Enbrel (etanercept) is a prescription drug used to treat certain inflammatory conditions. This drug can interact with certain medications and vaccines. For example, Enbrel can interact with infliximab (Remicade) and tofacitinib (Xeljanz, Xeljanz XR).
Enbrel is prescribed to treat:
- plaque psoriasis in adults and certain children
- psoriatic arthritis in adults
- rheumatoid arthritis in adults
- ankylosing spondylitis in adults
- juvenile psoriatic arthritis in certain children
- juvenile idiopathic arthritis in certain children
Enbrel comes as a liquid solution inside a single-use, prefilled syringe, autoinjector, cartridge, or vial. It also comes as a powder inside a multiple-use vial, which is mixed with sterile water. With any form of the drug, you or a healthcare professional will inject the drug under your skin.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Enbrel’s possible interactions. And for more information about Enbrel, including details about its uses, see this article.
Before starting Enbrel treatment, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Enbrel interacts with herbs or vitamins and supplements, see the “Are there other interactions with Enbrel?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Enbrel. Keep in mind that this table does not include all drugs that may interact with Enbrel. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| other tumor necrosis factor (TNF) blockers* | • adalimumab (Humira) • certolizumab (Cimzia) • golimumab (Simponi, Somponi Aria) • infliximab (Remicade) | can increase the risk of side effects from Enbrel† and other TNF blockers |
| biologic disease-modifying antirheumatic drugs (DMARDs) | • abatacept (Orencia) • anakinra (Kineret) • rituximab (Rituxan) • sarilumab (Kevzara) • tocilizumab (Actemra) | can increase the risk of infection‡ with Enbrel and biologic DMARDs |
| interleukin-1 blockers | • canakinumab (Ilaris) • rilonacept (Arcalyst) | can increase the risk of infection‡ with Enbrel and interleukin-1 blockers |
| integrin receptor antagonists | • natalizumab (Tysabri) • vedolizumab (Entyvio) | can increase the risk of infection‡ with Enbrel and integrin receptor antagonists |
| Janus kinase (JAK) inhibitors | • baricitinib (Olumiant) • tofacitinib (Xeljanz, Xeljanz XR) • upadacitinib (Rinvoq) | can increase the risk of infection‡ with Enbrel and JAK inhibitors |
| anifrolumab (Saphnelo) | — | can increase the risk of infection‡ with Enbrel and anifrolumab |
| belimumab (Benlysta) | — | can increase the risk of infection‡ with Enbrel and belimumab |
| cyclophosphamide (Cytoxan) | — | can increase the risk of side effects from Enbrel† and cyclophosphamide |
| sulfasalazine (Azulfidine) | — | can increase the risk of a low level of neutrophils (a type of white blood cell) with Enbrel and sulfasalazine |
* Enbrel belongs to a group of drugs called TNF blockers.
† To learn more about Enbrel’s side effects, see this article.
‡ Enbrel has a
Certain health conditions or other factors could increase your risk of harm with Enbrel. These factors are known as contraindications. In such cases, your doctor may not prescribe Enbrel for you.
Sepsis is a contraindication of Enbrel. If you have sepsis, your doctor likely won’t prescribe Enbrel for you. (Sepsis is a life threatening condition caused by your body’s reaction to an infection.) This is because Enbrel can lower your immune system’s ability to fight infection, which may worsen sepsis.
In fact, Enbrel has a
Before starting Enbrel, tell your doctor if you have any symptoms of infection or sepsis. Examples include chills or fever, body aches, and confusion. Your doctor can determine whether Enbrel is safe for you.
Enbrel is not known to interact with alcohol. However, the drug may not be safe for people with alcoholic hepatitis. For details, see the section below titled “Does my health history affect whether I should take Enbrel?”
If you have questions about consuming alcohol during Enbrel treatment, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Enbrel.
Interaction with other TNF blockers
Enbrel can interact with other TNF blockers. Like Enbrel, other TNF blockers are used to treat inflammatory conditions. Examples include plaque psoriasis and rheumatoid arthritis.
Examples of other TNF blockers include:
- adalimumab (Humira)
- certolizumab (Cimzia)
- golimumab (Simponi, Simponi Aria)
- infliximab (Remicade)
What could happen
Taking Enbrel with other TNF blockers increases your risk of serious infection. This is because Enbrel and other TNF blockers work by lowering the activity of your immune system. As a result, these medications may lower your immune system’s ability to fight infection.
In fact, Enbrel has a boxed warning about the risk of serious infection. To learn more, see the “Boxed warnings” section at the beginning of this article.
What you can do
Before starting Enbrel, tell your doctor if you already use another TNF blocker. They’ll likely prescribe a drug other than Enbrel for your condition.
Interaction with JAK inhibitors
Enbrel can interact with JAK inhibitors. These medications are used to treat inflammatory conditions, including rheumatoid arthritis.
Examples of JAK inhibitors include:
- baricitinib (Olumiant)
- tofacitinib (Xeljanz, Xeljanz XR)
- upadacitinib (Rinvoq)
What could happen
Using Enbrel with a JAK inhibitor can increase your risk of serious infection. Both Enbrel and JAK inhibitors can lower your immune system’s ability to fight infection. Your risk of infection increases if you take these medications together.
Enbrel has a boxed warning about the risk of serious infection. To learn more, see the “Boxed warnings” section at the beginning of this article.
What you can do
Before starting Enbrel, tell your doctor if you already take a JAK inhibitor. They’ll likely prescribe a drug other than Enbrel for your condition.
Interaction with cyclophosphamide
Enbrel can interact with cyclophosphamide (Cytoxan), which is used to treat many types of cancer.
