What Should I Do If Im Late For My Dose Or Miss My Dose
If you forget to use Repatha® or if you are not able to take your regularly scheduled dose, inject your next dose as soon as you remember, as long as it is within 7 days of the late dose. If it is more than 7 days from the missed dose and you are using the autoinjector every-2-week dose, inject the next dose based on your original schedule. This will put you back on your original schedule. If it is more than 7 days from the late dose and you are using the once-monthly dose, inject the dose and start a new schedule based on this date. If you are not sure when to take Repatha® after a late dose, ask your healthcare provider or pharmacist.1
Important Things To Remember For Your Humira Injection:
- Your HUMIRA Pen or prefilled syringe should be stored in its original carton in a refrigerator until you are ready to use it. Full storage instructions are available in the Medication Guide.
- If more comfortable, take your HUMIRA Pen or prefilled syringe out of the refrigerator 15 to 30 minutes before injecting to allow the liquid to reach room temperature. Do not warm HUMIRA in any other way .
- Do not use if the liquid is cloudy or discolored or has flakes or particles in it.
- Keep HUMIRA, injection supplies, and all other medicines out of the reach of children.
Give Yourself A Little Reward
Sugar is a known inflammatory food, but sometimes it really does help the medicine go down or rather, in, says Onidah M., 39, who has rheumatoid arthritis. My favorite treats are Almond Rocas so I put one on the table in front of me and I cant eat it until I get my injection done, she says. Its just one a week so I dont think its hurting me too much and it motivates me to just do the shot and get it over with.
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I Left My Repatha Outside Of The Refrigerator Isthis Okay
It’s best to store Repatha® in the refrigerator , butRepatha® can be stored at room temperature for up to 30days in its original box.
In the event of a temporary room temperature exposure ,Repatha® may be returned to the refrigerator for theduration of its shelf life.
If you left Repatha® out at room temperature for more than 30 days,discard Repatha®. If you think the room temperature went above 77°F,call 1-844-REPATHA to learn more.
How Do I Store And/or Throw Out Enbrel Sureclick
- Store in a refrigerator. Do not freeze.
- You may store unopened containers at room temperature. If you store at room temperature, be sure you know how long the product is good for. Ask the doctor or pharmacist if you are not sure.
- Do not put Enbrel SureClick back in the refrigerator after it has been stored at room temperature.
- If using the AutoTouch reusable autoinjector, do not refrigerate the autoinjector.
- Store in the original container to protect from light.
- Protect from very hot or very cold temperatures.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
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How Does Enbrel Work
Although the exact cause of many diseases such as psoriasis or rheumatoid arthritis, is not known, experts do know that the immune system plays a role.
Normally our immune system protects us from infection and helps our tissues to repair. In some people, the immune system does not function as it should and produces abnormal levels of immune cells or factors. One of these factors is called TNF .
TNF is a naturally occurring cytokine . Cytokines and other proteins play an important role in the development of many inflammatory conditions such as psoriasis and rheumatoid arthritis, and the resulting joint destruction. Elevated levels of TNF are found in the tissues and body fluids of people with these conditions.
TNF binds to one of two receptors on cells these are called p55 TNF receptor or p75 TNF receptor. Enbrel acts as a decoy p75 TNF receptor, which means both TNF-alpha and TNF-beta bind to it instead of the cell surface TNF receptors. This renders TNF inactive. A fragment of human immunoglobulin G1 that is attached to the structure of Enbrel gives it a more profound and long-lasting effect than naturally occurring soluble TNF receptors.
Drug Forms And Administration
Enbrel and Humira are available in different forms. Both drugs are given as subcutaneous injections.
For Enbrel
Enbrel is available in the following forms:
- prefilled syringe
- prefilled SureClick autoinjector
- powder to be mixed into a solution
- Enbrel Mini single-dose prefilled cartridge
Enbrel is given as a subcutaneous injection, usually once a week. If you have rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis, the standard Enbrel dose is one 50-mg injection every week.
For adults with plaque psoriasis, you may start out with a dose of 50 mg twice per week for the first 3 months. After that, youll likely reduce your dose to one 50-mg dose a week.
For children with either plaque psoriasis or juvenile idiopathic arthritis, the dosage is usually based on weight. Children who weigh 138 pounds or more will receive one 50-mg injection each week.
Children who weigh less than 138 pounds also receive one injection each week. The dose is based on weight. The milligram strength is calculated as 0.8 mg/kg.
For example, if a child weighs 42 pounds, that equals about 19 kg. The dose is calculated as 19 kg multiplied by 0.8 mg/kg, resulting in a dose of about 15 mg. Your childs doctor or pharmacist can calculate the correct dosage for you.
For Humira
Humira is available in the following forms:
- single-use prefilled syringe
- single-use prefilled pen
- single-use 40-mg vial
Much like Enbrel, the pediatric dose of Humira for polyarticular JIA is based on the childs weight:
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What To Do If You Miss A Dose
If you forget to take HUMIRA, inject a dose as soon as you remember. Then, take your next dose at your regular scheduled time. This will put you back on schedule. In case you are not sure when to inject HUMIRA, call your doctor or pharmacist.
