Etanercept Pre-filled Syringe

What is this medication for?

Etanercept belongs to a class of medications named biologic disease modifying anti-rheumatic drugs (bDMARD).  

Etanercept helps to reduce inflammation and prevents the body’s immune system from becoming overactive by blocking a substance in your body called TNF (tumor necrosis factor), which plays a key role in inflammation.  

It is usually used to treat several inflammatory conditions in:  

• Joints (rheumatoid arthritis, psoriatic arthritis)
• Skin (plaque psoriasis)
• Spine (axial spondyloarthritis, ankylosing spondylitis) 

How should I take or use this medication?

• Administered as an injection under the skin on the belly area (at least 2-inch away from the navel) or on the outside of the thigh.  
• This medication is usually prescribed once weekly or two times weekly dosing. Use this medication as prescribed by your physician.
• Each device is meant for one-time use only.  
• Do not stop taking your medication without checking with your healthcare professional.
• Wash your hand before and after use.  
• Follow the instructions below for the prefilled syringe (or as trained by your healthcare provider).
  1. Remove from refrigerator 30 minutes before use and check that the solution is clear and free of particles. Do not shake the solution.
  2. Choosing and preparing an injection site:
     • The recommended injection sites: (1) The abdomen (at least 2-inch away from the navel); (2) The front of the middle thighs; (3) The outer area of the upper arm.
     • Rotate sites of the injection. Do not inject into the same spot each time. Avoid areas that are red, bruised, or tender.  
     • Wipe the planned injection site with alcohol swab.  
  3. When you are ready to inject, remove the needle cover.
     • Pull the needle cover straight off with one hand, while holding the syringe by the barrel (middle part) with your other hand. Do not twist or bend it.
     • Important: Do not remove the needle cover until you are ready to inject. The syringe must be used within 5 minutes after removing the cover, or the medicine might dry out.
  4. Check the syringe.
     • You might see a small drop of liquid at the tip of the needle -- this is normal.
     • Do not touch the needle or let it touch anything.
     • Do not press the plunger before the injection.
  5. Remove air bubbles.
     • Hold the syringe with the needle pointing up.
     • Tap the syringe gently using your free hand to move air bubbles to the top.
     • Slowly push the plunger just enough to remove the bubbles.
  6. Get ready to inject.
     • Hold the syringe like a pencil using your dominant hand.
     • With your other hand, pinch the cleaned skin gently to make a fold.
     • Insert the needle at a 45-degree angle into the skin, then let go of the pinched skin.
     • With your free hand, hold the syringe near its base to stabilise it. Push the plunger slowly and steadily to inject all the medicine.
  7. Finish the injection.
     • Once the syringe is empty, pull the needle out gently at the same angle.
     • If there is any bleeding, press a cotton ball or gauze on the injection site for about 10 seconds.
     • Do not rub the injection site. 

What should I do if I forget to take or use this medication?

If you forget to take a dose, take it as soon as you remember. Then take your next dose at the usual time. Do not take two doses to make up for the missed dose.

If the next scheduled dose is due within the next 24 hours, to skip the missed dose. 

What precautions should I take when taking or using this medication?

Pre-screening is conducted before starting Etanercept. Etanercept is generally used with precaution in the following scenario:

• Hepatitis B or hepatitis C—this medicine may cause the virus to become active again
• Current or previous cancer
• Moderate to severe heart failure
• Tuberculosis 

Inform your healthcare professional if:  

• You are allergic to this medicine or any of its ingredients.
• You are pregnant, planning to become pregnant, or breastfeeding. 

What are some common side effects of this medication? ​

• Injection-site reaction (including pain, swelling, redness, itchiness at injection site).  
  • If you experience redness or swelling at the injection site, you may apply a cold compress to help relieve the symptoms.  
• Upper respiratory infections (runny nose, sore throat, hoarse voice or loss of voice)
  • If your symptoms are mild and improve over the next few days, you may continue to monitor them until they resolve. However, if your symptoms do not improve or become worse, please consult your doctor. 

What are some rare but serious side-effects that I need to seek medical advice immediately? 

The symptoms of a drug allergy include one or more of the following:  

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body  

For videos in 中文, Melayu and தமிழ், click here. 

Other rare but serious side effects:

• Signs of infection (fever, chills, very bad sore throat) as infections may be more likely while taking this medication. This medicine may increase your risk of serious infections or reactivate the infections, including tuberculosis, hepatitis B and infections caused by viruses, fungi, or bacteria.
• Signs of lupus (persistent unexplained rash, fever, joint pain or extreme tiredness)
• Signs of liver problems (yellowing of the skin or eyes, dark-coloured urine, light-colored stools)
• Signs of nerve problems (tingling, numbness, change in vision, muscle weakness)

If you experience any of the above symptoms, you should stop your medication and see your healthcare professional immediately. 

What food or medication should I avoid when I take or use this medication?

Avoid raw, undercooked or half-cooked food to reduce risk of getting infections.

Avoid live vaccinations such as yellow fever or BCG (tuberculosis)

Other biological immunosuppressive medications such as Anakinra, Abatacept. 

How should I store this medication?

Store in the original container to protect from light. Keep this medication away from children.  

Store in the refrigerator between 2-8°C. Do not freeze. Do not shake.  

If necessary, you may keep the injection at room temperature (maximum up to 25°C) for up to 28 days.

• Mark the date you take the injection out of the refrigerator on the carton.
• Do not return to the fridge once it has reached room temperature.
• Discard if it has been kept at room temperature for 28 days and not used. 

How do I throw away this medication safely? ​

Discard the pen in a metal tin or hard plastic container to avoid needlestick injury.