Home Drug Guide Etanercept-szzs

Drug Guide

Generic Name

Etanercept-szzs

Brand Names Erelzi

Classification

Therapeutic: Immunosuppressant, Anti-rheumatic agent

Pharmacological: Tumor necrosis factor (TNF) inhibitor

FDA Approved Indications

  • Juvenile idiopathic arthritis (JIA)
  • Ankylosing spondylitis
  • Crohn's disease (moderate to severe)
  • Plaque psoriasis
  • Psoriatic arthritis
  • Rheumatoid arthritis

Mechanism of Action

Erelzi (etanercept-szzs) is a recombinant biological agent that acts as a decoy receptor for TNF-alpha, binding to TNF-alpha and reducing its activity, thereby diminishing inflammatory responses.

Dosage and Administration

Adult: Typically, 50 mg subcutaneously once weekly or 25 mg twice weekly. Dose adjustments depend on specific condition and response.

Pediatric: Doses vary based on weight and condition; for juvenile idiopathic arthritis, common doses are 0.8 mg/kg (up to 50 mg) once weekly.

Geriatric: Generally, no adjustment necessary but caution advised due to increased risk of infections.

Renal Impairment: No specific adjustment, but caution recommended.

Hepatic Impairment: No specific adjustment, caution advised.

Pharmacokinetics

Absorption: Slow subcutaneous absorption with peak serum concentrations in 48-120 hours.

Distribution: Widely distributed in the extracellular fluid.

Metabolism: Metabolized by proteolytic enzymes; no significant hepatic metabolism.

Excretion: Primarily via cellular uptake and degradation; no specific renal excretion data.

Half Life: Approximately 4.8 days (115 hours).

Contraindications

  • Hypersensitivity to etanercept or excipients
  • Active infections, including localized infections

Precautions

  • Screen for latent tuberculosis before starting therapy
  • Monitor closely for signs of infection during treatment
  • Use caution in patients with heart failure
  • Potential for development of autoimmune antibodies, including lupus-like syndrome

Adverse Reactions - Common

  • Injection site reactions (Common)
  • Upper respiratory infections (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Serious infections (e.g., tuberculosis, sepsis) (Uncommon to rare)
  • Lymphoma and other malignancies (Rare)
  • Demyelinating diseases (Rare)
  • Hepatitis B reactivation (Rare)

Drug-Drug Interactions

  • Other immunosuppressants, Live vaccines (avoid concomitant use)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Baseline screening for tuberculosis, hepatitis B/C, and screening for autoimmune diseases.

Diagnoses:

  • Risk for infection
  • Impaired skin integrity

Implementation: Administer subcutaneously as prescribed, monitor for signs of infection or adverse reactions.

Evaluation: Assess for therapeutic response and adverse effects, monitor for infections throughout therapy.

Patient/Family Teaching

  • Report signs of infection promptly.
  • Do not receive live vaccines during therapy.
  • Maintain good hygiene and avoid contact with sick individuals.
  • Inform healthcare providers about etanercept therapy prior to any surgery or dental procedures.

Special Considerations

Black Box Warnings:

  • Risk of serious infections and malignancies, including lymphoma.

Genetic Factors: Patients with certain genetic predispositions may have increased risk of adverse effects.

Lab Test Interference: May cause false-positive results in tuberculin skin testing; confirm with other diagnostics.

Overdose Management

Signs/Symptoms: Unusual increase in side effects or signs of infection.

Treatment: Supportive care; no specific antidote; discontinue etanercept and monitor patient closely.

Storage and Handling

Storage: Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze.

Stability: Stable until expiration date if stored properly. Protect from light and freezing.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.