Enbrel (etanercept) and Remicade (infliximab) are prescription drugs used to manage certain autoimmune conditions. Enbrel is given as a subcutaneous injection, and Remicade is given as an IV infusion. Both drugs have approved biosimilars.
This article explains the main ways that Enbrel and Remicade are alike and different. For more information about these drugs, including details about their uses, see the in-depth articles on Enbrel and Remicade.
Enbrel contains etanercept as its active ingredient.
Remicade contains infliximab as its active ingredient.
Both Enbrel and Remicade are part of a drug class called tumor necrosis factor (TNF) blockers. TNF is linked to inflammation. By blocking TNF, these medications can help reduce inflammation and ease symptoms.
Enbrel and Remicade are prescription medications used to treat certain autoimmune diseases. Your doctor may prescribe either of these drugs if you’re an adult and you have one of the following conditions:
- rheumatoid arthritis (RA), an autoimmune disease that affects your joints
- psoriatic arthritis, a type of arthritis that can develop from psoriasis
- ankylosing spondylitis, a type of arthritis that affects your spine
- plaque psoriasis, an autoimmune disease that results in plaques (scaly patches) forming on your skin
In addition, Enbrel is also used to treat:
- polyarticular juvenile idiopathic arthritis in children ages 2 years and older
- juvenile psoriatic arthritis in children ages 2 years and older
- plaque psoriasis in children ages 4 years and older
Remicade is also used to treat the following types of inflammatory bowel disease in adults and children ages 6 years and older:
Enbrel and Remicade differ in how they’re given. Enbrel comes in several forms, while Remicade comes in only one form.
Enbrel is given as an injection under your skin, usually once or twice every week. If Enbrel becomes part of your treatment plan, a healthcare professional will teach you how to use it. Then you can give yourself Enbrel at home.
Enbrel is available in the following forms:
- prefilled syringes
- prefilled SureClick autoinjector
- Enbrel Mini prefilled cartridge (to be used in a reusable AutoTouch autoinjector)
- vial of powder (to be mixed into a solution before injection with a syringe)
- vial of solution (to be drawn up and injected with a syringe)
Remicade is given as an intravenous (IV) infusion, usually once every 4 to 8 weeks. With an infusion, medication is dripped into your vein over a period of time. A Remicade infusion takes about 2 hours.
If you start treatment with Remicade, you’ll receive your infusions from a healthcare professional in their office or hospital.
Remicade is available in just one form: a vial of powder. A healthcare professional will mix the powder with sterile water as part of the preparation for your infusion.
For both Enbrel and Remicade, your dosage will depend on your condition. Talk with your doctor to discuss the dosage that may work best for your treatment plan.
Cost may be a factor when you’re considering adding Enbrel or Remicade to your treatment plan.
Keep in mind that what you’ll pay for either drug depends on your treatment plan, your health insurance, and the pharmacy you use.
Enbrel and Remicade are both biologic medications. A biologic is made from parts of living organisms. So it’s not possible to copy biologic drugs exactly.
Enbrel and Remicade both have biosimilar forms, some of which currently aren’t available on the U.S. market.
Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs. A biosimilar tends to cost less than its “parent” drug.
If you’re interested in using a biosimilar form of Enbrel or Remicade, talk with your doctor about which ones are available.
Enbrel and Remicade are both meant to be long-term treatments. So you may be wondering what their possible side effects are. Both drugs can cause mild or serious side effects.
Enbrel and Remicade work in a similar way, so they can cause many of the same side effects. But there are also some that are different.
Mild side effects
Enbrel and Remicade may cause mild side effects in some people. The chart below lists examples of mild side effects that can occur with these drugs.
| Enbrel | Remicade | |
|---|---|---|
| itchy skin | ✓ | — |
| fatigue | — | ✓ |
| headache | — | ✓ |
| abdominal pain | — | ✓ |
| injection or infusion site reactions | ✓ | ✓ |
| respiratory infections | ✓ | ✓ |
| diarrhea | ✓ | ✓ |
| rash | ✓ | ✓ |
| fever | ✓ | ✓ |
This chart may not include all mild side effects of these drugs.
For more information on mild side effects of the two drugs, see Enbrel’s prescribing information and Remicade’s prescribing information.
