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ENBREL is most effective when used strictly according to your doctor’s instructions. It is equally important that you take all necessary precautions to prevent any avoidable problems. Your doctor will have reviewed your case already, but please also read the following checklist yourself before you start treatment. If you answer ‘YES’ to any of these questions, tell your doctor before injecting ENBREL.

Are you:

  • allergic to any medicines
  • allergic to any substances, such as foods, preservatives, dyes or latex
  • taking other medicines your doctor does not know about (prescribed or not)
  • about to have an operation
  • about to receive a vaccination

Note: live vaccines are not recommended whilst on biologic treatment. For further information on vaccinations, contact the Immunisation Advisory Centre on 0800 466 863 or refer to

Tell any other doctor, dentist or pharmacist who is treating you that you are on ENBREL.

Do you have, or have you had:

  • a serious infection including hepatitis, tuberculosis or a history of recurring infections
  • low resistance to disease
  • diabetes
  • heart failure
  • blood disorders
  • cancer
  • are about to have major surgery
  • multiple sclerosis or optic neuritis (inflammation of the nerves of the eyes)
  • chicken pox or have been recently exposed to chickenpox.

What to watch out for

Like any medicine, ENBREL may cause side effects. The most common ones are mild and temporary. The important thing is to talk to your doctor or pharmacist if you notice anything unusual or if you have any concerns.

Common, mild reactions

Most injections can cause a mild reaction around the injection site. The reactions may include itching, soreness, redness, swelling, bleeding or pain at the injection site. Generally, injection site reactions are not severe and do not occur as often after the first month of treatment. Infections, including colds and sinus infections are very common.

Less common side effects

Although they may be unrelated to ENBREL, there are a number of minor health problems, such as headache, runny nose or rash, which you should tell your doctor about if they become persistent.

Unusual severe symptoms and infections

Specific and more severe symptoms your doctor should know about immediately include:

  • signs of an infection such as fever, chills, mouth ulcers or sore throat
  • signs of lung disease such as breathlessness during exercise or a dry cough
  • signs of nervous system disorders such as seizures, numbness or tingling throughout your body, weakness in your arms and/or legs and dizziness, or problems with your eye sight
  • inflammation (swelling) of the spinal cord
  • inflammation (swelling) of the inner eye
  • inflammation (swelling) of blood vessels in the skin or lymph glands
  • signs of an allergic reaction such as swelling of the face, lips or tongue which may cause difficulty in swallowing or breathing, or hives
  • other signs of immune system disorders such as skin rash, blisters and ulcers on the skin, in the mouth or airways
  • signs of a blood disorder such as tiredness, headaches, shortness of breath when exercising, dizziness, paleness, nose bleeds, unusual bleeding or bruising or more frequent infections
  • worsening of existing heart failure.

Uncommon infections may include tuberculosis and blood poisoning.

Do not be alarmed by this list of possible side effects. You may not experience any of them.

While you are using ENBREL

Things you must do:

  • tell any other doctors, dentists and pharmacists who are treating you that you are using ENBREL
  • tell your doctor if ENBREL is not making your condition better
  • if you have or develop any serious infection while using ENBREL, do not inject any more ENBREL and contact your doctor immediately
  • seek medical advice immediately if you have any symptoms such as persistent fever, sore throat, bruising, bleeding or paleness
  • these symptoms may point to the existence of a potentially life threatening blood disorder, which may require you to stop taking ENBREL
  • be careful driving or operating dangerous machinery until you know how it affects you
  • it is not known whether ENBREL causes dizziness or drowsiness.

If you take too much (overdose)

Immediately telephone your doctor or the Poisons Information Centre (in New Zealand; tel 0800 POISON or 0800 764 766), or go to Accident and Emergency at your nearest hospital, if you think that you or anyone else may have used too much ENBREL. Do this even if there are no signs of discomfort or poisoning. Always take the labelled medicine carton with you, even if it is empty.

You may need urgent medical attention. There is very limited data on overdose with ENBREL. Ask your doctor if you have any concerns.