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Here you'll find all of the FAQs provided on www.enlivenservices.com. Of course, you can always call 1-888-4ENBREL (1-888-436-2735) with other treatment or insurance questions. Enliven Services representatives are available to assist you 8 am to 11 pm, Eastern time, Monday through Friday, and Enliven Services registered nurses are available 8 am to 11 pm, Eastern time, 7 days a week.
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What are the most common side effects of ENBREL?
In clinical trials, ENBREL was generally well tolerated. The most common side effects of ENBREL included injection site reactions, upper respiratory infections (sinus infections), and headaches.
Click here for other important safety information.
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How often do I need to take ENBREL?
You should take ENBREL as prescribed by your physician, and you should receive training and instruction on how to take ENBREL from your health care professional. Your dosing may differ based on your condition. The recommended dose of ENBREL for adult patients with moderately to severely active RA or ankylosing spondylitis, or psoriatic arthritis is 50 mg per week, which can be given as one subcutaneous (SC) injection using either a 50 mg/mL ENBREL® SureClick™ autoinjector or 50 mg/mL single-use prefilled syringe. A 50 mg dose can also be given as two 25 mg SC injections using 25 mg/0.5 mL single-use prefilled syringes or multiple-use vials.*
If you have moderate to severe plaque psoriasis, the recommended starting dose of ENBREL for adult patients is a 50 mg dose, given twice a week (3 or 4 days apart) for 3 months. After 3 months, the recommended dose is to step down to a maintenance dose of 50 mg once weekly. The recommended dose is administered subcutaneously, using Enbrel® SureClick™ autoinjectors or single-use prefilled syringes.
The recommended dose of ENBREL for pediatric patients ages 2 to 17 years with moderate to severely active polyarticular JIA is 0.8 mg/kg per week (up to a maximum of 50 mg per week). For pediatric patients weighing 63 kg (138 pounds) or more, the weekly dose of 50 mg may be administered using Enbrel® SureClick™ autoinjectors or prefilled syringes. For pediatric patients weighing 31 to 62 kg (68 to 136 pounds), the total weekly dose should be administered as two subcutaneous (SC) injections, either on the same day or 3 or 4 days apart using the 25 mg/0.5 mL prefilled syringe or the multiple-use vial. The dose for pediatric patients weighing less than 31 kg (68 pounds) should be administered as a single SC injection once weekly using the correct volume from the multiple-use vial.
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Why can't ENBREL be taken as a pill?
The stomach contains acids that break down, or "digest," protein in the foods we eat before it enters the bloodstream. Because ENBREL is a protein, if it were swallowed, acids in the stomach would break it down just like protein in food and prevent the medicine from working. But when ENBREL is injected under the skin, it can enter the circulation intact.
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How should I store ENBREL?
ENBREL should be stored in the refrigerator, never in the freezer. ENBREL must be kept at a temperature of 36° to 46°F (2° to 8°C), which is standard for most refrigerators.
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What are the recommended injection sites for administering ENBREL?
Choose an injection site on the front of the middle thighs or on the abdomen, except for the two-inch area right around the navel. These areas usually have enough tissue for the injection and are easy to reach. If a parent or caregiver is performing the injection, the outer area of the upper arms is another option.
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 or lesions.
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Sometimes the skin around the injection site becomes red and itchy. Is this normal?
In medical studies, some patients experienced mild to moderate injection site reactions, usually within the first month. Most reactions resolved without discontinuation of ENBREL. If you have any concerns, talk to your doctor.
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My physician prescribed ENBREL for me. Can you tell me if my health insurance company will cover it?
Our insurance specialists at 1-888-4ENBREL (1-888-436-2735) are here to help you, and we would be happy to contact your health insurance company on your behalf to determine if it covers ENBREL. Please have your insurance card and information ready when you contact 1-888-4ENBREL (1-888-436-2735) so we may expedite your request.
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What services do the insurance specialists at 1-888-4ENBREL
(1-888-436-2735) provide?
Our insurance specialists at 1-888-4ENBREL (1-888-436-2735) can assist you with coverage issues related to ENBREL. Insurance specialists can contact your health insurance company to verify your benefits and determine whether ENBREL is covered by your health plan. In addition, they monitor health insurance company coverage policies and can assist in resolving denied claims.
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What are the hours of operation for 1-888-4ENBREL
(1-888-436-2735)?
