Enbrel
| Noun | 1. | Enbrel - a genetically engineered anti-TNF compound (trade name Enbrel) consisting of receptors that bind TNF; it is injected twice a week in the treatment of rheumatoid arthritis |
Enbrel
etanercept
Pharmacologic class: Immunomodulator
Therapeutic class: Antiarthritic
Pregnancy risk category B
Action
Reacts with and deactivates free-floating tumor necrosis factor, responsible for inflammation
Availability
Powder for injection: 25 mg in multiple-use vial
Prefilled syringe (single-use): 50 mg/ml
Indications and dosages
➣ Moderately to severely active rheumatoid arthritis; ankylosing spondylitis; psoriatric arthritis
Adults: 50 mg subcutaneously q week given as a single injection. Dosages above 50 mg/week are not recommended.
➣ Chronic moderate to severe plaque psoriasis
Adults ages 18 and older: 50 mg subcutaneously twice weekly (given 3 or 4 days apart) for 3 months, followed by reduction to a maintenance dosage of 50 mg weekly
➣ Polyarticular-course juvenile rheumatoid arthritis
Children ages 4 to 17: 0.8 mg/kg subcutaneously q week, to a maximum of 50 mg weekly
Contraindications
• Hypersensitivity to drug or its components
• Sepsis
Precautions
Use cautiously in:
• immunosuppression, chronic infection, heart failure
• latex allergy (needle cover of diluent syringe contains latex)
• elderly patients
• pregnant or breastfeeding patients
• children younger than age 4.
Administration
• Inject subcutaneously into thigh, abdomen, or upper arm.
• For adult, use single-use, 50 mg/ml prefilled syringe.
• For child weighing 63 kg (138 lb) or more, use single-use, 50 mg/ml pre-filled syringe for weekly dose; for child weighing 31 to 62 kg (68 to 137 lb), administer total weekly dose from multipleuse vial as two injections on same day or 3 or 4 days apart; for child weighing less than 31 kg (68 lb), give as a single weekly injection using multipleuse vial.
• Rotate injection sites.
Adverse reactions
CNS: asthenia, headache, depression, dizziness, paresthesia, fatigue, demyelinating disorders (such as multiple sclerosis and myelitis), cerebral hemorrhage, seizures, cerebrovascular accident (CVA)
CV: hypotension, hypertension, chest pain, deep-vein thrombosis, thrombophlebitis, myocardial ischemia, myocardial infarction (MI), heart failure
EENT: ocular inflammation, pharyngitis, rhinitis, sinusitis
GI: nausea, vomiting, diarrhea, abdominal pain, dyspepsia, anorexia, cholecystitis, abdominal abscess, GI hemorrhage, intestinal perforation, pancreatitis
GU: pyelonephritis, membranous glomerulonephropathy
Hematologic: anemia, aplastic anemia, leukopenia, pancytopenia, thrombocytopenia
Metabolic: hypomagnesemia
Musculoskeletal: bursitis, polymyositis, joint pain
Respiratory: cough, congestion, dyspnea, bronchitis, pneumonia, pulmonary embolism, interstitial lung disease
Skin: flushing, cellulitis, pruritus, rash, cutaneous vasculitis, urticaria, alopecia, angioedema
Other: altered taste, weight gain, adenopathy, fever, irritation at injection site, peripheral edema, flulike symptoms, autoantibody formation, lupus-like syndrome, serious infections, malignancies
Interactions
None significant
Patient monitoring
See Watch for signs and symptoms of malignancies, pancytopenia and infection.
See Monitor for evidence of GI bleeding, lupus-like syndrome, and serious hypersensitivity reactions. Stop therapy immediately if these occur.
• Monitor CBC and coagulation studies.
See Check for signs and symptoms of cardiac compromise and cerebrovascular events.
• Monitor pulmonary function test results periodically to assess lung status.
• Assess patient's ability to self-administer drug.
• Check for irritation at injection site. As needed, apply cool compresses.
• Examine eyes for conjunctival dryness. As needed, apply artificial tears.
Patient teaching
See Tell patient to withhold dose and contact prescriber if he develops signs or symptoms of infection or is exposed to anyone with chickenpox.
See Tell patient to immediately report hypersensitivity reaction, neurologic or respiratory problems, sudden weight gain, chest pain, or easy bruising or bleeding.
• Teach patient or caregiver how to administer drug and handle and dispose of equipment.
• Caution patient not to get live-virus vaccines.
• Tell female to inform prescriber if she is pregnant or breastfeeding.
• Advise patient to expect redness, swelling, and pain at injection site. Assure him that these problems will diminish over time.
• As appropriate, review all other significant and life-threatening adverse reactions mentioned above.
Enbrel
(ĕn′brĕl′)Enbrel®
Etanercept Rheumatology A TNF inhibitor that targets the immune system, ↓ M&M of moderately to severely active rheumatoid arthritis in Pts with an inadequate response to one or more disease-modifying antirheumatic drugs–DMARDs; can be used in combination with MTX for nonresponders to MTX aloneEnbrel
A brand name for ETANERCEPT.Enbrel
- noun
Synonyms for Enbrel
noun a genetically engineered anti-TNF compound (trade name Enbrel) consisting of receptors that bind TNF
Synonyms
- etanercept
Related Words
- anti-TNF compound
- brand
- brand name
- marque
- trade name
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