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Multi-use vial injection demo

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.


Enbrel multi-use vial injection instructions: vial adapter method

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method What is the Vial Adapter Method?
This method uses a vial adapter to help mix the powder with the liquid and withdraw ENBREL. This method should not be used for children using multiple doses from the same vial of ENBREL.
Enbrel multi-use vial injection instructions: vial adapter method - Section 1

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Gather your injection materials
Here is what you’ll need to get started.
Enbrel multi-use vial injection packaging

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Gather your injection materials
  • 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
Check the Enbrel dose tray expiration date

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Check the expiration date
  • If the expiration date has passed, do NOT use the dose tray
  • Contact your pharmacist or call 1-888-4ENBREL (1-888-436-2735)
Enbrel multi-use vial injection components

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Review your injection materials
  • 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).

Check Enbrel mixing fluid in syringe

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Check the mixing fluid
  • 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).

Enbrel multi-use vial injection instructions: vial adapter method - Section 2

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Prepare the needle, vial, and adapter
Learn how to set up your needle, vial, and adapter.
Remove Enbrel vial cap

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Remove vial cap
  • 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.

Cleaning an Enbrel vial stopper

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Clean stopper
  • 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.

Opening an Enbrel injection needle and adapter package

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Open needle and adapter packages
  • 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.

Attaching Enbrel injection plunger

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Attach plunger
  • 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)
Removing Enbrel twist-off cap

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Remove twist-off cap
  • 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.

Attaching Enbrel injection vial adapter to syringe

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Attach vial adapter to syringe
  • Twist the vial adapter onto the syringe, turning clockwise, until you feel slight resistance

IMPORTANT: Do NOT over-tighten.

Attaching Enbrel vial adapter to vial

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Attach vial adapter to 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.

Pushing Enbrel injection plunger into vial

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Push plunger down
  • 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)
Dissolving Enbrel powder

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Dissolve powder
  • 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).

Enbrel multi-use vial injection instructions: vial adapter method - Section 3

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Withdraw the solution
Learn the steps for filling your syringe with ENBREL.
Withdrawing Enbrel from vial

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Withdraw ENBREL from 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
Checking Enbrel vial for bubbles

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Check for bubbles
  • 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
Removing Enbrel vial adapter

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Remove vial adapter
  • 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.

Attaching Enbrel injection needle

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Attach the needle
  • 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.

Enbrel multi-use vial injection instructions: vial adapter method - Section 4

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Inject ENBREL
Walk through each step to inject ENBREL.
Enbrel injection sites

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Choose your injection site

There are three recommended injection sites for ENBREL:

  1. The front of the middle thighs
  2. The outer area of the upper arms
  3. The stomach (except for the two-inch area right around the navel)
Alternating Enbrel injection sites

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Rotate injection sites
  • 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.

Preparing Enbrel injection site

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Prepare your injection site
  • Wipe your injection site with a new alcohol swab

IMPORTANT: Do NOT touch this area again before giving the injection.

Removing Enbrel injection needle cover

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Remove needle cover
  • 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.

Pinching Enbrel injection site

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Pinch injection site
  • 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
Injecting Enbrel

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Push plunger down
  • 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
Removing Enbrel injection

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Pull needle out
  • 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.

Cleaning Enbrel injection site

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Repeat steps for additional injections
  • 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
Enbrel multi-use vial injection instructions: vial adapter method - Section 5

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Disposal and storage
Here’s how to get rid of your materials and store ENBREL.
Disposing of Enbrel injection needle

Do not use this method for children injecting multiple doses from a single vial.

1 of 36
Vial Adapter Method Getting rid of materials
  • 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. To get a needle disposal container for free, call 1-888-4ENBREL (1-888-436-2735).

Enbrel needle disposal container

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method How to get rid of needle disposal 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.

Enbrel needle disposal container

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method How to get rid of supplies
  • The ENBREL vial, vial adapter, and used alcohol swabs should be placed in the trash
  • The dose tray and cover may be recycled
  • Needle disposal containers and disposal information are available at no cost to ENBREL patients. Just call 1-888-4ENBREL (1-888-436-2735)
Enbrel multi-use vial injection packaging

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Storing ENBREL

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.

Enbrel

Do not use this method for children injecting multiple doses from a single vial.

