Enbrel interactions: Alcohol, medications, and other factors

Enbrel (etanercept) is a brand-name drug prescribed for certain inflammation-related conditions. Enbrel has interactions with other drugs and certain supplements. Examples include some antidiabetic medications, corticosteroids, and others.
Enbrel is prescribed for treating:
rheumatoid arthritis (RA) in adults
rheumatoid arthritis (RA)
plaque psoriasis in adults and children 4 years and older
plaque psoriasis
psoriatic arthritis (PsA) in adults
psoriatic arthritis (PsA)
ankylosing spondylitis (AS) in adults
ankylosing spondylitis (AS)
polyarticular juvenile idiopathic arthritis (pJIA) in children ages 2 years and older
polyarticular juvenile idiopathic arthritis (pJIA)
juvenile psoriatic arthritis (JPsA) in children ages 2 years and older
juvenile psoriatic arthritis (JPsA)
An interaction occurs when one substance causes another substance to have a different effect than expected.
interaction
Enbrel comes in different forms, and they have the same interactions. The forms are:
powder inside a vial that a healthcare provider makes into a solution for subcutaneous injection
solution in an injection pen for subcutaneous injection
solution in a pre-filled cartridge for use with the AutoTouch autoinjector
To learn more about Enbrel’s interactions, keep reading. For additional information about Enbrel, including details about its uses, see this article.
this article
Before you start treatment with Enbrel, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Enbrel interacts with supplements, herbs, or vitamins, see the “Enbrel and other interactions” section.)
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Here’s a table of drugs that can interact with Enbrel. Keep in mind that this table doesn’t include all drugs that may interact with Enbrel. Some of these interactions are described in detail in “Drug interactions in depth.”
antidiabetic medications
Ozempic
low blood sugar
corticosteroids
dexamethasone
prednisone
Ilaris
Kineret
Olumiant
Xeljanz
Cimzia
Humira
Orencia
Benlysta
methotrexate
Tysabri
Entyvio
Sometimes, certain factors or conditions could prevent your doctor from prescribing Enbrel due to the risk of harm. These are known as contraindications. The contraindications of Enbrel include:
Sepsis is a severe immune response to an infection. It’s a medical emergency requiring immediate attention. This contraindication is to advise medical professionals to not give doses of Enbrel if you are currently experiencing sepsis. Enbrel works by decreasing activity in your immune system, which can make it harder to treat an infection.
sepsis
Talk with your doctor if you have questions about Enbrel and infection. You can also see the “boxed warning” section in this article. Enbrel has a boxed warning about the risk of serious infections. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.
boxed warning
There are no known interactions between Enbrel and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Enbrel treatment.
alcohol
This is because drinking alcohol can worsen the condition you’re receiving Enbrel to treat. For example, if you have psoriasis or PsA, drinking alcohol may worsen your symptoms.
If you consume alcohol during Enbrel treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while using Enbrel, talk with your doctor.
Here’s a closer look at certain drug interactions of Enbrel.
Enbrel can interact with methotrexate. Methotrexate is prescribed to treat several different conditions. Doctors may prescribed it with Enbrel to treat certain conditions, including RA, PsA, or AS.
Interaction result:Taking Enbrel with methotrexate can increase the risk of infection as a side effect of Enbrel and methotrexate.
Interaction explained:Enbrel has a boxed warning about the risk of serious infections. According to studies of Enbrel, serious infections were more common in people who took Enbrel with other medications that raise the risk for infection, including methotrexate.
boxed warning
studies
Steps you or your doctor may take:Enbrel is approved for use with methotrexate to treat certain conditions. Your doctor will analyze the risks and benefits of using Enbrel with methotrexate to determine if this combination can treat your condition. They can discuss those risks and benefits with you.
If your doctor prescribes methotrexate with Enbrel, they’ll monitor you closely for signs of infection. They’ll have you stop taking Enbrel (and possibly methotrexate) if you develop a serious infection during treatment.
To learn more about infection and other side effects Enbrel may cause, you can check out this article.
this article
Enbrel can interact with antidiabetic medications, which are prescribed to treat diabetes.
diabetes
Interaction result: Taking Enbrel may increase the effect of and risk of low blood sugar as a side effect of antidiabetic medications.
Interaction explained: According to studies of the drug, starting treatment with Enbrel has caused low blood sugar (hypoglycemia) in people who were also taking medications for diabetes.
studies
Examples of antidiabetic drugs: Here are some antidiabetic drugs that may interact with Enbrel:
semaglutide (Ozempic)
Ozempic
glyburide (Diabeta, others)
metformin (Fortamet, Glumetza)
metformin
sitagliptin (Januvia)
Januvia
insulins, such as insulin glargine (Lantus, others)
Lantus
Steps you or your doctor may take: If you are taking an antidiabetic medication and your doctor prescribe Enbrel, they may lower the dosage of your antidiabetic medication. They may also want you to monitor your blood sugar level more closely during treatment.
Enbrel can interact with corticosteroids. Corticosteroids are prescribed to treat various conditions. A doctor may prescribe these drugs with Enbrel to treat certain conditions, including PsA, RA, or AS.
