Enbrel vs. Trexall

• Are Enbrel and Trexall the Same Thing?
• What Are Possible Side Effects of Enbrel?
• What Are Possible Side Effects of Trexall?
• What is Enbrel?
• What is Trexall?
• What Drugs Interact with Enbrel?
• What Drugs Interact with Trexall?
• How Should Enbrel Be Taken?
• How Should Trexall Be Taken?

Enbrel (etanercept) and Trexall (methotrexate) are used to treat disorders such as rheumatoid arthritis and psoriasis.

Enbrel is also used to treat juvenile idiopathic arthritis and ankylosing spondylitis.

Trexall is also used to treat some cancers.

Enbrel and Trexall belong to different drug classes. Enbrel is a tumor necrosis factor inhibitor and Trexall is an antimetabolite.

Side effects of Enbrel and Trexall that are similar include nausea, vomiting, stomach/abdominal pain, or headache.

Side effects of Enbrel that are different from Trexall include diarrhea, redness or discomfort at the injection site, heartburn, weight changes, cold symptoms (cough, runny nose), or weakness.

Side effects of Trexall that are different from Enbrel include inflammation of the mouth and lips, upset stomach, dizziness, tired feeling, bleeding gums, blurred vision, and leukopenia (low number of white cells in blood).

Both Enbrel and Trexall may interact with steroids.

Enbrel may also interact with anakinra, cyclophosphamide, sulfasalazine, or drugs that weaken your immune system (such as cancer medicine).

Trexall may also interact with azathioprine, chloramphenicol, hydroxychloroquine, retinol, tretinoin, isotretinoin, sulfa drugs, phenytoin, probenecid, tetracycline, theophylline, gold treatments, oral diabetes medications, penicillin antibiotics, medicines that reduce stomach acid, nonsteroidal anti-inflammatory drugs (NSAIDs), or salicylates such as aspirin and others.

Common side effects of Enbrel include:

• Mild nausea
• Vomiting
• Diarrhea
• Stomach pain
• Headache
• Redness or discomfort at the injection site
• Heartburn
• Weight changes
• Cold symptoms (cough, runny nose)
• Weakness

Serious side effects include:

• Seizures
• Bruising
• Bleeding
• Skin changes (rash, pustules, blisters, patchy skin color, red spots, or a butterfly-shaped rash over cheeks and nose)
• Swelling
• Difficulty breathing or swallowing
• Numbness and tingling, burning pain
• Vision changes
• Dizziness
• Signs of infection (fever, chills, sore throat, body aches, confusion, neck stiffness, flu symptoms, itching, swelling, warmth, redness, or oozing),
• Rapid weight gain
• Chest pain
• Ongoing cough
• Coughing up mucus or blood
• Black, bloody, or tarry stools
• Changes in mood or personality (in children)
• Joint pain or swelling with fever, swollen glands, muscle aches, chest pain, unusual thoughts or behavior, and/or seizures (convulsions)

Common side effects of Trexall include:

• inflammation of the mouth and lips,
• nausea,
• vomiting,
• upset stomach,
• abdominal pain,
• dizziness,
• tired feeling,
• headache,
• bleeding gums,
• blurred vision, and
• leukopenia (low number of white cells in blood).

Tell your doctor if you have serious side effects of Trexall including:

• dry cough,
• shortness of breath,
• diarrhea,
• white patches or sores inside your mouth or on your lips,
• blood in your urine or stools,
• urinating less than usual or not at all,
• fever,
• chills,
• body aches,
• flu symptoms,
• sore throat and headache with a severe blistering/peeling/red skin rash,
• pale skin,
• easy bruising or bleeding,
• weakness,
• stomach pain,
• loss of appetite,
• dark urine,
• clay-colored stools, or
• jaundice (yellowing of the skin or eyes).

Severe side effects occur more frequently in patients taking the high doses of Trexall.

Enbrel (etanercept) is a tumor necrosis factor inhibitor used to treat certain autoimmune disorders such as rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, and plaque psoriasis.

Trexall (methotrexate) is an antimetabolite drug that is used to treat some cancers, severe skin diseases such as severe psoriasis, and to treat forms of rheumatoid arthritis. Trexall is available in generic form as methotrexate.

Enbrel may interact with anakinra, cyclophosphamide, sulfasalazine, or drugs that weaken your immune system (such as cancer medicine or steroids). Tell your doctor all medications and supplements you use.

Trexall may interact with azathioprine, chloramphenicol, hydroxychloroquine, retinol, tretinoin, isotretinoin, steroids, sulfa drugs, phenytoin, probenecid, tetracycline, theophylline, gold treatments, oral diabetes medications, penicillin antibiotics, medicines that reduce stomach acid, nonsteroidal anti-inflammatory drugs (NSAIDs), or salicylates such as aspirin and others. Tell your doctor all medications and supplements you use. This drug should not be used in pregnant or breastfeeding women due to likely harm to the fetus or infant.

Trexall may interact with allopurinol, methotrexate, blood thinners, olsalazine, sulfasalazine, sulfamethoxasole, trimethoprim, or ACE inhibitors.

Enbrel is available in three preparations; 0.98 mL of a 50 mg/mL solution of etanercept, 0.51 mL of a 50 mg/mL solution of etanercept and 25 mg etanercept. All are used for injection; only the 25 mg strength is available in a multiuse vial, the others are available in a prefilled syringe. Starting dose is often 50 mg injected twice a week in adults and 0.8 mg per Kg in pediatric patients weighing less than 63 Kg. Other doses may be used.

Trexall is supplied in 5, 7.5, 10, and 15 mg tablets. The dose is designed for each patient's problem and can range from about 7.5 mg per week to 30 mg per day, depending on the disease process and the doctor's judgment. Trexall has been used in children with juvenile rheumatoid arthritis, but most doses were individualized.