Insurance specialists are available to assist you from 8 am to 8 pm, Eastern time, Monday through Friday.
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I heard that my health insurance company is not covering ENBREL for any patients. Can you help?
Our insurance specialists at 1-888-4ENBREL (1-888-436-2735) will do all they can to help and will work to overturn unfavorable coverage decisions. There are several steps that we can take to help secure payment from your health insurance company. Once we determine the reason that the health insurance company is not covering ENBREL, we can discuss the appropriate next steps. For example, we have materials to assist you and your physician in advocating for coverage, such as sample advocacy letters, appeal letters, and letters of medical necessity.
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Does Medicaid cover and reimburse for ENBREL?
To find out the specific coverage policy and guidelines for a particular agency, please contact 1-888-4ENBREL (1-888-436-2735) to speak with an insurance specialist.
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Does Medicare cover and reimburse for ENBREL used for ongoing therapy?
The Medicare Prescription Drug, Improvement, and Modernization Act allows Medicare beneficiaries the opportunity to enroll in prescription drug plans that may help pay for the cost of self-injectable biologic medicines like ENBREL. These new drug plans could make ENBREL coverage more available to you.
To learn more about the recent changes to Medicare and what they can mean for you, please visit www.medicare.gov or call 1-888-4ENBREL (1-888-436-2735).
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Can you help me work through the process of obtaining prior authorization for ENBREL?
Yes. Insurance specialists can help you and your physician with prior authorization. Please call our insurance specialists at 1-888-4ENBREL (1-888-436-2735) 8 am to 8 pm, Eastern time, Monday through Friday, with your insurance information to get started.
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Sometimes the skin around the injection site becomes red and itchy. Is this normal?
In medical studies, some patients experienced mild to moderate injection site reactions, usually within the first month. Most reactions resolved on their own, without treatment. If you have any concerns, talk to your doctor.
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After mixing the liquid and the powder, the solution appeared cloudy. Does this matter?
Before mixing, the powder should be white. After you add the liquid (diluent), the powder usually dissolves in about 10 minutes. The mixed solution should be clear and colorless. (A small amount of foam or bubbles may be present; this is normal.) Do not inject the solution if it is discolored, or contains lumps, flakes, or particles. If all the powder in the ENBREL vial is not dissolved or there are particles present after 10 minutes, call 1-888-4ENBREL (1-888-436-2735) for assistance.
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Can I receive immunizations (vaccinations) while taking ENBREL?
Patients receiving ENBREL may receive concurrent vaccinations, except for live vaccines. It is recommended that JIA patients, if possible, be brought up to date with all immunizations in agreement with current immunization guidelines prior to initiating ENBREL therapy. Contact your health care provider with questions about immunization.
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What should I do if my child with JIA has contact with someone who has chickenpox?
It is important to tell your doctor right away if your child has contact with someone who has the chickenpox virus. If your child is exposed to the varicella (chickenpox) virus, he or she may need to stop taking ENBREL until directed by your health care provider.
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What should I do if I get a fever or an infection while taking ENBREL?
If you get an infection, especially one with a fever, you need to contact your doctor.
Because they target specific immune system functions, medicines like ENBREL may affect the body's ability to defend itself against infection while ENBREL is being taken. ENBREL inhibits the action of tumor necrosis factor (TNF), one of the body's natural defenses against serious infection.
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What should I do with my needles, syringes, or autoinjectors after I inject?
Follow these safety guidelines when disposing of used needles:
- Immediately after each injection, you should discard the used needles, syringes, or autoinjectors in a puncture-resistant container specifically designed for their disposal. These are often called SHARPS containers because they can hold sharp items securely.
- NEVER recap or reuse a needle, syringe, or autoinjector.
- Keep the SHARPS container out of the reach of children.
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What should I do with my needle disposal container once it's full?
Once you've filled your SHARPS container with used needles, syringes, or autoinjectors, you need to dispose of it as instructed by your health care professional. For public safety reasons, containers generally require special disposal. State and local laws for disposing of needles vary considerably from town to town. For information in your area, call 1-888-4ENBREL (1-888-436-2735).
Important: Do not recycle the SHARPS container. Never put your SHARPS container in the trash with other plastic recyclables (unless your local laws permit this). And never empty the contents of your SHARPS container in order to reuse it.
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How should I travel with ENBREL?
