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imatinib

Pronunciation

Generic Name: imatinib (im MA ta nib)
Brand Name: Gleevec

What is imatinib?

Imatinib interferes with the growth of some cancer cells.

Imatinib is used to treat certain types of leukemia (blood cancer), bone marrow disorders, and skin cancer, or certain tumors of the stomach and digestive system.

Imatinib may also be used for purposes not listed in this medication guide.

What is the most important information I should know about imatinib?

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What should I discuss with my healthcare provider before taking imatinib?

You should not use imatinib if you are allergic to it.

To make sure imatinib is safe for you, tell your doctor if you have:

  • liver disease;

  • kidney disease;

  • underactive thyroid, recent or upcoming thyroid surgery;

  • heart disease, congestive heart failure;

  • history of stomach ulcer or bleeding; or

  • if you are receiving chemotherapy.

Do not use imatinib if you are pregnant. It could harm the unborn baby. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant during treatment.

It is not known whether imatinib passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Imatinib can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medicine.

How should I take imatinib?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Imatinib should be taken with a meal. Do not take imatinib on an empty stomach.

Take imatinib with a full glass of water.

You may dissolve the imatinib tablet in water or apple juice to make swallowing easier.

Do not crush, chew, or break an imatinib tablet. The medicine from a crushed or broken pill can be dangerous if it gets in your eyes, mouth, or nose, or on your skin. If this occurs, wash your skin with soap and water or rinse your eyes with water. Ask your doctor or pharmacist how to safely handle and dispose of a crushed or broken tablet.

Imatinib can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.

You will also need frequent tests to check your liver function.

Do not stop using imatinib without your doctor's advice.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember, making sure you also eat a meal and drink a large glass of water. Skip the missed dose if it is almost time for your next dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking imatinib?

This medicine may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly. Dizziness or severe drowsiness can cause falls, accidents, or severe injuries.

Grapefruit and grapefruit juice may interact with imatinib and lead to potentially dangerous effects. Avoid the use of grapefruit products while taking imatinib.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

This medicine can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Imatinib side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • fluid retention--shortness of breath (even while lying down), swelling, rapid weight gain (especially in your face and midsection);

  • fluid build-up in the lungs--pain when you breathe, wheezing, gasping for breath, cough with foamy mucus;

  • liver problems--upper stomach pain, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • low blood cell counts--fever, chills, flu-like symptoms, swollen gums, mouth sores, skin sores, rapid heart rate, pale skin, easy bruising, unusual bleeding, feeling light-headed;

  • signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • signs of tumor cell breakdown--lower back pain, blood in your urine, little or no urinating; numbness or tingly feeling around your mouth; muscle weakness or tightness; fast or slow heart rate, weak pulse; confusion, fainting;

  • thyroid symptoms--extreme tired feeling, dry skin, joint pain or stiffness, muscle pain or weakness, hoarse voice, feeling more sensitive to cold temperatures; or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • nausea, vomiting, stomach pain, diarrhea;

  • joint or muscle pain;

  • skin rash; or

  • feeling tired.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Imatinib dosing information

Usual Adult Dose for Chronic Myelogenous Leukemia:

Chronic phase: 400 mg orally once a day
Accelerated phase or blast crisis: 600 mg orally once a day

A dose increase may be considered in the absence of a severe adverse drug reaction and severe non-leukemia related neutropenia or thrombocytopenia in the following circumstances: disease progression (at any time), failure to achieve a satisfactory hematologic response after at least 3 months of treatment, failure to achieve a cytogenetic response after 6 to 12 months of treatment, or loss of a previously achieved hematologic or cytogenetic response:
Disease progression chronic phase: 600 mg orally once a day
Disease progression accelerated phase or blast crisis: 400 mg orally 2 times a day

Duration of therapy: Therapy may be continued as long as there is no evidence of progressive disease or unacceptable toxicity.

Comments:
-This drug should be taken with a meal and a large glass of water.

Uses:
-Newly diagnosed patients with Philadelphia chromosome positive chronic myeloid leukemia (Ph+CML) in chronic phase
-Patients with Philadelphia chromosome positive chronic myeloid leukemia (Ph+CML) in blast crisis (BC), accelerated phase (AP), or in chronic phase (CP) after failure of interferon-alpha therapy

Usual Adult Dose for Acute Lymphoblastic Leukemia:

600 mg orally daily

Duration of therapy: Therapy may be continued as long as there is no evidence of progressive disease or unacceptable toxicity.