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Vial Adapter Method Important information for storing ENBREL
  • 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

How to inject Enbrel using the free-hand method
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Free-Hand Method What is the Free-Hand Method?
This method uses a 25-gauge needle (not included) to help mix the powder with the liquid and withdraw ENBREL. You should get the 25-gauge needle from your doctor.
Enbrel multi-use vial injection instructions: vial adapter method - Section 1
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Free-Hand Method Gather your injection materials
Here is what you’ll need to get started.
Gather your Enbrel injection materials
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Free-Hand Method Gather your injection materials
  • 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
Check the Enbrel dose tray expiration date
1 of 39
Free-Hand Method Check the expiration date
  • If the expiration date has passed, do NOT use the dose tray
Contact your pharmacist or call 1-888-4ENBREL (1-888-436-2735).
Enbrel multi-use vial injection components
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Free-Hand Method Review your injection materials
  • 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).
Check Enbrel mixing fluid in syringe
1 of 39
Free-Hand Method Check the mixing fluid
  • 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).
Enbrel multi-use vial injection instructions: vial adapter method - Section 2
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Free-Hand Method Prepare the needle and vial
Learn how to set up your needle and vial.
Remove Enbrel vial cap
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Free-Hand Method Remove vial cap
  • 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.

Cleaning an Enbrel vial stopper
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Free-Hand Method Clean stopper
  • 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.
Opening an Enbrel injection needle and adapter package
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Free-Hand Method Prepare 25-gauge needle

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
Attaching Enbrel injection plunger
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Free-Hand Method Attach plunger
  • 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)
Removing Enbrel twist-off cap
1 of 39
Free-Hand Method Remove twist-off cap
  • 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.

Attach vial adapter to syringe
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Free-Hand Method Attach needle to syringe
  • 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
Opening an Enbrel injection needle and adapter package
1 of 39
Free-Hand Method Prepare 27-gauge needle

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
Remove and store the needle cover
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Free-Hand Method Remove needle cover
  • 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)
IMPORTANT: Do NOT twist or bend the needle cover while you are removing it. Do NOT try to put the needle cover back on the syringe. Do NOT touch the needle or allow it to touch any surface. Do NOT touch or bump the plunger.
Enbrel multi-use vial injection instructions: vial adapter method - Section 3
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Free-Hand Method Withdraw the solution
Learn the steps for filling your syringe with ENBREL.

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Free-Hand Method Insert needle into vial
  • 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
IMPORTANT: If the needle is not correctly lined up with the center of the stopper, you will feel constant resistance as it goes through the stopper and you will not hear a “pop.”
Pushing Enbrel injection plunger into vial
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Free-Hand Method Push plunger down
  • 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)
Dissolving Enbrel powder
1 of 39
Free-Hand Method Dissolve powder
  • 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)
IMPORTANT: Do NOT shake. Do NOT inject the solution if it is discolored or contains lumps, flakes, or particles. If all the powder in the ENBREL vial is not dissolved or if there are particles present after 10 minutes, call 1-888-4ENBREL (1-888-436-2735).
Withdrawing Enbrel from vial
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Free-Hand Method Withdraw ENBREL from vial
  • 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
Check for bubbles in syringe
1 of 39
Free-Hand Method Check for bubbles
  • 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

1 of 39
Free-Hand Method Remove syringe and needle from vial
  • 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
Removing Enbrel vial adapter
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Free-Hand Method Attach 27-gauge needle to syringe
  • 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
IMPORTANT:  Do NOT remove the needle cover from the syringe yet.
Enbrel multi-use vial injection instructions: vial adapter method - Section 4
1 of 39
Free-Hand Method Inject ENBREL
Walk through each step to inject ENBREL.
Choose your Enbrel injection site
1 of 39
Free-Hand Method Choose your injection site

There area three recommended injection sites for ENBREL:

  1. The front of the middle thighs
  2. The outer area of the upper arms
  3. The stomach (except for the two-inch area right around the navel)
Alternating Enbrel injection sites
1 of 39
Free-Hand Method Rotate injection sites
  • 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.
Preparing Enbrel injection site
1 of 39
Free-Hand Method Prepare your injection site
  • Wipe your injection site with a new alcohol swab
IMPORTANT: Do NOT touch this area again before giving the injection.
Removing Enbrel needle cover
1 of 39
Free-Hand Method Remove needle cover
  • 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.)
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.
Pinching Enbrel injection site
1 of 39
Free-Hand Method Pinch injection site
  • 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
Injecting Enbrel
1 of 39
Free-Hand Method Push plunger down
  • 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
Removing Enbrel injection
1 of 39
Free-Hand Method Pull needle out
  • 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.

