Precautions and Warnings With Etanercept

Etanercept could increase the risk of dangerously low blood counts, certain nervous system conditions, and allergic reactions. Before taking etanercept, warnings and precautions should be reviewed with your healthcare provider. Tell him or her if you have any conditions that affect the blood, any current infection, or any disease that affects the immune system.

Etanercept: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking etanercept (Enbrel®) if you have:
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.

Specific Precautions and Warnings With Etanercept

Some warnings and precautions to be aware of prior to taking etanercept include the following:
  • Etanercept can increase your chance of infections, including serious infections. You should not start this drug if you have an infection (even a skin infection). While taking it, tell your healthcare provider right away if you think you may have any infection. Etanercept may not be the best choice for people who get frequent infections.
  • In rare cases, etanercept has been reported to cause certain nervous system conditions, including multiple sclerosis (MS), seizures, epilepsy, and other conditions. The medication may also make these conditions worse. Talk to your healthcare provider before taking etanercept if you have MS, seizures, or any other nervous system condition.
  • In rare cases, etanercept has caused dangerously low blood counts (including aplastic anemia). You should tell your healthcare provider about any unusual bruising, bleeding, or paleness while taking this drug.
  • Etanercept can increase your risk of lymphoma (a certain type of cancer). In clinical studies, people who took both etanercept and cyclophosphamide (Cytoxan®) had an even higher risk of lymphoma. In general, these medications should not be taken together.
  • Etanercept 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 this medication.
  • Allergic reactions can occur with etanercept. These reactions include:
    • Rashes
    • Hives
    • Itching
    • Wheezing or difficulty breathing
    • Unusual swelling.
Let your healthcare provider know right away if you think you are having an allergic reaction to this medication.
  • Etanercept 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 etanercept 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 etanercept. Talk to your healthcare provider about this precaution before starting the medication.
  • You should not receive live vaccines while taking etanercept. Talk to your healthcare provider before receiving any vaccines while on this drug.
  • In rare cases, etanercept 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 (jaundice)
    • Extreme tiredness
    • Loss of appetite
    • Dark urine
    • Pale-colored stools.
If you notice any of these symptoms, you should talk to your healthcare provider.
  • Etanercept can interact with certain medications (see Drug Interactions With Etanercept).
  • Etanercept 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 etanercept during pregnancy (see Enbrel and Pregnancy).
  • It is not known if etanercept 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 drug while nursing would be okay for your particular situation.
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Etanercept (Enbrel)

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