Comments:
-This drug should be taken with a meal and a large glass of water.

Use: For relapsed or refractory Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL)

Usual Adult Dose for Myeloproliferative Disorder:

400 mg orally once a day

Duration of therapy: Therapy may be continued as long as there is no evidence of progressive disease or unacceptable toxicity.

Comments:
-Determine PDGFRb gene rearrangements status prior to initiating treatment. Information on FDA-approved tests for the detection of PDGFRb rearrangements is available at http://www.fda.gov/companiondiagnostics.
-This drug should be taken with a meal and a large glass of water.

Use: For patients with myelodysplastic/myeloproliferative (MDS/MPD) diseases associated with PDGFR (platelet-derived growth factor receptor) gene rearrangements as determined with an FDA-approved test

Usual Adult Dose for Myelodysplastic Disease:

400 mg orally once a day

Duration of therapy: Therapy may be continued as long as there is no evidence of progressive disease or unacceptable toxicity.

Comments:
-Determine PDGFRb gene rearrangements status prior to initiating treatment. Information on FDA-approved tests for the detection of PDGFRb rearrangements is available at http://www.fda.gov/companiondiagnostics.
-This drug should be taken with a meal and a large glass of water.

Use: For patients with myelodysplastic/myeloproliferative (MDS/MPD) diseases associated with PDGFR (platelet-derived growth factor receptor) gene rearrangements as determined with an FDA-approved test

Usual Adult Dose for Systemic Mastocytosis:

-For patients with ASM without the D816V c-Kit mutation: 400 mg orally daily
-If c-Kit mutational status is not known or unavailable: 400 mg orally daily may be considered for patients with ASM not responding satisfactorily to other therapies
-For patients with ASM associated with eosinophilia, a clonal hematological disease related to the fusion kinase FIP1L1-PDGFR alpha, a starting dose of 100 mg/day is recommended. Dose increase from 100 mg to 400 mg for these patients may be considered in the absence of adverse drug reactions if assessments demonstrate an insufficient response to therapy.
-For patients with ASM associated with eosinophilia (a clonal hematological disease related to the fusion kinase FIP1L1-PDGFR alpha: 100 mg orally daily; a dose increase from 100 mg to 400 mg for these patients may be considered in the absence of adverse drug reactions if assessments demonstrate an insufficient response to therapy

Duration of therapy: Therapy may be continued as long as there is no evidence of progressive disease or unacceptable toxicity.

Comments:
-Determine D816V c-Kit mutation status prior to initiating treatment.
-This drug should be taken with a meal and a large glass of water.

Use: For patients with aggressive systemic mastocytosis without the D816V c-Kit mutation as determined with an FDA-approved test

Usual Adult Dose for Hypereosinophilic Syndrome:

-For patients with HES/CEL: 400 mg orally daily
-For patients with HES/CEL with demonstrated FIP1L1-PDGFR alpha fusion kinase: 100 mg orally daily; dose increase from 100 mg to 400 mg for these patients may be considered in the absence of adverse drug reactions if assessments demonstrate an insufficient response to therapy

Duration of therapy: Therapy may be continued as long as there is no evidence of progressive disease or unacceptable toxicity.

Comments:
-This drug should be taken with a meal and a large glass of water.

Use: For patients with hypereosinophilic syndrome and/or chronic eosinophilic leukemia who have the FIP1L1-PDGFR alpha fusion kinase (mutational analysis or FISH demonstration of CHIC2 allele deletion) and for patients with HES and/or CEL who are FIP1L1-PDGFR alpha fusion kinase negative or unknown

Usual Adult Dose for Chronic Eosinophilic Leukemia:

-For patients with HES/CEL: 400 mg orally daily
-For patients with HES/CEL with demonstrated FIP1L1-PDGFR alpha fusion kinase: 100 mg orally daily; dose increase from 100 mg to 400 mg for these patients may be considered in the absence of adverse drug reactions if assessments demonstrate an insufficient response to therapy

Duration of therapy: Therapy may be continued as long as there is no evidence of progressive disease or unacceptable toxicity.

