What is Enbrel?

Enbrel is a prescription biologic medication used to treat certain autoimmune diseases like rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, and plaque psoriasis. It comes as an autoinjector called Enbrel Sureclick, a syringe, and delivered with a machine (i.e., Enbrel Mini).

It contains the active ingredient etanercept, which is a tumor necrosis factor (TNF) blocker that targets overactive immune system cells to reduce inflammation and manage disease symptoms. Enbrel works by binding to TNF and blocking its function, which interrupts the inflammatory cascade that leads to joint swelling, pain, and damage in inflammatory forms of arthritis.

Enbrel comes in an autoinjector pen called the Enbrel SureClick that allows patients to self-administer the medication subcutaneously. The autoinjector contains a pre-filled cartridge with a single dose of Enbrel and spring-activated needle for injection. Using the autoinjector allows for a simple, convenient way to take the medication at home.

Understanding the Enbrel SureClick Autoinjector

The Enbrel SureClick autoinjector is a prefilled, single-dose disposable device designed to make self-injection straightforward and convenient. Here are the main parts to understand:

• Cap – Covers the needle before injection to keep it sterile. Remove the cap just before injecting.
• Viewing window – Allows you to see the Enbrel solution inside the device. Make sure the liquid looks clear to slightly yellowish and does not contain particles.
• Expiration date – Check that the date has not passed before using. Do not use if expired.
• Medicine – Each SureClick contains 50 mg of Enbrel in a prefilled syringe. No reconstitution is required.
• Needle guard – Covers the needle after injection to prevent injury. The needle guard will deploy and lock automatically after the full dose is given.
• Start button – Pressing this blue button starts the injection after the autoinjector is positioned on skin.
• Injection complete indicator – Orange part that is visible when injection is done.

Familiarize yourself with these parts before using the Enbrel SureClick to ensure proper administration. With some preparation and by following all instructions, the autoinjector allows you to easily and comfortably deliver your Enbrel dose subcutaneously.

Before the Injection

Before injecting Enbrel, take the autoinjector out of the refrigerator and allow it to reach room temperature. This is an important step, as injecting cold medication can be uncomfortable. Leaving Enbrel at room temperature for about 30 minutes before injection allows the medication to warm up.

Some tips for allowing Enbrel to reach room temperature:

• Take Enbrel out of the refrigerator about 30 minutes before your scheduled injection time.
• Do not try to warm the medication by heating it in a microwave or placing it in hot water, as this can damage the medication.
• Lay the autoinjector on a flat surface like a tabletop or counter while you wait for it to warm up.
• Avoid leaving Enbrel out of the refrigerator for longer than 30 minutes before injecting. The medication can be safely kept at room temperature for up to 30 days if needed, but it’s best to inject it as soon as it reaches room temperature. You also should not put it back in the refrigerator.
• Check the solution in the autoinjector window periodically. When ready to inject, the solution should be clear and colorless, with no lumps or particles.

Allowing Enbrel to warm to room temperature helps make the injection process smooth and comfortable. Once the medication has reached room temperature, you are ready for the next steps of preparing the injection site and injecting Enbrel.

Choosing the Injection Site

The recommended injection sites for Enbrel SureClick are the abdomen, thighs, and upper arms. These areas generally have more padding between the skin and muscle which makes injections easier and more comfortable.

When choosing a site, avoid injecting within 2 inches of the navel or any scar tissue or bruises. Also avoid areas that are tender, red, hard or have psoriasis plaques.

Rotate injection sites with each use. Do not inject into the exact same spot each time. Recommended rotation patterns include:

• Abdomen: Divide the abdomen into quadrants using the navel as the center. Inject in a different quadrant each time.
• Thighs: Alternate between left and right thigh.
• Upper arms: Alternate between left and right upper arm.

Properly rotating sites allows one area to fully heal between injections. This helps minimize skin reactions or buildup of scar tissue.

Preparing the Injection Site

Before administering your Enbrel injection, you will need to properly prepare the injection site. This helps ensure the medication is delivered safely and effectively.

The first step in preparing the injection site is to wash your hands thoroughly with soap and warm water. Be sure to scrub for at least 20 seconds. This helps remove dirt and bacteria from your hands before handling the injection components.

Once your hands are clean, use an alcohol wipe to clean the skin at the injection site you have chosen. Be sure to let the alcohol fully dry before proceeding. Cleaning the skin with an alcohol wipe kills bacteria on the surface of the skin and prevents infection.