Cleaning Enbrel injection site
1 of 39
Free-Hand Method Repeat steps for additional injections
  • 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
IMPORTANT: If there is enough solution in the vial for another dose, write the date you mixed the powder and liquid in the area marked “Mixing Date” on the sticker and attach it to the vial.

1 of 39
Free-Hand Method Store any remaining solution
  • 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
Enbrel multi-use vial injection instructions: vial adapter method - Section 5
1 of 39
Free-Hand Method Disposal and storage
Here’s how to get rid of your materials and store ENBREL.
Disposing of Enbrel injection materials
1 of 39
Free-Hand Method Getting rid of materials
  • 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. To get a needle disposal container for free, call 1-888-4ENBREL (1-888-436-2735).

Enbrel needle disposal container
1 of 39
Free-Hand Method How to get rid of needle disposal 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.

Enbrel needle disposal container
1 of 39
Free-Hand Method How to get rid of supplies
  • The ENBREL vial and used alcohol swabs should be placed in the trash
  • The dose tray and cover may be recycled
  • Needle disposal containers and disposal information are available at no cost to ENBREL patients. Just call 1-888-4ENBREL (1-888-436-2735)
Storing Enbrel
1 of 39
Free-Hand Method Storing ENBREL
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.
Important information for storing Enbrel
1 of 39
Free-Hand Method Important information for storing ENBREL
  • 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

Please see the full Prescribing Information, Important Safety Information, and Medication Guide for more details about ENBREL.

Prescription Enbrel® (etanercept) is taken by injection.

IMPORTANT SAFETY INFORMATION
What is the most important information I should know about 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 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.

Before starting ENBREL, tell your healthcare provider if you:
  • 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
What are the possible side effects of ENBREL?

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.

INDICATIONS
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 moderately to severely active 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.

Psoriatic Arthritis

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.

Ankylosing Spondylitis (AS)

ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.

Moderate to Severe Plaque Psoriasis

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).

IMPORTANT SAFETY INFORMATION
What is the most important information I should know about 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 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.

Before starting ENBREL, tell your healthcare provider if you:
What are the possible side effects of ENBREL?

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.

INDICATIONS
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 moderately to severely active 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.

Psoriatic Arthritis

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.

Ankylosing Spondylitis (AS)

ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.

Moderate to Severe Plaque Psoriasis

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).

  • Close
IMPORTANT SAFETY INFORMATION: What is the most important information I should know about Enbrel® (etanercept)?

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 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.

Before starting ENBREL, tell your healthcare provider if you:

What are the possible side effects of ENBREL?

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, upper respiratory infections (sinus
infections), and headache.

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.

INDICATIONS
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 moderately to severely active 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.

Psoriatic Arthritis

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.

Ankylosing Spondylitis(AS)

ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing
spondylitis.

Moderate to Severe Plaque Psoriasis

ENBREL is indicated for chronic moderate to severe plaque psoriasis (PsO) in children 4 years and older and adults ages who may benefit from taking injections or pills (systemic therapy) or phototherapy (ultraviolet light).



At Enbrel.com, you can learn about Enbrel® (etanercept), a self-injected biologic medicine
used to treat inflammatory diseases with long-term effects. You can find information about
moderate to severe rheumatoid arthritis(RA), moderate to severe plaque psoriasis, psoriatic
arthritis, moderately to severely active polyarticular juvenile idiopathic arthritis(JIA), and
ankylosing spondylitis(AS). You can learn about symptoms, treatment, how Enbrel®
(etanercept) works for each condition, results for each condition, results for each condition, and safety information.

Enbrel.com supports you and your loved ones from diagnosis to treatment. You can find
resources like injection demonstrations, patient testimonial videos, questions to ask your
doctor, and even help with finding a rheumatologist or dermatologist near you.

Enbrel.com also provices ongoing assistance with ENBREL SupportTM, a patient support
program to help with out-of-pocket costs and connect you with registered nurses and
ENBREL Nurse Partners. The resources available will help you get started. Resources
include the ENBREL Starter Kit, injection and medicine refill reminders, free needle disposal
containers, travel packs, and ongoing education.

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IMPORTANT SAFETY INFORMATION:
What is the most important information I should know about Enbrel® (etanercept)?

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.