Kickas.org Forums Treatments, Drugs and Alternatives Anti TNF and other biological medications Enbrel dosing regimens

Well, I've been on weekly dosing for two months now. Doing great. In fact, I went to the Burning Man Festival and did great there. Because I left on a Tuesdeay and came back on a Monday, I had to do some playing with my ENBREL dosing. I normally take my ENBREL on Saturday. But two weeks before, I switched to Sunday (went 8 days instead of 7), and then the week of Burning Man I went from Sunday to Monday (when I got home). Did fine. Then this week I shortened it to 6 days to get back to Saturday.

I've also learned a neat little trick. I find it inconvenient to mix two doses of ENBREL and then inject them. So at some point during the week, when I have a few minutes of "down time" I'll mix a dose (or both), attach the capped needle to the syringe, and pop it back in the fridge. Since ENBREL keeps for two weeks once it's been mixed, there's no problem with doing that. Then when I wake up on Saturday, I have two pre-mixed syringes in the fridge waiting for me. I wake up, take both syringes out and set them on the table to warm up, start my water for tea, go and shower/shave/brush my teeth, and then come back and give myself my shots before I get dressed.

So much more convenient that way!

Of course this last week, I messed the whole thing up. When I mixed my doses, I forgot to wipe off the rubber septa of the vials before I mixed them. I know that the resuspension solution is actually bacteriostatic, so I figured it was no biggie. Then, when I went to give myself the shot, I dropped the friggin' syringe into my hand right after I'd uncapped it. I just wiped off the needle with alcohol and injected.

Cavalier of me? Yeah. But it was yesterday and I figure that if I was going to get an infection, it would have showed up by now. But I really need to be more careful.

I've noticed a lot of people on ENBREL get really paranoid about infection (wandering around with alcohol gel and obsessively washing their hands and getting antibacterial EVERYTHING). It's important to remember that ENBREL is not an immunosuppressant, but an immunoMODULATOR. Other than TB, it does not increase your sensitivity to bacterial infections. It's viruses (particularly upper respiratory infections) that are the big issue. I was just romping around in the desert (which is admittedly a very sterile environment since it's so dessicating there), but I almost never washed my hands and I didn't get sick. I did an pediatric ER rotation and saw more sniffoos and sore throats than I can count. I just washed my hands before and after every patient and I haven't gotten sick once yet.

If you're just on ENBREL and not on any immunosuppressants (prednisone, MTX, etc.), you really can relax about it. A nose cold is not the worst thing in the world.

___________________________________________
-Mike
Certified Mad Doctor (in training)

Well Ok,
I just wondered why after visiting the hospital with all those sick people, like with pnuemonia, brochiitis three days later I came down with Brochitis....just wondering I guess it was all in my head.........but I do wash My hand all the time after everything but that's the way I have always been. Even before taking Enbrel.
But we are not all the same.....

Well, remember, Bronchitis is a viral infection, so that's what you're susceptible to.

___________________________________________
-Mike
Certified Mad Doctor (in training)

Ok, got you.... thanks...

Mike,
I have noticed a difference between the two. I had to go from getting two shots a week to getting one shot a week due to the Enbrel causing skin infections. I could tell a big difference in my pain levels. I decided to start back getting it twice a week regardless of the infections, but luckily I haven't had any more infections as of yet and it has been several months now!
Thanks,
Kelley:)

HI Mike,

I've been on Enbrel almost 3 years. Have not been sick in the 3 years nor have I had to use any sick days at work. I work in health care and am around people all day.

I have never been concerned about infections........hmmmmm....maybe I should have????

The only issue that seems more frequent is UTI's but this has not caused any down time.





Betty

Hey Mike....

I like your idea about pre- mixing.

Betty

hi,
i am thinking on starting on embrel, my doc says that I can try it for 3-4 months and stop,
i wanted to know how long you have been on embrel

rahul

Mike,

On the autoimmune thing...I agree but want to add:

If you have a young child LIVING with you, your risk of viral infections is exponentially greater. Small humans in a contained, typically warm, environment for 40 hrs a week are little petrie dishes. TRUST ME, I have two of them..LOL. I can guarantee that if there is a virus in school that I will get sick with it, even if my son doesn't get it. He is in elementary school. We are a antibacterial, wash your hands conscience kind of family and have been a little maniacal about it for a few reasons.

Just wanted to give a little different perspective.
Take care!
Holly

Hey Mike

Eric is on Remicade now, as the Enbrel does nothing for his Crohns.

His next appt is Oct. 8th, and when the Remicade nurse called yesterday, I told her he was getting a cold.

The nurse told me to cancel the appt if his cold is not gone by then.

I was told the same thing when he was on Enbrel. Don't give him his shot if he has a fever, or has a cold. Unless it is the tail end of a cold.

So, we are always trying to be a little careful.

Lori