Injection Training Kit
Request an Injection Training Kit for Pen or syringe that walks you through the injection steps. Includes a demonstration device and visual aid.
Dosage For Polyarticular Juvenile Idiopathic Arthritis
Enbrel can be used in children ages 2 years and older for polyarticular juvenile idiopathic arthritis. Children who weigh 138 pounds or more will receive one 50-mg injection each week.
For children who weigh less than 138 pounds , one injection is given each week. The dose is based on weight.
The milligram strength is calculated as 0.8 mg/kg. For example, if a child weighs 42 pounds, that equals about 19 kg. The dose is calculated as 19 kg multiplied by 0.8 mg/kg, resulting in a dose of about 15 mg. Your childs doctor or pharmacist can calculate the correct dosage for you.
Enbrel prefilled syringes and autoinjectors only come in doses of 25 mg or 50 mg. You need to use the powder for a dose other than 25 or 50 mg.
The powder comes as 25 mg/mL and must be mixed before use. Once the powder is mixed, you can draw out the exact amount of medication that you need. So for the example above, you would draw out 0.6 mL of medication for a dose of 15 mg.
Weight-based dosing should never be greater than one 50-mg injection per week.
In juvenile idiopathic arthritis, children may continue taking steroid medications, anti-inflammatory medications, or pain medications that help relieve symptoms.
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Choose The Right Delivery Method For You
Patients have two choices for injecting themselves and both have pros and cons, Dr. Troum says. A standard needle and syringe comes pre-filled with the right amount of medication and you simply stick it in your body and push the plunger down. This method allows you to control the speed but can be more difficult for people anxious about doing self-injections, Dr. Troum says.
The alternative is a newer device called an auto-injector. Its a spring-loaded syringe that only requires you to hold it to your skin and press a button. The downside is you cant control the speed or pressure but it can take some of the fear out of the process because its over so quickly, he says.
Everyone raves about auto-injectors but personally I love using a manual syringe, says Melanie S., 50, who has psoriatic arthritis. Being able to inject the medication very slowly lessens the pain, bruising, and swelling, she says.
From a medication standpoint it doesnt matter which delivery method you use, so Dr. Troum recommends trying each to see which you prefer. You may also be limited by your health insurance, as some insurance companies will cover only one method or will require special authorization to cover a different type.
Enbrel For Polyarticular Juvenile Idiopathic Arthritis
Enbrel is also approved to treat moderate to severe polyarticular juvenile idiopathic arthritis in children ages 2 years and older.
Polyarticular JIA is a type of arthritis that occurs in people younger than 18 years old. It causes swelling and pain in five or more joints. Its not known what causes polyarticular JIA.
Although polyarticular JIA may cause pain in any joint, the most commonly affected areas are small joints in the fingers and hands.
Enbrel works by decreasing the swelling in joints. This helps make it easier and less painful for children with polyarticular JIA to move their affected joints.
In clinical trials of children ages 2 to 17 years old with polyarticular JIA, 74% saw a decrease in symptoms after 3 months of taking Enbrel. After 3 months, children were split into two groups: those who continued to take Enbrel and those who started taking a placebo .
In the second part of the trial, about 77% of children taking a placebo had an arthritis flare-up. In comparison, 24% of children taking Enbrel had a flare-up. Children taking Enbrel didnt have their first flare-up of symptoms until at least 116 days after starting treatment. Children taking a placebo had their first flare-up 28 days after starting treatment.
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What Are The Possible Side Effects Of Etanercept
Get emergency medical help if you have signs of an allergic reaction: hives difficult breathing swelling of your face, lips, tongue, or throat.
Serious and sometimes fatal infections may occur.
- signs of lymphoma–fever, night sweats, weight loss, stomach pain or swelling, swollen glands
- signs of tuberculosis—cough, night sweats, loss of appetite, weight loss, feeling very tired
- new or worsening psoriasis–skin redness or scaly patches, raised bumps filled with pus
- nerve problems—dizziness, numbness or tingling, problems with vision, or weak feeling in your arms or legs
- signs of heart failure–shortness of breath, swelling in your lower legs
- lupus-like syndrome—joint pain or swelling, chest discomfort, feeling short of breath, skin rash on your cheeks or arms o
- liver problems–right-sided upper stomach pain, vomiting, tiredness, loss of appetite, yellowing of your skin or eyes.
Common side effects may include:
- pain, swelling, itching, or redness where the medicine was injected or
- cold symptoms such as stuffy nose, sneezing, sore throat.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
How Is This Drug Best Taken
Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
All products:
- It is given as a shot into the fatty part of the skin on the top of the thigh, belly area, or upper arm.
- If you will be giving yourself the shot, your doctor or nurse will teach you how to give the shot.
- Wash your hands before and after use.
- Do not shake.
- Move the site where you give the shot with each shot.
- Do not give into skin that is irritated, tender, bruised, red, scaly, hard, scarred, or has stretch marks.
- Do not give into skin within 2 inches of the belly button.
- Different brands of this drug may be clear or have a slight color. Be sure you know what your brand needs to look like when ready to use. Do not use if the solution changes color. If you are not sure, talk with the pharmacist.
