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What happens if I miss a dose?

Call your doctor for instructions if you miss your Enbrel dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Enbrel?

Do not receive a “live” vaccine while using Enbrel, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), Bacillus Calmette-Guérin (BCG), oral polio, rotavirus, smallpox, typhoid, yellow fever, varicella (chickenpox), H1N1 influenza, and nasal flu vaccine.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox.

Important information about enalapril

Do not use enalapril without telling your doctor if you are pregnant or planning a pregnancy. Enalapril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment.

Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking enalapril. Drink plenty of water each day while you are taking this medication.

What other drugs will affect enalapril?

Before taking enalapril, tell your doctor if you are taking any of the following drugs:

gold injections to treat arthritis;
lithium (Lithobid, Eskalith);
a potassium supplement such as K-Dur, Klor-Con;
salt substitutes that contain potassium;
aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), naproxen (Aleve, Naprosyn), and others; or
a diuretic (water pill).
This list is not complete and there may be other drugs that can interact with enalapril. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling yourdoctor.

What is enalapril?

Enalapril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme.

Enalapril is used to treat high blood pressure (hypertension), congestive heart failure, kidney problems caused by diabetes, and to improve survival after a heart attack.

Enalapril may also be used for purposes other than those listed in this medication guide.

What other drugs will affect Enbrel?

Tell your doctor about all other medications you use, especially:

anakinra (Kineret);
cyclophosphamide (Cytoxan, Neosar);
sulfasalazine (Azulfidine); or
drugs that weaken your immune system (such as cancer medicine or steroids).
This list is not complete and there may be other drugs that can interact with Enbrel. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Enbrel side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Enbrel: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Enbrel and call your doctor right away if you have any of these symptoms of lymphoma:

fever, night sweats, weight loss, tiredness;
feeling full after eating only a small amount;
pain in your upper stomach that may spread to your shoulder;
easy bruising or bleeding, pale skin, feeling light-headed or short of breath, rapid heart rate; or
nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Stop using Enbrel and call your doctor at once if you have any of these other serious side effects:

signs of infection (fever, chills, sore throat, body aches, confusion, neck stiffness, flu symptoms);
shortness of breath with swelling, rapid weight gain;
chest pain, ongoing cough, coughing up mucus or blood;
signs of skin infection such as itching, swelling, warmth, redness, or oozing;
black, bloody, or tarry stools;
changes in mood or personality (in children);
numbness, burning, pain, or tingly feeling;
joint pain or swelling with fever, swollen glands, muscle aches, chest pain, unusual thoughts or behavior, and/or seizure (convulsions); or
patchy skin color, red spots, or a butterfly-shaped skin rash over your cheeks and nose (worsens in sunlight).
Less serious Enbrel side effects may include:

mild nausea, vomiting, mild diarrhea, mild stomach pain;
runny or stuffy nose, cold symptoms; or
headache.
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.

See also: Enbrel side effects (in more detail)

How should I use Enbrel?

Before you start treatment with Enbrel, your doctor may perform tests to make sure you do not have tuberculosis or other infections. Some infections are more likely to occur in certain areas of the world. Tell your doctor where you live and where you have recently traveled or plan to travel to during treatment.

Enbrel is injected under the skin. You may be shown how to use injections at home. Do not self inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes. You may need to mix Enbrel with a liquid (diluent) before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medication.

A child must weigh at least 138 pounds to use the Sureclick autoinjector. Children who weigh less than 138 pounds should use a different form of Enbrel.

Use a different place on your body each time you give the injection. Your care provider will show you the best places on your body to inject the medication. Do not inject into the same place two times in a row. Avoid injecting into skin that is bruised, tender, red, or hard.

You may have pain, redness, swelling, or warmth where the Enbrel was injected. Call your doctor if these symptoms continue for longer than 5 days.

Use each disposable needle only one time. A single-use prefilled syringe or Enbrel Sureclick autoinjector is for one injection only. Throw the used syringe or autoinjector away after one use, even if there is still medicine left in it. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Enbrel can lower blood cells that help your body fight infections. Your blood may need to be tested often. Serious and sometimes fatal infections may occur during treatment with Enbrel. Contact your doctor right away if you have signs of infection such as: fever, cough, sweating, tired feeling, or if you feel short of breath.

If you have hepatitis B you may develop liver symptoms after you stop taking Enbrel, even months after stopping. Your doctor may want to check your liver function for several months after you stop using Enbrel. Visit your doctor regularly.

If you need surgery, tell the surgeon ahead of time that you are using Enbrel.

Store Enbrel in the refrigerator. Do not freeze. After mixing Enbrel with a diluent, store in the refrigerator and use it within 14 days. Do not use Enbrel after the expiration date on the label has passed. Do not shake the prefilled syringe. Vigorous shaking can ruin the medicine. Do not use the medication if it has changed colors or appears cloudy. Call your doctor for a new prescription.

Before taking enalapril

Do not use this medication if you are allergic to enalapril or to any other ACE inhibitor, such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take enalapril:

kidney disease (or if you are on dialysis);
liver disease;
heart disease or congestive heart failure;
diabetes; or
a connective tissue disease such as Marfan syndrome, Sjogren’s syndrome, lupus, scleroderma, or rheumatoid arthritis.
FDA pregnancy category D. Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Enalapril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. Enalapril can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Before using Enbrel

You should not use Enbrel if you are allergic to etanercept, or if you have a severe infection such as sepsis (infection of the blood). Some people using Enbrel have developed a rare fast-growing type of lymphoma (cancer). This condition affects the liver, spleen, and bone marrow, and it can be fatal. This has occurred mainly in teenagers and young adults using Enbrel or similar medicines to treat Crohn’s disease or ulcerative colitis. However, people with autoimmune disorders (including psoriasis) may have a higher risk of lymphoma. Talk to your doctor about your individual risk.

Before using Enbrel, tell your doctor if you have ever had tuberculosis, if anyone in your household has tuberculosis, or if you have recently traveled to an area where tuberculosis is common.

To make sure you can safely use Enbrel, tell your doctor if you have any of these other conditions:

a weak immune system, or any type of infection including a skin infection or open sores;
diabetes;
congestive heart failure;
a nerve disorder such as multiple sclerosis, myelitis, or optic neuritis;
epilepsy or other seizure disorder;
asthma or other breathing disorder;
if you have ever had hepatitis B;
if you are allergic to latex rubber; or
if you are scheduled to receive any vaccines, or if you have recently been vaccinated with BCG (Bacille Calmette-Guerin).
FDA pregnancy category B. Enbrel is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether etanercept passes into breast milk or if it could harm a nursing baby. Do not use Enbrel without telling your doctor if you are breast-feeding a baby. Children using this medication should be current on all childhood immunizations before starting treatment with Enbrel.

How should I take enalapril?

Take enalapril exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from enalapril.

Take each dose with a full glass of water.

Enalapril can be taken with or without food.

Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking enalapril. Drink plenty of water each while you are taking this medication.

To be sure enalapril is helping your condition, your blood pressure will need to be checked on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking enalapril. You may need to stop using the medicine for a short time.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Store enalapril at room temperature away from moisture and heat.

See also: Enalapril dosage (in more detail)