After about three days the Enbrel starts to wear off with me and that is after it takes a day to work. Enbrel use to start working in half a day and it even though two days before I was due for the next weekly injection it was wearing off, the pain level did not get as bad as I once had. Now it feels like it has completely wore off and I am back in pain for half the week. I am in my fourth month on Enbrel.
I am still on Mtx and Folic Acid and Sulfasalazine. Mtx worked for a couple of months then it felt like it stopped working. It actually does help a little but no where near enough. I have been able to cut out the Celebrex but I have needed to take it for a few days and Paracetamol. Can't take Tramadol because I am too foggy headed and nauseated. I can't take codiene or asprin due to side effects, it gives me bad stomach pain.
I wonder if it is because my Enbrel pen injections are not being kept at a constant temperature due to how far they have to travel before I get them. Would this effect their level of effectiveness? Should I provide some insulated travel packs to get my Enbrel home from the Pharmacist? The Pharmacy get them delivered in a polystyrene box and chilled gel packs but it is often left in the store room until the staff get around to unpacking the stock then it gets put into the refrigerator. I receive my Rx in a foil bag for me to take home and the injections are warm by the time I get home.. I live in a sub- tropical climate on an island in Queensland, Australia.
Aren't your pens sent overnight with ice packs?
Big secret, Enbrel can be left at room temperature for quite some time with no ill effect, they just won't put it in the data.
As you stated in your post...if the travel time from your pharmacy is long you can call the Enbrel/Etanercept and they will set you up with a co-pay assist card and send you travel coolers at no charge. Or, you can just use whatever as a cooler for the trip.
The Enbrel WILL be less effective if it gets below refrigerated temperature for more than a few hours. However, It has presevatives and will not likely grow bacteria for a few days if it doesn't get below 70 degrees. Anything hotter than that and it's trash!
I had to throw out 3months worth when we moved across country because I forgot it was in my truck. The ice melted and the inside of the cab was atleast 150 (in Nevada) for hours. Throwing away 6grand is never easy!!
Check every possible reason with the Enbrel advisors from the phone numbers on your medication, and your rhuemy first. Once they and you have ruled out error, or degraded meds, it could be that Enbrel just isn't the correct biologic med for you. Lots of folks have to try several biologics until they get one that works. You do need to give it time though. One pharmacist said that Humira for example, could take 6 months or more to kick in. I started on Enbrel last August, and by December I knew it was not working. I switched to Humira and am still waiting for it to start working.
I left a box of Enbrel in a drawer for a week. I called the company and asked what to do. They said it was just fine. Enbrel has been tested to be a room temperature for some undisclosed length of time which apparently is more than a week. If it gets really hot, the proteins will de-nature, so during the summer it might be a problem in a hot truck or warehouse. Enbrel won't say how hot it can get.
I really don't think Enbrel would let their drug be shipped in a way that could ruin it. I think they know what they're doing. I think that you will likely need to increase the frequency of your doses, or go to another biologic. Enbrel can be prescribed at 50mg 2x a week, at least for awhile.
One thing you could try is going to 25mg 2x a week. That will keep the levels a bit more even in your system.
I talked to enbrel...the experation date does not change if the syringes don't get above 75 degrees for longer than 24hrs. and are then kept refrigerated.
If they are left unrefrigerated for longer than 24hrs and don't reach a temperature above 75 degrees the experation is 45 days from that time. And the effectiveness may deminish.
If the syringes reach temperatures above 75 degrees for more than 2hrs they are trash.
Enbrel doesn't just toss a pack of syringes in a box and cross their fingers and hope the delivery is on time. The two ice-packs and foil-lined insulated bag will stay at a refrigerated temperature for over a week. They most certainly know what they are doing.
The first loading dose of Enbrel is 50mg for 3-4weeks every 4 days max. Then a regular maintenance dose of 50mg max once per week. Some people take 25mg twice per week some take 25mg once per week.
I have taken Enbrel for 13 years.
Thanks for the information. I was more concerned about the Pharmacist who gets his deliveries after lunch and leaves the boxes in the store room, sometimes until the following day. Just to get my Enbrel to the Pharmacy would take no less than 4 hours and it could take much longer. I do hope that it is trucked on one of the priority type deliveries.
My daily temperature in summer is 26-33C I think that is around 79-85F. It is still around the 27, 28 C in Autumn. The Enbrel is transported in a polystyrene box with chilled gel packs not ice. The Enbrel can sometimes be at room temperature when I pick it up from the Pharmacy and that is because it has not been unpacked and comes straight form the storeroom amongst all the boxes delivered. I have been asked to come back the next day and when I did it was in the refrigerator by then I do suspect that it may have been left in the storeroom overnight.
I do think I was hoping to have some other reason why Enbrel is not working so well on me. Of course I will mention all this to my Rheumy.
You can probably get them delivered to your house. Call your insurance pharmacy benefit company and see. Then you won't have any doubt. I've never had a problem with a delivered shipment. The packaging lasts for three days in normal conditions. Once I left a package in my car in the sun for a day. When I opened it, the ice packs were still not completely melted.