if you have any kind of infection, unless your healthcare provider says it is okay
- Have any open cuts or sores
- Have diabetes, HIV, or a weak immune system
- Have TB or have been in close contact with someone who has had TB
- Were born in, lived in, or traveled to countries where there is more risk for getting TB. Ask your healthcare provider if you are not sure
- Live, have lived in, or traveled to certain parts of the country (such as, the Ohio and Mississippi River valleys, or the Southwest) where there is a greater risk for certain kinds of fungal infections, such as histoplasmosis. These infections may develop or become more severe if you take ENBREL. If you don’t know if these infections are common in the areas you’ve been to, ask your healthcare provider
- Have or have had hepatitis B
- Have or have had heart failure
- Develop symptoms such as persistent fever, bruising, bleeding, or paleness while taking ENBREL
- Use the medicine Kineret (anakinra), Orencia (abatacept), or Cytoxan (cyclophosphamide)
- Are taking anti-diabetic medicines
- Have, have had, or develop a serious nervous disorder, seizures, any numbness or tingling, or a disease that affects your nervous system such as multiple sclerosis or Guillain-Barré syndrome
- Are scheduled to have surgery
- Have recently received or are scheduled for any vaccines. All vaccines should be brought up-to-date before starting ENBREL. Patients taking ENBREL should not receive live vaccines.
- Are allergic to rubber or latex
- Are pregnant, planning to become pregnant, or breastfeeding
- Have been around someone with chicken pox
ENBREL can cause serious side effects including: New infections or worsening of infections you already have; hepatitis B can become active if you already have had it; nervous system problems, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes; blood problems (some fatal); new or worsening heart failure; new or worsening psoriasis; allergic reactions; autoimmune reactions, including a lupus-like syndrome and autoimmune hepatitis.
Common side effects include: Injection site reactions and upper respiratory infections (sinus infections).
In general, side effects in children were similar in frequency and type as those seen in adult patients. The types of infections reported were generally mild and similar to those usually seen in children.
These are not all the side effects with ENBREL. Tell your healthcare provider about any side effect that bothers you or does not go away.
If you have any questions about this information, be sure to discuss them with your healthcare provider. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Please see Prescribing Information and Medication Guide.
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with moderately to severely active rheumatoid arthritis. ENBREL can be taken with methotrexate or used alone.
ENBREL is indicated for chronic moderate to severe plaque psoriasis (PsO) in children 4 years and older and adults who may benefit from taking injections or pills (systemic therapy) or phototherapy (ultraviolet light).
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with psoriatic arthritis. ENBREL can be used with or without methotrexate.
ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.
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.
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ENBREL is a medicine that affects your immune system. ENBREL can lower the ability of your immune system to fight infections. Serious infections have happened in patients taking ENBREL. These infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections. Your healthcare provider should test you for TB before you take ENBREL and monitor you closely for TB before, during, and after ENBREL treatment, even if you have tested negative for TB.
There have been some cases of unusual cancers, some resulting in death, reported in children and teenage patients who started using tumor necrosis factor (TNF) blockers before 18 years of age. Also, for children, teenagers, and adults taking TNF blockers, including ENBREL, the chances of getting lymphoma or other cancers may increase. Patients with RA may be more likely to get lymphoma.
- Have any existing medical conditions
- Are taking any medicines, including herbals
- Think you have, are being treated for, have signs of, or are prone to infection. You should not start taking ENBREL if you have any kind of infection, unless your healthcare provider says it is okay
- Have any open cuts or sores
- Have diabetes, HIV, or a weak immune system
- Have TB or have been in close contact with someone who has had TB
- Were born in, lived in, or traveled to countries where there is more risk for getting TB. Ask your healthcare provider if you are not sure
- Live, have lived in, or traveled to certain parts of the country (such as, the Ohio and Mississippi River valleys, or the Southwest) where there is a greater risk for certain kinds of fungal infections, such as histoplasmosis. These infections may develop or become more severe if you take ENBREL. If you don’t know if these infections are common in the areas you’ve been to, ask your healthcare provider
- Have or have had hepatitis B
- Have or have had heart failure
- Develop symptoms such as persistent fever, bruising, bleeding, or paleness while taking ENBREL
- Use the medicine Kineret (anakinra), Orencia (abatacept), or Cytoxan (cyclophosphamide)
- Are taking anti-diabetic medicines
- Have, have had, or develop a serious nervous disorder, seizures, any numbness or tingling, or a disease that affects your nervous system such as multiple sclerosis or Guillain-Barré syndrome
- Are scheduled to have surgery
- Have recently received or are scheduled for any vaccines. All vaccines should be brought up-to-date before starting ENBREL. Patients taking ENBREL should not receive live vaccines.
- Are allergic to rubber or latex
- Are pregnant, planning to become pregnant, or breastfeeding
- Have been around someone with chicken pox
ENBREL can cause serious side effects including: New infections or worsening of infections you already have; hepatitis B can become active if you already have had it; nervous system problems, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes; blood problems (some fatal); new or worsening heart failure; new or worsening psoriasis; allergic reactions; autoimmune reactions, including a lupus-like syndrome and autoimmune hepatitis.
Common side effects include: Injection site reactions and upper respiratory infections (sinus infections).
In general, side effects in children were similar in frequency and type as those seen in adult patients. The types of infections reported were generally mild and similar to those usually seen in children.
These are not all the side effects with ENBREL. Tell your healthcare provider about any side effect that bothers you or does not go away.
If you have any questions about this information, be sure to discuss them with your healthcare provider. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Please see Prescribing Information and Medication Guide.
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with moderately to severely active rheumatoid arthritis. ENBREL can be taken with methotrexate or used alone.
ENBREL is indicated for chronic moderate to severe plaque psoriasis (PsO) in children 4 years and older and adults who may benefit from taking injections or pills (systemic therapy) or phototherapy (ultraviolet light).
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with psoriatic arthritis. ENBREL can be used with or without methotrexate.
ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.
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.