What could happen
Enbrel and cyclophosphamide can both lower your immune system’s ability to fight infection. So taking these drugs together can increase your risk of infection even more.
In addition, your risk of certain cancers may be greater when Enbrel is used with cyclophosphamide.
It’s important to note that Enbrel has a boxed warning about the risks of serious infection and cancer. To learn more, see the “Boxed warnings” section at the beginning of this article.
What you can do
Before using Enbrel, tell your doctor if you’re taking cyclophosphamide. They may prescribe a drug other than Enbrel for your condition.
Enbrel may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Enbrel.
Does Enbrel interact with supplements?
Before starting Enbrel treatment, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Enbrel and herbs
There are currently no reports of Enbrel interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Enbrel.
Enbrel and vitamins
There are currently no reports of Enbrel interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Enbrel.
Does Enbrel interact with food?
There are currently no reports of Enbrel interacting with food. If you have questions about foods to avoid while taking Enbrel, talk with your doctor.
Does Enbrel interact with vaccines?
You should not receive live vaccines during your Enbrel treatment. Live vaccines contain weakened versions of the bacteria or virus that they’re meant to protect against.
Enbrel lowers your immune system’s ability to fight infection. So receiving a live vaccine during Enbrel treatment could increase your risk of getting the condition the vaccine protects against.
Examples of live vaccines include those for rotavirus and chickenpox, as well as the measles, mumps, rubella (MMR) vaccine. If you need to receive a vaccine, talk with your doctor first to make sure it’s safe.
Does Enbrel interact with lab tests?
Enbrel may interact with a skin test for TB. This test checks whether your body currently carries the TB bacterium. Having this test done while taking Enbrel may lead to a false-negative result. This means the test may show no TB infection even though the TB bacterium is present. These false-negative results can occur for up to 6 weeks after you stop Enbrel treatment.
Your doctor will likely give you a TB skin test before you start Enbrel, and they may repeat this test during treatment.
If you have questions about getting any lab tests during Enbrel treatment, talk with the healthcare professional ordering the test.
Does Enbrel interact with cannabis or CBD?There are currently no reports of Enbrel interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Enbrel.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Enbrel. Before starting Enbrel, talk with your doctor about your health history. They’ll determine whether this drug is right for you.
Health conditions or other factors that might interact with Enbrel include:
Alcoholic hepatitis: Before starting Enbrel treatment, tell your doctor if you have alcoholic hepatitis. With this condition, you have inflammation of the liver caused by heavy alcohol consumption. Enbrel may not be a safe treatment option for people with this condition.
If you have alcoholic hepatitis, your doctor can determine whether Enbrel is right for you.
Heart failure: Before using Enbrel, be sure your doctor knows if you have heart failure. This drug may worsen heart failure in people who already have this condition. Your doctor can tell you whether Enbrel is a safe treatment option.
Hepatitis B: Before using Enbrel, tell your doctor if you’ve ever had hepatitis B. Enbrel may reactivate the hepatitis B virus (HBV) in people who already have this virus in their bodies. (With reactivation, HBV becomes active again and causes symptoms of infection.)
If you have hepatitis B, your doctor can determine whether Enbrel is right for you.
Nerve problems: Enbrel treatment may lead to conditions that affect your nervous system, such as multiple sclerosis (MS). This could worsen any nerve problem you may already have.
If you have a nerve problem, talk with your doctor before starting Enbrel treatment. They can determine whether Enbrel is a safe treatment option.
Pregnancy: It’s not known whether Enbrel is safe to use during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before starting Enbrel.
Breastfeeding: It’s not known whether it’s safe to use Enbrel while breastfeeding. The drug passes into breast milk, but it isn’t known whether it may cause side effects in a child who’s breastfed. If you’re breastfeeding or planning to, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Enbrel or any of its ingredients, your doctor will likely not prescribe Enbrel. You can ask your doctor about other treatments that may be better choices for you.
Find answers to some frequently asked questions about Enbrel and possible interactions.
Can I take Enbrel and methotrexate together?
Yes, you may take Enbrel with methotrexate (Jylamvo, Trexall, others). There are no known interactions between these drugs. In fact, doctors may prescribe Enbrel with methotrexate for certain inflammatory conditions. These include rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis.
It’s important to note that taking Enbrel with methotrexate may increase your risk of serious infection. Enbrel has a boxed warning about this risk. To learn more, see the “Boxed warnings” section at the beginning of this article.
If you have questions about taking methotrexate with Enbrel, talk with your doctor or pharmacist.
Is it safe to take Enbrel if I’m also taking a corticosteroid?
While there isn’t an interaction between Enbrel and corticosteroids, taking them together may increase your risk of infection. Keep in mind that Enbrel has a boxed warning about the risk of serious infection. To learn more, see the “Boxed warnings” section at the beginning of this article.
That said, your doctor may prescribe Enbrel with a corticosteroid for certain conditions. These include rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. Your doctor can tell you more about the safety of taking these medications together.
If you have questions about taking a corticosteroid during Enbrel treatment, talk with your doctor or pharmacist.
Taking certain steps can help you avoid interactions with Enbrel. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- other medications you take, as well as any vitamins, supplements, and herbs
- what to do if you start taking a new drug during your Enbrel treatment
Your doctor or pharmacist can help you fill out a
It’s also important to understand Enbrel’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Using Enbrel exactly as prescribed can also help prevent interactions.
If you still have questions about Enbrel and its possible interactions, talk with your doctor. Questions you may want to ask include:
- Will I be monitored more closely during Enbrel treatment if I have certain health conditions?
- Do any of the other medications I take increase my risk of side effects from Enbrel?
- Do other drugs that could treat my condition have similar interactions?
To learn more about Enbrel, see these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.