Etanercept

About Etanercept

Etanercept is a lab-made protein that binds TNF, an immune signal behind joint and skin inflammation, and stops it acting on cells. Adults usually inject 50 mg once a week; for plaque psoriasis the label starts at 50 mg twice a week for three months, then weekly. Children are dosed by weight, from age two for juvenile arthritis and from age four for psoriasis. In rheumatoid arthritis, methotrexate and steroids can be continued alongside it.

The boxed warning covers serious infections, including tuberculosis, and lymphoma and other cancers reported in children and teenagers treated with TNF blockers. Tuberculosis testing comes before the first dose, and hepatitis B is checked because it can reactivate. It is not used in sepsis. It can also cause or worsen nerve disorders such as multiple sclerosis, worsen heart failure, lower blood counts or cause a lupus-like illness. Injection-site reactions and minor infections are the common side effects.

Taking Etanercept

How to take it

Usually once a week on the same day. Let it reach room temperature first, 15 to 30 minutes for a syringe and at least 30 minutes for the SureClick autoinjector, without warming it any other way. Inject under the skin of the thigh, the abdomen away from the navel or, if someone else gives it, the outer upper arm, rotating sites and avoiding tender, bruised or hard skin.

If you miss a dose

Inject it as soon as you remember. If it is almost time for the next dose, skip the missed one and keep to your usual schedule. Do not inject a double dose.

Storage

In the refrigerator at 36 to 46°F (2 to 8°C), in the carton to protect it from light; do not freeze or shake it. It may be kept at room temperature for a limited time that depends on the product, and must not then go back in the refrigerator. Put used devices in a sharps container.

Interactions to know about

Live vaccines are not given during treatment. In studies, adding anakinra or abatacept increased serious infections, and use with cyclophosphamide is not recommended. Diabetes medicines may need adjusting. Report fever, cough or other signs of infection promptly.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Etanercept differs from pharmacy to pharmacy

With one maker and no biosimilar for sale, there is nothing cheaper to substitute. In federal acquisition-cost data, pharmacies pay about the same per milligram for the autoinjector, the syringe and the Mini cartridge, so quotes differ mainly by mark-up, and on a medicine this expensive small differences in mark-up add up. A pharmacy that does not stock it must order it in and keep it refrigerated until you collect it.

Ways to pay less for Etanercept without insurance

• Contact Amgen SupportPlus before paying cash. Amgen offers a co-pay card for people with commercial insurance and, through the Amgen Safety Net Foundation, help for people who are uninsured or whose insurance excludes the medicine, each with eligibility rules.
• If you have Medicare, ask about the federal Extra Help program.
• For psoriasis, if your schedule changes after the first three months, ask the prescriber to update the quantity on the prescription.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Etanercept

1. 1.Which device is this, and can you show me how to use it?
2. 2.How long can it stay out of the refrigerator?
3. 3.Which infection symptoms should make me call my prescriber?
4. 4.Which vaccines should I have before starting?
5. 5.How will it be kept cold until I collect it?

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