Arthritis Home > Enbrel Warnings and Precautions
There are several precautions and warnings with Enbrel to be aware of, including an increased risk of lymphoma, the danger of taking the medication if you have an infection, and potential drug interactions. You should not take Enbrel if you are allergic to any ingredient used to make the medicine. Prior to taking Enbrel, be sure to tell your healthcare provider if you have multiple sclerosis, seizures, or congestive heart failure.
Enbrel: What Should I Tell My Healthcare Provider?You should talk with your healthcare provider prior to taking Enbrel® (etanercept) if you have:
- Multiple sclerosis
- Seizures or epilepsy
- Congestive heart failure (CHF)
- Any disease that affects the immune system, such as diabetes, cancer, HIV, or AIDS
- Any condition that affects the blood, including blood-clotting disorders
- Any current infection
- Infections that come and go (such as cold sores)
- Plans to receive vaccinations
- An upcoming surgery
- A history of hepatitis B infection or tuberculosis
- Exposure to chickenpox or tuberculosis (TB)
- Wegener's granulomatosis
- A latex allergy
- Any other allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
Some Enbrel Warnings and PrecautionsPrecautions and warnings with Enbrel to be aware of include the following:
- Enbrel can increase your chance of infections, including serious infections. You should not start this medication if you have an infection (even a skin infection). While taking Enbrel, tell your healthcare provider right away if you think you may have any infection. This medication may not be the best choice for people who get frequent infections.
- In rare cases, Enbrel has been reported to cause certain nervous system conditions, including multiple sclerosis (MS), seizures, epilepsy, and other conditions. This medication may also make these conditions worse. Talk to your healthcare provider before taking Enbrel if you have MS, seizures, or any other nervous system condition.
- In rare cases, Enbrel has caused dangerously low blood counts (including aplastic anemia). You should tell your healthcare provider about any unusual bruising, bleeding, or paleness during treatment.
- Enbrel can increase your risk of lymphoma (a certain type of cancer). In clinical studies, people who took both Enbrel and cyclophosphamide (Cytoxan®) had an even higher risk of lymphoma. In general, these medications should not be taken together.
- Enbrel can cause certain infections (such as hepatitis B or tuberculosis) that are inactive in the body to become active again. Tell your healthcare provider if you have ever had hepatitis B or tuberculosis before starting treatment.
- Allergic reactions can occur with Enbrel. These reactions include rashes, hives, itching, wheezing or difficulty breathing, and unusual swelling. Let your healthcare provider know right away if you think you are having an allergic reaction to the drug.
- Enbrel prefilled syringes and SureClick™ syringes contain rubber that can cause an allergic reaction in a person with a latex allergy.
- In clinical studies, people with congestive heart failure (CHF) who took Enbrel had an increased risk of death. Also, worsening of heart failure and new cases of heart failure (in people that did not already have CHF) have been reported in people taking Enbrel. Talk to your healthcare provider about this precaution before starting the medication.
- You should not receive live vaccines while taking Enbrel. Talk to your healthcare provider before receiving any vaccines while on this medication.
- In rare cases, Enbrel has caused lupus-like conditions or autoimmune hepatitis. Symptoms of a lupus-like condition may include an unexplained rash across the nose and checks (known as a butterfly rash) or ulcers in the mouth or nose. Autoimmune hepatitis symptoms can include:
- Abdominal pain (stomach pain)
- Yellowing of the skin or whites of the eyes
- Extreme tiredness
- Loss of appetite
- Dark urine
- Pale-colored stools.
If you notice any of these symptoms, you should talk to your healthcare provider.
- Enbrel can interact with certain medications (see Enbrel Drug Interactions).
- Enbrel is considered a pregnancy Category B medication. This means that it is unlikely to harm an unborn baby. However, the full risks of using the drug while pregnant are not known. Be sure to talk to your healthcare provider about the risks and benefits of taking it while pregnant (see Enbrel and Pregnancy).
- It is not known if Enbrel passes through breast milk. Therefore, if you are breastfeeding or plan to start, be sure to talk with your healthcare provider about this. He or she can help you decide if taking the medication while nursing would be okay for your particular situation.