Interaction result: Taking Enbrel with corticosteroids can increase the risk of infection as a side effect of Enbrel and other TNF blockers.
Interaction explained: Enbrel and corticosteroids can raise your risk for infection as a side effect when taken on their own. Combining the two may further raise this risk, according to studies of Enbrel.
studies
Examples of corticosteroid drugs: Here are some corticosteroids that may interact with Enbrel:
budesonide (Uceris, others)
budesonide
dexamethasone (Hemady)
dexamethasone
methylprednisolone (Medrol, others)
methylprednisolone
prednisone (Rayos)
prednisone
Steps you or your doctor may take: Enbrel and corticosteroids are used to treat some of the same conditions. In certain situations, they may be used together despite the increased risk for infection. Your doctor will analyze the risks and benefits of using Enbrel with a corticosteroid and determine if this combination can treat your condition. They can discuss your risks and benefits to using this combination.
If your doctor prescribes Enbrel and a corticosteroid to you, they’ll closely monitor you for signs of infection throughout treatment.
Enbrel may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Enbrel.
It’s possible for drugs to interact with supplements such as vitamins and herbs.
herbs
There are no specific reports of herbs interacting with Enbrel. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Enbrel treatment.
reports
There are no specific reports of vitamins interacting with Enbrel. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin products with Enbrel.
reports
There were no reports of food interactions with Enbrel. If you’d like to learn more about eating certain foods during treatment with Enbrel, talk with your doctor.
reports
Enbrel is known to interact with live vaccines. A live vaccine contains live but weakened pieces of the virus or bacterium it defends against. When your immune system is strong, live vaccines usually won’t cause infection.
But Enbrel works by weakening your immune system. So if you get a live vaccine, your immune system may be unable to fight the virus or bacterium. This may cause you to become sick or develop symptoms of the illness the vaccine is meant to prevent.
Some examples of live vaccines to avoid during Enbrel treatment include:
measles, mumps, rubella (MMR)
measles, mumps, rubella (MMR)
chickenpox
chickenpox
nasal formulation of the flu vaccine
flu vaccine
Note: There may be other live vaccines to consider as well. Before starting Enbrel, talk with your doctor or pharmacist about any vaccines you may need.
Enbrel is not known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk to your doctor.
Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Enbrel. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Enbrel. The impact of cannabis may affect how well you stick to your Enbrel treatment plan.
Cannabis
reported
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions and other factors may increase the risk of interactions with Enbrel. Before you take this drug, be sure to talk with your doctor about your health history. Enbrel may not be the right treatment option if you have certain medical conditions or other factors affecting your health.
Health conditions or factors that might interact with Enbrel include:
Active infection: Your doctor will likely want to treat any infection you have first before prescribing Enbrel. Enbrel can make it harder for your body to fight an infection.
Diabetes, HIV, or weakened immune system due to another cause: Enbrel has a boxed warning about the risk for serious infection. If you have diabetes, HIV, or a weakened immune system due to another cause, you may be at higher risk for this side effect. See the introduction of this article to learn more about this warning.
HIV
Heart failure: Although rare, treatment with Enbrel can cause heart failure as a side effect. If you already have heart failure, taking Enbrel could worsen your condition. If your doctor prescribes Enbrel to you, they may monitor your heart failure closely throughout treatment.
heart failure
Hepatitis B virus (HBV): Be sure to let your doctor know if you have been exposed to HBV, the virus that causes hepatitis B. If you’ve been exposed to HBV, taking Enbrel could cause the virus to become active again (meaning it causes symptoms). If you’ve had HBV and your doctor prescribes Enbrel, they’ll likely want to closely monitor you during treatment for any signs of HBV becoming active again.
hepatitis B
Nervous system condition, such as multiple sclerosis (MS): Rarely, Enbrel can cause side effects related to the nervous system, including new cases of MS and other nervous system problems. If you have an existing nervous system condition, taking Enbrel could worsen it.
MS
Scheduled surgery: Having surgery can place you at risk for infection. Enbrel has a boxed warning about the risk for serious infection. See the introduction of this article to learn more about this warning. Your doctor may delay prescribing Enbrel until some time after your surgery.
Allergic reaction: If you’ve had an allergic reaction to Enbrel or any of its ingredients, your doctor will likely not prescribe Enbrel. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
allergic reaction
Breastfeeding: It is unknown whether it’s safe to use Enbrel while breastfeeding. The drug passes into breast milk in small amounts but doesn’t appear to cause effects on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Enbrel. They can talk with you about treatment options and ways to feed your child.
Pregnancy: There haven’t been enough clinical trials to determine whether Enbrel is safe to use while pregnant. If you’re pregnant or planning to become pregnant, tell your doctor before starting Enbrel. They can advise you on the right treatment plan for you.
clinical trials
You can take certain steps to help prevent interactions with Enbrel. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:
Let them know if you drink alcohol or use cannabis.
Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
supplements, herbs, and vitamins
Create a medication list, which your doctor and pharmacist can help you fill out.
medication list
It’s also important to read the Enbrel label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.
paperwork
If Enbrel doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.
You can also help prevent interactions with Enbrel by taking it exactly as your doctor prescribes.
Disclaimer: Medical News Today 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.