Comments:
-This drug should be taken with a meal and a large glass of water.

Use: For patients with hypereosinophilic syndrome and/or chronic eosinophilic leukemia who have the FIP1L1-PDGFR alpha fusion kinase (mutational analysis or FISH demonstration of CHIC2 allele deletion) and for patients with HES and/or CEL who are FIP1L1-PDGFR alpha fusion kinase negative or unknown

Usual Adult Dose for Dermatofibrosarcoma Protuberans:

100 mg orally daily

Duration of therapy: Therapy may be continued as long as there is no evidence of progressive disease or unacceptable toxicity.

Comments:
-This drug should be taken with a meal and a large glass of water.

Use: For patients with unresectable, recurrent and/or metastatic dermatofibrosarcoma protuberans (DFSP)

Usual Adult Dose for Gastrointestinal Stromal Tumor:

-For patients with unresectable and/or metastatic, malignant GIST: 400 mg orally daily; the dose may be increased up to 800 mg daily (given as 400 mg 2 times a day) may be considered, as clinically indicated, in patients showing clear signs or symptoms of disease progression at a lower dose and in the absence of severe adverse drug reactions; therapy may be continued as long as there is no evidence of progressive disease or unacceptable toxicity.
-For the adjuvant treatment of adult patients following complete gross resection of GIST: 400 mg orally daily; in clinical trials, therapy was administered for one year; the optimal treatment duration is not known

Comments:
-This drug should be taken with a meal and a large glass of water.

Uses:
-Kit+ Gastrointestinal Stromal Tumors (GIST): Patients with Kit (CD117) positive unresectable and/or metastatic malignant gastrointestinal stromal tumors
-Adjuvant Treatment of GIST: Adjuvant treatment of adult patients following complete gross resection of Kit (CD117) positive GIST

Usual Pediatric Dose for Chronic Myelogenous Leukemia:

1 year and older:
340 mg/m2 orally once a day or 170 mg/m2 orally 2 times a day
Maximum Dose: 600 mg daily
Duration of therapy: Therapy may be continued as long as there is no evidence of progressive disease or unacceptable toxicity.

Comments:
-Therapy can be given as a once daily dose or the daily dose may be split into 2 doses, with one portion dosed in the morning and one portion in the evening.
-This drug should be taken with a meal and a glass of water.
-There is no experience with this drug in children under 1 year of age.

Use:
-Newly diagnosed patients with Philadelphia chromosome positive chronic myeloid leukemia (Ph+CML) in chronic phase

Usual Pediatric Dose for Acute Lymphoblastic Leukemia:

1 year and older:
340 mg/m2 orally once a day
Maximum Dose: 600 mg once a day
Duration of therapy: Treatment may be continued as long as there is no evidence of progressive disease or unacceptable toxicity.

Comments:
-This drug should be taken with a meal and a glass of water.
-There is no experience with this drug in children under 1 year of age.

Use: For pediatric patients with newly diagnosed Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL) in combination with chemotherapy

What other drugs will affect imatinib?

Many drugs can interact with imatinib. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with imatinib, especially:

  • bosentan;

  • dihydroergotamine or ergotamine;

  • fentanyl (Abstral, Actiq, Fentora, Duragesic, Lazanda, Onsolis);

  • nefazodone;

  • pimozide;

  • St. John's wort;

  • an antibiotic--clarithromycin, erythromycin, telithromycin;

  • antifungal medicine--itraconazole, ketoconazole, posaconazole, voriconazole;

  • antiviral medicine to treat hepatitis C or HIV/AIDS--atazanavir, boceprevir, cobicistat (Stribild, Tybost), delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, nevirapine, ritonavir, saquinavir, telaprevir;

  • a blood thinner--warfarin, Coumadin, Jantoven;

  • heart medicine--nicardipine, quinidine;

  • medicine to prevent organ transplant rejection--cyclosporine, sirolimus, tacrolimus;

  • seizure medication--carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone; or

  • tuberculosis medication--isoniazid, rifabutin, rifampin, rifapentine.

This list is not complete and many other drugs can interact with imatinib. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about imatinib.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 11.06.

Date modified: July 24, 2017
Last reviewed: October 06, 2015

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