Only inject Enbrel into areas with no signs of skin problems like redness, swelling, scarring, or irritation. Avoid injecting into areas that are bruised, scarred, or feel hard. Also do not inject into moles, scars, bruises, or areas where the skin is tender, damaged, red, or hard.

Properly cleaning the injection site with an alcohol wipe before each use of Enbrel helps minimize skin reactions and ensure proper delivery of the medication.

Removing the Cap

To remove the cap from the Enbrel SureClick autoinjector, first inspect the cap to make sure it is intact and has not been previously removed. Grasp the cap and gently pull it straight off the autoinjector. Do not twist or bend the cap, as this could damage the internal needle.

Once you have removed the cap, set it aside on a clean surface. Be careful not to touch the exposed needle under the cap with your fingers, as this could contaminate the needle. The autoinjector is now ready for positioning and injection. Avoid removing the cap until you are ready to inject, as this helps keep the needle sterile.

If the cap is loose, damaged, or missing, do not use that autoinjector. Call your healthcare provider for a replacement. Never try to recap a used autoinjector or you may risk accidental needlestick injury.

Positioning the Autoinjector

Hold the autoinjector at a 90 degree angle against the injection site you have cleaned. You want to position it straight up and down, perpendicular to the skin, not at an angle. This allows the needle to properly insert into the skin.

Gently press the autoinjector firmly against the skin to start the injection. You will hear a click which signals the start of the injection, but continue holding it firmly in place. It is important to keep holding it securely against the skin throughout the entire injection process.

Do not try to inject at an angle as this can affect how well the medication is delivered. Keep the autoinjector straight up and down. Apply enough pressure so that it remains firmly in contact with the skin.

Starting the Injection

Once you have positioned the autoinjector against your skin at the injection site, you are ready to start the injection. To do this, you simply need to:

• Firmly push the autoinjector all the way down against your skin until it stops moving. This will trigger the start button.
• Listen for the click. The click signals that the injection has started and the medicine is being delivered.
• Keep pushing down on the autoinjector. It is important to hold the autoinjector in place against your skin after the click for about 10 seconds to allow the full dose to be delivered.
• You may hear a second click during this time – this is just an indicator that the injection is nearly complete.
• After 10 seconds, you can then lift the autoinjector straight off of the injection site. The purple indicator will be visible to confirm the dose has been fully given.

Pushing the autoinjector all the way down until it stops moving is the action that starts the injection process. Keep the autoinjector firmly in place for 10 seconds after the click to allow the full dose to be properly injected.

Completing the Injection

After the loud click, continue holding the Enbrel SureClick autoinjector firmly against your skin for 10 seconds to ensure the full dose is delivered. Do not remove it sooner than 10 seconds, even if you think the injection is complete.

Holding the device in place allows time for all of the medication to be injected under the skin. If you remove it too soon, some medication may stay in the autoinjector and you will not get your full dose.

Keep holding the autoinjector firmly against the injection site for a slow count of 10 seconds. Count slowly in your head or out loud. After counting to 10, you can then lift the autoinjector straight up from your skin to complete the injection.

The blue indicator will now be visible to confirm the injection is complete. You may see a few drops of liquid on your skin, which is normal. Press a cotton ball or gauze pad over the injection site and hold for 10 seconds. Do not rub the site.

After the Injection

After you have completed the injection, you can remove the autoinjector from your skin. Check the viewing window to ensure the purple indicator is visible, confirming the full dose has been delivered. There may be a small amount of blood at the injection site – you can press a cotton ball or gauze over the injection site for 10 seconds to stop any bleeding. Do not rub the injection site.

It is important to properly dispose of the used autoinjector right away. Place the used SureClick autoinjector into an FDA-cleared sharps disposal container right away after use. Do not throw away (dispose of) loose needles and syringes in your household trash. Do not recycle your used sharps disposal container.

If you do not have an FDA-cleared sharps disposal container, you may use a household container 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
• Properly labeled to warn of hazardous waste inside the container

When your sharps disposal container is almost full, follow your community guidelines for the right way to dispose of your sharps disposal container. There may be state or local laws about how to throw away used needles and syringes.

Medical Disclaimer

This information is offered to educate the general public. The information posted on this website does not replace professional medical advice, but for general information purposes only. There is no Doctor – Patient relationship established. We strongly advised you to speak with your medical professional if you have questions concerning your symptoms, diagnosis and treatment.