Drug Information for ENBREL (etanercept) For Subcutaneous Injection (Immunex Corp): Patient Instructions for UseENBRELĀ® (en-brel)(etanercept)Single-use Prefilled Syringe

  • How do I prepare and give an injection with ENBREL® Single-use Prefilled Syringe?

    There are 2 types of ENBREL® single-use prefilled syringes:

    • The 50 mg single-use prefilled syringe that contains one 50 mg dose of ENBREL®.
    • The 25 mg single-use prefilled syringe that contains one 25 mg dose of ENBREL®.

    Your doctor will tell you which one to use.

    A 50 mg dose can be given as one injection using a 50 mg single-use prefilled syringe or as two injections using 25 mg single-use prefilled syringes. Your doctor will tell you whether the two injections with 25 mg single-use prefilled syringes should be given on the same day once a week or on two different days (3 or 4 days apart) in the same week.

    Children must weigh at least 138 pounds to use the ENBREL® 50 mg single-use prefilled syringe. Children who weigh less than 138 pounds should use a different form of ENBREL®. The ENBREL® 25 mg single-use prefilled syringe should not be used in pediatric patients weighing less than 68 pounds.

    IMPORTANT: The needle cover on the single-use prefilled syringe contains latex. Tell your doctor if you are allergic to latex.

    STEP 1: Setting Up for an Injection

    • Select a clean, well-lit, flat work surface, such as a table.
    • Take the ENBREL® carton containing the prefilled syringes out of the refrigerator and place it on your flat work surface. Remove one prefilled syringe and place it on your work surface. Do not shake the prefilled syringe of ENBREL®. Place the carton containing any remaining prefilled syringes back into the refrigerator (2° to 8°C [36° to 46°F]). If you have any questions about storage, contact your doctor, nurse, or pharmacist for further instructions.
    • Check the expiration date on the prefilled syringe. If the expiration date has passed, do not use the prefilled syringe and contact your pharmacist or call 1-888-4ENBREL (1-888-436-2735) for assistance.
    • Wait 15 to 30 minutes to allow the ENBREL® in the prefilled syringe to reach room temperature. DO NOT remove the needle cover while allowing it to reach room temperature. Do not warm ENBREL® in any other way (for example, do not warm it in a microwave or in hot water).
    • Hold the prefilled syringe with the covered needle pointing down. If bubbles are seen in the syringe, very gently tap the prefilled syringe to allow any bubbles to rise to the top of the syringe. Turn the syringe so that the purple horizontal lines on the barrel are directly facing you. Check to see if the amount of liquid in the syringe falls between the purple lines. The top of the liquid may be curved. If the syringe does not have the right amount of liquid, DO NOT USE THAT SYRINGE. Contact your pharmacist or call 1-888-4ENBREL (1-888-436-2735) for assistance.
    • Assemble the additional supplies you will need for your injection. These include an alcohol swab, a cotton ball or gauze, and a puncture-resistant disposal container.
    • Wash your hands with soap and warm water.
    • Make sure the solution in the prefilled syringe is clear and colorless. You may notice small white particles in the solution. These particles are formed from ENBREL® and this is acceptable. However, do not inject the solution if it is cloudy or discolored, or contains large or colored particles – contact your pharmacist or call 1-888-4ENBREL (1-888-436-2735) for assistance.

    STEP 2: Choosing and Preparing an Injection Site

    • Three recommended injection sites for ENBREL® using a prefilled syringe include: (1) the front of the middle thighs; (2) the abdomen, except for the two-inch area right around the navel; and, (3) the outer area of the upper arms.
    • Rotate the site for each injection. Do not inject into areas where the skin is tender, bruised, red, or hard. Avoid areas with scars or stretch marks.
    • If you have psoriasis, you should try not to inject directly into any raised, thick, red, or scaly skin patches (“psoriasis skin lesions”).
    • To prepare the area of skin where ENBREL® is to be injected, wipe the injection site with an alcohol swab. Do not touch this area again before giving the injection.

    STEP 3: Injecting ENBREL® Using a Prefilled Syringe

    • Pick up the prefilled syringe from your flat work surface. Hold the barrel of the prefilled syringe with one hand and pull the needle cover straight off.When you remove the needle cover, there may be a drop of liquid at the end of the needle; this is normal. Do not touch the needle or allow it to touch any surface. Do not touch or bump the plunger. Doing so could cause the liquid to leak out.
    • Holding the syringe with the needle pointing up, check the syringe for air bubbles. If there are bubbles, gently tap the syringe with your finger until the air bubbles rise to the top of the syringe. Slowly push the plunger up to force the air bubbles out of the syringe.
    • Holding the syringe in one hand like a pencil, use the other hand to gently pinch a fold of skin at the cleaned injection site and hold it firmly.
    • Insert the needle at a slight angle (45 degrees) to the skin. With a quick, “dart-like” motion, insert the needle into the skin.
    • After the needle is inserted, let go of the skin. Pull the plunger back slightly. If blood comes into the syringe, do not inject ENBREL® because the needle has entered a blood vessel. Withdraw the needle and discard it in a puncture-resistant container. Repeat the steps to prepare for an injection using a new prefilled syringe of ENBREL®. Do not use the same prefilled syringe.
    • If no blood appears in the syringe, slowly push the plunger all the way down to inject ENBREL®.
    • When the syringe is empty, pull the needle out of the skin, being careful to keep it at the same angle as inserted. There may be a little bleeding at the injection site. You can press a cotton ball or gauze over the injection site for 10 seconds. Do not rub the injection site. If needed, you may cover the injection site with a bandage.

    STEP 4: Disposing of Supplies

    The syringe should NEVER be reused. NEVER recap a needle.

    Dispose of the used syringe as instructed by your healthcare provider, or by following these steps:

    • Do not throw the used syringe in the household trash or recycle.
    • Place the used syringe in a hard plastic disposal container with a screw-on cap or a metal container with a plastic lid, such as a coffee can, labeled “used syringes.” If a metal container is used, cut a small hole in the plastic lid and tape the lid to the metal container. If a hard plastic container is used, always screw the cap on tightly after each use. Do not use glass or clear plastic containers. Puncture-resistant containers may also be purchased at your local pharmacy.
    • When the container is full, tape around the cap or lid to make sure the cap or lid does not come off.
    • You should always check first with your healthcare provider for instructions on how to properly dispose of a filled disposal container. There may be special state and local laws for disposing of used needles and syringes. Do not throw the disposal container in household trash. Do not recycle.
    • Always keep the container out of the reach of children.

    A healthcare provider familiar with ENBREL® should answer all questions. A toll-free information service is also available: 1-888-4ENBREL (1-888-436-2735).



    Manufactured by:Immunex Corporation,Thousand Oaks, CA 91320-1799Marketed by Amgen Inc. and Wyeth Pharmaceuticals

    © 1998 – 2008 Immunex Corporation. All rights reserved.

    1XXXXXX - v1Issue Date: 06/2008

  • Drug Information Provided by National Library of Medicine (NLM).