My husband is on Enbrel for Rheumatiod arthritis and just came down with a cold, sinus headache, and runny nose. I tried calling his Rheumy, but they are closed until Monday. Should he still inject tomorrow? He is on the 50mg pen injector once a week.
Call your pharmicists also or whoever you get the enbrel from they should also be able to help you
As mentioned above, every physician normally has someone on call if they are not available. In our town (I finally found out!) we call the hospital and ask for the on-call doctor. He usually will call back very shortly.
Enliven Services (1-888-4ENBREL), the Enbrel support program, is a good resource, but the answer above is correct, that they will usually ultimately refer you to your doctor, who knows you and your history, and can examine you if necessary.
There is good news and bad news about Enbrel and sinus problems. The bad news is that Enbrel can aggravate sinus problems in general, even if there is not an infection present The good news is that, if you have to wait a couple of days, it doesn't necessarily have to turn your life upside down.
Has your husband had sinus problems and infections in the past? That was my history too, and I have been on Enbrel for the last 4 1/2 years. I found that if I took Enbrel strictly on schedule for a month or so, I ended up (or believe I did have) a sinus infection. It can be difficult to decide. The good news is that, if you self-inject, your schedule can be flexible (not like having to re-schedule an infusion of Remicade, which I'd tried earlier). I ended up stretching out the injections to 4, 5, or 6 days. The half-life of Enbrel is about 3 days. GIving my body that extra day or so to 'recover' some immune-fighting power seemed to help keep infection away. Your husband may want to ask your doctor how he should adjust/react to various side effects. Working with his doctor, he will gain experience after a while in figuring out what works best - every patient is a little different!
When I had to take antibiotics I had to also go off the Enbrel. I was afraid I would feel terrible, but at least for me, that fact that my immune system was fighting something else, and the fact that antibiotics (certain ones like azithromycin that comes in a "Z-pak" are often used for sinus infections) can often have some antiinflammatory effect, seemed to compensate for the lack of other medicine, to some degree. Of course, by the time I could use Enbrel again, I was relieved! I don't know if this would be true for people in general, however, my arthritis is pretty well controlled, though I had already had joint damage in one wrist and one ankle before I was diagnosed.
Where infection is concerned, I would rather be safe than sorry - one can sometimes compensate with other (pain) meds for the lack of the biologic drug, something to ask your doctor about, if its necessary.
It is generally recommended that you skip or postpone your dose if you are coming down with a cold or flu ot if you already have one. As the other commenters mentioned, there should be somebody on call who would be able to counsel you on this, but in the absence of that, your husband should postpone - giving your immune system even more of a dip when you're already sick can make it harder for you to fight the infection.
For tips on how to manage these sinus issues that come with using the Biologics, check out this post on managing side effects.
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Hi Alma,
Even if your rheumatologist's office is closed, someone should be on call for this type of question. If you cannot get follow up from your rheumatologist, call your family doctor. Even if your family doctor is not the prescribing MD, he or she should be able to give guidance about how to manage the cold and sinus infection, including whether or not to take the Enbrel. You may need to be very assertive with the office staff to get an answer, but persist politely until you do get an answer. This is an important and legitament question. The Enbrel support line may be able to give you some guidance, although they will likely tell you that your doctor needs to make this decision.