- Throw away needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow all local rules for getting rid of it. Talk with a doctor or pharmacist if you have any questions.
Auto-injectors, prefilled pens, and prefilled syringes:
Auto-injectors and prefilled pens:
- Check the window on the auto-injector when the injection is done. If the window does not show that the dose has been given or if it looks like this drug is still injecting, call the doctor right away to find out what to do.
Single-use vial:
Multi-dose container:
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Pediatric Dosage For Moderate To Severe Plaque Psoriasis
Enbrel can be used in children ages 4 years and older for moderate to severe plaque psoriasis. Children who weigh 138 pounds or more will receive one 50-mg injection each week.
For children who weigh less than 138 pounds , one injection is given each week. The dose is based on weight.
The milligram strength is calculated as 0.8 mg/kg. For example, if a child weighs 42 pounds, that equals about 19 kg. The dose is calculated as 19 kg multiplied by 0.8 mg/kg, resulting in a dose of about 15 mg. Your childs doctor or pharmacist can calculate the correct dosage for you.
Injection Training Support Is Always Available
Your HUMIRA Nurse Ambassador* can help with any questions you may have about injectingfrom setting up an in-home injection training visit to connecting you with online resources.
Dont yet have a Nurse Ambassador? . Once enrolled, youll be connected with your own Nurse Ambassador, who can point you to many treatment resources, including injection training. You can also get a sharps container and mail-back disposal kit for your used HUMIRA Pens or syringesat no additional cost to you. Watch this short video to learn how to use your container, and what to do when its getting full.
Your Ambassador will call you within one business day. But if you need to speak to someone sooner, call to speak with a registered nurse. Nurses are on call to provide injection help and assistance to patients taking HUMIRA.
*Nurse Ambassadors are provided by AbbVie and do not work under the direction of your health care professional or give medical advice. They are trained to direct patients to their HCP for treatment-related advice, including further referrals.
On-call nurses are available at for assistance Monday through Friday, from 8 AM to 8 PM Eastern Time. At all other times, a nurse will return your call within 1 hour.
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What Is Enbrel Used For
Enbrel is approved to treat the following conditions:
- Rheumatoid arthritis
- Plaque psoriasis in adults and children who are at least 4 years old
- Psoriatic arthritis
- Ankylosing spondylitis
- Polyarticular juvenile idiopathic arthritis in children who are at least 2 years old.
It is sometimes used in combination with methotrexate when used to treat rheumatoid arthritis and psoriatic arthritis.
What Are The Ingredients In Enbrel
Active Ingredient: etanercept
Single-dose Prefilled Syringe, Single-dose Prefilled SureClick Autoinjector, and Enbrel Mini Single-dose Cartridge:
Inactive Ingredients: L-arginine hydrochloride, sodium chloride, and sucroseMultiple-dose Vial:
Multiple-dose Vial:
Inactive Ingredients: mannitol, sucrose, tromethamine
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Taking Enbrel With Other Drugs
Your doctor may recommend that you take other drugs together with Enbrel.
If youre an adult receiving Enbrel for rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis, your doctor may also prescribe the following drugs:
For children with juvenile idiopathic arthritis who take Enbrel, doctors may prescribe the following medications:
- prednisone or other glucocorticoids
- other pain relievers
Can I Take Enbrel If I Have Diabetes
Yes, you can take Enbrel as long as your diabetes is well controlled. If your blood sugar levels are too high, taking Enbrel can increase your risk of serious infections.
Sometimes people with diabetes who take Enbrel can develop hypoglycemia . This can lead to sweating, confusion, and dizziness and can be dangerous. Its important to monitor your blood sugar levels while taking Enbrel. Your doctor may need to lower the dose of your diabetes medications if your glucose drops too low while taking Enbrel.
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How To Inject Enbrel
Enbrel is a medication thats given as a subcutaneous injection. Youll probably get your first dose of Enbrel in your doctors office. Then your doctor or pharmacist may show you how to inject Enbrel so you can use the medication at home.
You should take Enbrel according to your doctor or healthcare providers instructions. The Enbrel website also provides step-by-step instructions and videos on how to use each Enbrel product.
Here are some other tips for using Enbrel:
How Do I Dispose Of The Injector
Put the used autoinjector/orange needle cap OR the Pushtronex® in anFDA-cleared sharps-disposal containerright away after use. Do not throw away the autoinjector/orange cap ORthe Pushtronex® in yourhousehold trash. If you do not have an FDA-cleared sharps-disposal container, youmay use a householdcontainer that is made of a heavy-duty plastic can be closed with a tight-fitting,puncture-resistant lid,without sharps being able to come out upright and stable during use leak-resistant and properly labeled towarn of hazardous waste inside the container.2When your sharps-disposal container is almost full, you will need to follow yourcommunity guidelines for theright way to dispose of your sharps-disposal container. There may be state or locallaws about how you shouldthrow away used needles and syringes. For more information about safe sharpsdisposal, and for specificinformation about sharps disposal in the state that you live in, go to the FDAswebsite atwww.fda.gov/safesharpsdisposal.2
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