Enbrel is used in Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, and Non-radiographic Axial Spondyloarthritis (Adults): For moderate-to-severe active rheumatoid arthritis (alone or with methotrexate/other synthetic DMARDs), severe active and progressive rheumatoid arthritis, active and progressive psoriatic arthritis, severe active ankylosing spondylitis, and severe non-radiographic axial spondyloarthritis. Administered via SC injection at 25 mg twice weekly or 50 mg once weekly. Treatment should be reviewed if there is no response within 12 weeks. Plaque Psoriasis (Adults): For moderate-to-severe plaque psoriasis when other systemic therapies or PUVA are inadequate or contraindicated. Administered via SC injection at 25 mg twice weekly or 50 mg once weekly. Alternatively, 50 mg twice weekly for up to 12 weeks, followed by 25 mg twice weekly or 50 mg once weekly. Discontinue if there is no response after 12 weeks. Polyarthritis and Extended Oligoarthritis (Children 2–17 years): For children who have had an inadequate response to or cannot tolerate methotrexate. Administered via SC injection at 400 micrograms/kg twice weekly (maximum 25 mg per dose, given 3–4 days apart) or 800 micrograms/kg once weekly (maximum 50 mg per dose). Discontinuation should be considered if there is no response after 4 months.

Contraindication: Enbrel (Etanercept) is contraindicated in patients with an active infection. Precaution: Precautions should be taken regarding the development of malignancy, diabetes mellitus, exacerbation of heart failure, history of blood disorders, history of malignancy, demyelinating disorders, and a general predisposition to infection. Patients must be monitored for active HBV and worsening HCV infections. In case of exposure to the herpes zoster virus, treatment should be interrupted and varicella-zoster immunoglobulin should be considered. Patients must be evaluated for active and latent tuberculosis (TB) prior to starting treatment; active TB requires at least 2 months of standard treatment before initiating etanercept, and chemoprophylaxis should be used for inadequately treated or high-risk patients. Effective contraception is required during treatment and for 3 weeks after the last dose. Pregnancy: The available studies do not reliably establish an association with major birth defects. However, etanercept crosses the placenta and has been detected in the serum of infants born to treated mothers. Its use is generally not recommended during pregnancy (use only if essential/benefits outweigh risks). Women of child-bearing potential should use effective contraception during treatment and for 3 weeks after the last dose. Infants exposed in utero should not receive live vaccines for 16 weeks after the mother's last dose. Breastfeeding: Enbrel (Etanercept) is distributed into human milk in low concentrations and is minimally absorbed by breastfed infants. Some guidelines recommend avoiding its use during breastfeeding (or using it only if the benefit outweighs the risk), while others suggest that the benefits of breastfeeding and the importance of the drug to the mother should be weighed carefully. Renal/Hepatic Impairment: The manufacturer advises caution in patients with moderate to severe alcoholic hepatitis.

Enbrel contains Etanercept, a biological medicine available as an injection (25 mg or 50 mg vial). It is primarily used for the treatment of various severe rheumatic disorders and plaque psoriasis.

Enbrel Common/Very Common adverse effects: Injection site reactions (erythema, itching, pain, swelling), infections (including upper respiratory tract infections), fever, headache, cystitis, allergic reactions, and autoantibody formation. Uncommon: Abscess, anaemia, angioedema, bursitis, cholecystitis, diarrhoea, endocarditis, eye inflammation, gastritis, heart failure, hepatic disorders, inflammatory bowel disease, leucopenia, myositis, neoplasms, neutropenia, sepsis, skin ulcers, thrombocytopenia, and vasculitis. Rare/Very Rare/Frequency Not Known: Bone marrow disorders, cutaneous lupus erythematosus, demyelination, interstitial lung disease, pulmonary fibrosis, sarcoidosis, seizures, severe cutaneous adverse reactions (SCARs), transverse myelitis, and hepatitis B reactivation.

Enbrel preparations should be stored in a refrigerator (2–8°C) in the original carton to protect from light. They may be kept at room temperature for up to 14 days, after which they must be discarded. Do not shake or freeze. For patient comfort, prefilled syringes or dose trays can be left at room temperature for 15–30 minutes prior to administration.

Safe Dispensing: To avoid medication errors, it is recommended that prescribers communicate both the brand and generic names on the prescription. Because it is a biological medicine, it must be prescribed and dispensed by brand name. Patient Monitoring & Education: Patients and caregivers should be advised to seek immediate medical attention if they develop symptoms suggestive of blood disorders (e.g., persistent fever, sore throat, bruising, bleeding) or tuberculosis (e.g., persistent cough, weight loss, fever).