Etanercept
ENBREL
Pronunciation: et-a-NER-sept
What it isTNF receptor fusion protein; rheumatoid arthritis, psoriasis and ankylosing spondylitis.
Why this oneA shorter half-life than the antibody TNF blockers, so it clears faster if infection develops.
What limits itIt does NOT work in inflammatory bowel disease, unlike the antibody agents — a common misassumption. Screen for tuberculosis and hepatitis B.
FDA-approved for
- rheumatoid arthritis (1998)
- psoriasis, ankylosing spondylitis
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis | adult | 50 mg weekly | 50 mg weekly | 50 mg weekly |
| Plaque psoriasis | adult | 50 mg twice weekly x3 months | 50 mg weekly | 50 mg twice weekly (starting) |
| Plaque psoriasis or juvenile idiopathic arthritis | pediatric | 0.8 mg/kg weekly | 0.8 mg/kg weekly | 50 mg weekly |
Renal Undefined
Hepatic Undefined
Instructions
- Subcutaneous injection
- Rotate injection sites
- Test for latent TB before and monitor during therapy
Available strengths
- inj 50 mg/mL
Contraindications
- Sepsis
Cautions
- Serious infections — discontinue if serious infection/sepsis
- Malignancies incl. lymphoma
- Neurologic (demyelinating) events
- New/worsening heart failure
- Hematologic reactions (pancytopenia, aplastic anemia)
- Hepatitis B reactivation
- Allergic reactions
- Autoimmunity
- Immunosuppression
Adverse reactions
- Infections
- Injection site reactions
Pregnancy Registry data do not reliably support association with major birth defects; consider risks/benefits.
Lactation Present in low levels in human milk, minimally absorbed by breastfed infant.
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 50 mg/mL | inj | per unit | — | $2080.99/mL | not offered |
Generic entry2029 est. (biosimilar)
⚠ BOXED WARNINGS
- Serious infections
- Malignancy
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilitySerious infection, cytopenias, hepatic injury and malignancy risk require laboratory and clinical monitoring.
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