If you are going to travel with ENBREL for more than a few hours, keep it in its original packaging, wrap it in bubble wrap, and place it in your travel cooler, then pack it with ice. Put a thermometer in the cooler and check it every few hours, adding ice as necessary to maintain a temperature of 36° to 46°F (2°to 8°C). Some hotels may have a small refrigerator available on request for your convenience. Check with the hotel before your arrival. If you're traveling by air, please call the airline ahead of time, or call 1-888-4ENBREL (1-888-436-2735).
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Can I travel by air with my ENBREL needles, syringes, or autoinjectors?
In these times of heightened security, many people wonder if they can carry their ENBREL needles, syringes, or autoinjectors on board an airplane. Check with your airline before you travel, they may be able to advise you whether you may carry needles, syringes, or autoinjectors on board an airplane.
You may also wish to carry medical documentation regarding your medical condition to present to the screener. Notify the screener if you are carrying a SHARPS container in your carry-on baggage.
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I mistakenly missed a dose. What should I do?
If you forget to take ENBREL when you are supposed to, contact your doctor to find out when to take your next dose of ENBREL.
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How long will it take to see results?
Each person's experience with ENBREL is different. Your results may vary.
- In medical studies, ENBREL was shown to be effective in about 2 out of 3 adults with moderately to severely active RA who used it, and has been shown to begin working in as few as 2 weeks, with most patients receiving benefit within 3 months.
- In a medical study, ENBREL was shown to be effective in about 3 out of 4 children with JIA who used it. For these JIA patients, ENBREL has been shown to begin working in approximately 2 to 4 weeks.
- In a medical study, ENBREL was shown to be effective in about 50% of psoriatic arthritis patients who used it. Clinical responses were apparent at the time of the first visit (4 weeks) and were maintained through 6 months of therapy.
- In a medical study, ENBREL was shown to be effective in about 3 out of 5 adults with AS who used it. Clinical responses were seen at 2 weeks in 46% of patients, with 59% of patients receiving benefit within 8 weeks.
- In medical studies, nearly half of patients saw a significant improvement in their plaque psoriasis within 3 months of using ENBREL. Overall, 3 out of 4 patients saw improvement. ENBREL can work fast; many patients saw improvement within 2 months. ENBREL has been shown to be effective through 12 months of therapy.
It's impossible to predict when or how much your symptoms will improve. Although ENBREL has been shown to control the signs and symptoms of the conditions for which it's approved, there are some people who will not benefit from ENBREL. If you have concerns about how your treatment is progressing, talk to your doctor.
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Now that I'm feeling a lot better with ENBREL, why can't I decrease my dose—or skip a dose every now and then?
ENBREL should be taken at the dosage your doctor has prescribed. Please consult your doctor if you have any questions.
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Can I still use ENBREL if I take it out of the refrigerator but don't use it right away?
It depends. ENBREL can remain unrefrigerated for short periods of time. However, store ENBREL in the refrigerator at 36° to 46°F (2° to 8°C).
If you have any questions about storing and using ENBREL, call Enliven Services toll-free at 1-888-4ENBREL (1-888-436-2735).
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What should I do if I bend or damage a needle or autoinjector?
If a needle or autoinjector is damaged in any way, don't try to fix it or use it. Discard it in your SHARPS container. If a syringe or autoinjector is damaged, call Enliven Services toll-free at 1-888-4ENBREL and a representative will help you.
Remember: to help prevent needle damage, review the proper techniques for preparing ENBREL. There are several sources available to you: the patient handbook and video that came in your Resource Kit, the instructions that come in each carton of ENBREL, the "Patient Support Services" section of www.enbrel.com, and the Enliven Services representatives at the toll-free number.
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I'm having surgery, and my doctor said I will temporarily have to stop taking ENBREL. Why?
Most likely, your doctor wants to minimize any risk of surgery-related infection. Your doctor is taking routine precautions in having you stop ENBREL for a period of time before and after your operation. Ask your doctor when you can resume your therapy with ENBREL. Note: Medical studies in RA show that if you have responded to therapy with ENBREL and your doctor does recommend that you stop your treatments temporarily, it is likely you will experience the same benefits when you begin using it again.
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*25 mg vial is still available for subcutaneous injection (SC).
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Medication Guide for ENBREL
Please read the Medication Guide for ENBREL and discuss with your doctor.
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