Enbrel Drug Interactions

Concurrent Treatment with Abatacept: In clinical studies, concurrent administration of abatacept and ENBREL therapy resulted in increased incidences of serious adverse events. This combination has not demonstrated increased clinical benefit; such use is not recommended (see Precautions).
Concurrent Treatment with Methotrexate: ENBREL may be administered in combination with methotrexate for the treatment of rheumatoid arthritis. In a safety and efficacy clinical trial, methotrexate had no effect on the pharmacokinetics of ENBREL. The effect of ENBREL on the human pharmacokinetics of methotrexate has not been investigated. The safety and efficacy of ENBREL in combination with methotrexate for the treatment of psoriasis have not been studied. ENBREL should not be administered in combination with methotrexate for the treatment of psoriasis (see Precautions).
Concurrent Treatment with Anakinra: Patients treated with ENBREL and anakinra were observed to have a higher rate of serious infection when compared with patients who were treated with ENBREL alone (historical data). In addition, in a double-blind placebo-controlled trial in patients receiving background methotrexate, patients treated with ENBREL and anakinra were observed to have a higher rate of serious infections and neutropenia than patients treated with ENBREL alone (see Precautions).
Concurrent Treatment with Sulfasalazine: In a clinical study of patients who were receiving established doses of sulfasalazine, to which ENBREL was added, patients in the combination group experienced a statistically significant decrease in mean white blood cell counts in comparison to groups treated with ENBREL or sulfasalazine alone. The clinical significance of this interaction is unknown.
Live Vaccines: No safety data are available on the effects of live vaccine when used in combination with ENBREL. Live vaccines should therefore not be given concurrently with ENBREL.
Other: Product Information for methotrexate should be referenced when ENBREL is administered with methotrexate. Interactions between ENBREL and other drugs have not been evaluated in formal studies. No interactions have been observed when ENBREL was administered with glucocorticoids, salicylates (except sulfasalazine), NSAIDs, analgesics, or methotrexate in clinical trials with adult rheumatoid arthritis patients.
No clinically significant pharmacokinetic drug-drug interactions were observed in studies with methotrexate, digoxin and warfarin.
Effects on Laboratory Tests: No effects on laboratory tests have been reported in adults. An analysis of 54 JCA patients in an open-label study demonstrated low haemoglobin, low albumin and low lymphocyte counts in 63%, 39% and 30% of juvenile patients, respectively. These observations, however, appear to be attributed to the underlying disease, rather than treatment with ENBREL.