Before having etanercept

Before having etanercept make sure your doctor or nurse knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have any infection or think that you may be at risk of an infection.
• If you have heart problems.
• If you have ever had a problem with your blood.
• If you have multiple sclerosis, optic neuritis (inflammation of the nerves of the eyes) or transverse myelitis (inflammation of the spinal cord).
• If you have ever had tuberculosis (TB).
• If you have alcoholic hepatitis (inflammation of your liver due to drinking alcohol).
• If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
• If you have ever had an allergic reaction to this or any other medicine.

How etanercept is given

• Before beginning treatment, read the manufacturer's printed information leaflet and follow the instructions you have been given with this treatment.
• Etanercept is given as an injection under the skin. Your doctor will tell you how to use etanercept, how much to use, and how often to use it. Follow these directions carefully and ask your doctor or clinic for further advice if you are unsure about anything.
• Store etanercept injections in a refrigerator, but remember to take your dose out of the fridge 15-30 minutes before your injection is due to allow the solution to reach room temperature before it is given.
• Before you have the injection, check that the injection solution is clear, colourless or pale yellow, and that it does not contain any bits or particles.
• Try to remember to use etanercept on the same day(s) each week. Making a note in your diary of which days your dose is due can help.
• If you forget a dose and your next dose is not due yet, you should inject the forgotten dose as soon as you remember and then continue on your usual days. If you forget a dose and your next dose is due on the following day or if you do not remember until the day that your next injection is due, you must skip the missed dose. Do not have two doses on the same day to make up for a missed dose.

Getting the most from your treatment

• You will be given a Patient Alert Card when you start this treatment. The card contains some important safety information for you to read. Keep it with you and take it to your clinic appointments.
• Tell your doctor if you come into contact with anyone with chickenpox while you are having this treatment. You may need treatment to prevent you from getting chickenpox.
• If you need to have any vaccinations speak to your doctor, as some vaccines are not suitable for you while you are being treated with etanercept.
• If you have diabetes you may need to check your blood glucose levels more regularly as this preparation can affect the levels of sugar in your blood.
• If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment that you are being treated with etanercept.
• Keep your regular doctor and clinic appointments so your progress can be monitored.
• Do not stop this treatment without speaking to your doctor first as your symptoms may return.
• If you buy any medicines, check with a pharmacist that they are safe to take alongside etanercept.

Can etanercept cause problems?

Along with their useful effects all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

• fever, sore throat, or unexplained bruising or bleeding
• swelling of the face, throat or mouth or difficulty breathing
• a severe itchy skin rash

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store etanercept

• Keep all medicines out of the reach and sight of children.
• Store in a refrigerator. Do not freeze.

Important information about all medicines

References

• Manufacturer's PIL, Enbrel® 50 mg solution for injection in pre-filled syringe. Wyeth Pharmaceuticals, electronic Medicines Compendium. Dated November 2009, accessed February 2010.
• Manufacturer's PIL, Enbrel® 25 mg solution for injection in pre-filled syringe. Wyeth Pharmaceuticals, electronic Medicines Compendium. Dated November 2009, accessed February 2010.
• Manufacturer's PIL, Enbrel® 50 mg solution for injection in pre-filled pen. Wyeth Pharmaceuticals, electronic Medicines Compendium. Dated November 2009, accessed February 2010.
• British National Formulary; 58th Edition (September 2009) British Medical Association and Royal Pharmaceutical Society of Great Britain, London.