Serious side effects
In addition to the mild side effects described above, serious side effects may occur in people using Enbrel or Remicade. See the chart below for a list of possible serious side effects.
| Enbrel | Remicade | |
|---|---|---|
| hypoglycemia (low blood sugar) | ✓ | — |
| severe liver damage | — | ✓ |
| stroke | — | ✓ |
| heart attack | — | ✓ |
| serious infections* | ✓ | ✓ |
| certain types of cancer, such as leukemia, lymphoma, or skin cancer* | ✓ | ✓ |
| congestive heart failure | ✓ | ✓ |
| nervous system problems, such as multiple sclerosis, optic neuritis, or seizures | ✓ | ✓ |
| decreased blood cell levels | ✓ | ✓ |
| hepatitis B reactivation | ✓ | ✓ |
| lupus-like syndrome | ✓ | ✓ |
To learn about your specific risk of serious side effects from Enbrel or Remicade, talk with your doctor.
* Enbrel and Remicade both have boxed warnings for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be harmful. To learn more, see the “What are the warnings of Enbrel and Remicade?” section below.
Allergic reaction
For some people, these drugs can cause an allergic reaction.
In general, the symptoms of allergic reaction can be mild or serious. You can learn more about possible symptoms in this article.
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue treatment with Enbrel or Remicade.
If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to your medication, they may have you switch to a different treatment.
You may wonder whether Enbrel or Remicade is effective at treating your condition.
Studies have found both Enbrel and Remicade to be effective at treating various autoimmune conditions. If you’d like to read more about how each drug performed in studies, see the prescribing information for Enbrel and Remicade.
Enbrel or Remicade may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take either drug.
Boxed warnings: Infections and cancer
Both Enbrel and Remicade have boxed warnings for the risk of infections and cancer. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.
Infections: Enbrel and Remicade can increase your risk of serious infections, such as tuberculosis (TB). These infections may result in a hospital stay or even death.
Serious infections were more common in people who were taking Remicade or Enbrel with other drugs that affect the immune system.
Before you start treatment, tell your doctor if you have any current infections or have had any recently. This includes minor infections, such as a cold. During your treatment, let your doctor know right away if you have any signs of an infection, such as a fever or common cold symptoms.
Cancers: TNF blockers, including Enbrel and Remicade, may increase the risk of cancer in children and adolescents. In studies, this included Hodgkin’s and non-Hodgkin’s lymphoma in children. In rare cases, cancers associated with TNF blockers have been fatal. Because of this risk, doctors will regularly screen for cancer during treatment with Enbrel or Remicade.
Other warnings
In addition to the boxed warnings, Enbrel and Remicade have other warnings.
Before taking Enbrel or Remicade, talk with your doctor if you have any of the following conditions or health factors.
- Warnings for both Enbrel and Remicade:
- hepatitis B reactivation
- liver disease or alcoholic hepatitis
- heart failure
- nervous system problems, such as optic neuritis (an eye condition)
- allergic reaction
- pregnancy
- breastfeeding
- Warnings for Enbrel:
- Warnings for Remicade:
- serious infusion reactions
The short answer: It’s possible.
Details: While Enbrel and Remicade both work in a similar way, they stay in your body for different lengths of time.
It could be harmful to have both of these drugs in your system at the same time. This would raise your risk for serious side effects, especially severe infections.
If your doctor wants you to switch from Remicade to Enbrel, or vice versa, they’ll guide you on the timing. It’s important to wait until one drug is out of your system before switching to the other.
Reminder: You should not switch drugs or stop your current treatment unless your doctor tells you it’s OK.
Enbrel and Remicade work in a similar way, but they’re different in many ways. They have some of the same side effects, but also some different ones. They treat several of the same conditions.
One of the main differences is how you’ll experience receiving your treatment. Enbrel can be self-injected at home, usually once or twice per week. Remicade must be given as an IV infusion at your doctor’s office or hospital, usually every 4 to 8 weeks.
If you have questions about the best treatment plan for your condition, talk with your doctor. Some questions that might be helpful to ask your doctor include:
- Is there a reason why Enbrel might be better for my condition than Remicade?
- Would Enbrel or Remicade interact with any other medications I’m taking?
- Would Enbrel or Remicade be better for me based on my health history?
- What would happen if I missed my Remicade appointment due to being ill, traveling, etc.?
Q:
Is it safe for me to get vaccines, such as an annual flu shot, while taking Enbrel or Remicade?
AnonymousA:
Some vaccines are safe, but you should avoid live vaccines while taking Enbrel or Remicade.
Live vaccines contain weakened versions of viruses or bacteria. This helps your body recognize these viruses or bacteria as threats to avoid future infections.
But Enbrel and Remicade work by weakening your immune system, which increases your risk for infections. Live vaccines may cause actual infection in people with weakened immune systems.
Examples of live vaccines include:
- measles, mumps, rubella (MMR)
- chickenpox
- nasal spray form of flu vaccine
If you’re taking Enbrel or Remicade, talk with your doctor before scheduling any vaccinations. They’ll determine whether the vaccine is safe or if you should stop treatment to be vaccinated.
The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.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.