TNF-α Inhibitor (Fusion Protein) Pregnancy: B

Etanercept

Brand names: Enbrel, Benepali, Erelzi

Adult dose

Dose: 25 mg SC twice weekly or 50 mg SC once weekly

Route: subcutaneous injection

Frequency: twice weekly or once weekly

Max: 50 mg/week

Pre-filled pen/syringe; alternate injection sites; screen for TB and hepatitis B/C before starting; live vaccines contraindicated

Dose: 0.4 mg/kg

Route: subcutaneous

Frequency: once weekly

Max: 25 mg per dose

Concentration: 10 mg/mL or 25 mg/0.5 mL or 50 mg/mL prefilled syringe mg/ml

JIA ≥2 years: 0.4 mg/kg once weekly (max 25 mg); psoriasis ≥6 years: 0.8 mg/kg once weekly (max 50 mg)

Renal

No dose adjustment required

Hepatic

No dose adjustment required

Paediatric weight-based calculator

Patient weight (kg)

JIA ≥2 years: 0.4 mg/kg once weekly (max 25 mg); psoriasis ≥6 years: 0.8 mg/kg once weekly (max 50 mg)

Only TNF inhibitor that is a fusion protein (not monoclonal antibody) — binds both TNF-α and TNF-β
TEMPO trial: etanercept + MTX superior to either alone in RA
Less effective for inflammatory bowel disease than monoclonal anti-TNF agents (infliximab, adalimumab) — caution in IBD comorbidity

Reference: BNFc; BNF 86; NICE TA130; TEMPO trial. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways