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Imatinib Dosage

Medically reviewed by Drugs.com. Last updated on May 6, 2024.

Applies to the following strengths: 100 mg; 400 mg

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:


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

Uses:

Usual Adult Dose for Acute Lymphoblastic Leukemia

600 mg orally daily

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

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 if there is no evidence of progressive disease or unacceptable toxicity.

Comments:


Use: For patients with myelodysplastic/myeloproliferative (MDS/MPD) diseases associated with PDGFR (platelet-derived growth factor receptor) gene rearrangements

Usual Adult Dose for Myelodysplastic Disease

400 mg orally once a day

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

Comments:


Use: For patients with myelodysplastic/myeloproliferative (MDS/MPD) diseases associated with PDGFR (platelet-derived growth factor receptor) gene rearrangements

Usual Adult Dose for Systemic Mastocytosis


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

Comments:

Use: For patients with aggressive systemic mastocytosis without the D816V c-Kit mutation

Usual Adult Dose for Hypereosinophilic Syndrome


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

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


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

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 if there is no evidence of progressive disease or unacceptable toxicity.

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

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 if there is no evidence of progressive disease or unacceptable toxicity.

Comments:


Use:

Renal Dose Adjustments

Liver Dose Adjustments

Dose Adjustments

Concomitant strong CYP450 3A4 inducers: This drug should not be given concomitantly with strong CYP450 3A4 inducers (e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, phenobarbital); if patients must be coadministered a strong CYP450 3A4 inducer the dosage of imatinib should be increased by at least 50%.

Dose Adjustment for Hepatotoxicity and Non-Hematologic Adverse Reactions: Bilirubin greater than 3 times the upper limit of normal (ULN) or in liver transaminases greater than 5 x ULN: Withhold therapy until bilirubin levels have returned to a less than 1.5 x ULN and transaminase levels to less than 2.5 x ULN. In adults, therapy may then be continued at a reduced daily dose (i.e., 400 mg to 300 mg, 600 mg to 400 mg, or 800 mg to 600 mg); in children, daily doses can be reduced from 340 mg/m2/day to 260 mg/m2/day.

If a severe nonhematologic adverse reaction develops (e.g., severe hepatotoxicity, severe fluid retention) therapy should be withheld until the event has resolved; thereafter, therapy can be resumed as appropriate depending on the initial severity of the event.

Dose adjustments for ASM associated with eosinophilia (starting dose 100 mg):
ANC less than 1 x 10(9)/L and/or platelets less than 50 x 10(9)/L:
1. Stop therapy until ANC greater than or equal to 1.5 x 10(9)/L and platelets greater than or equal to 75 x 10(9)/L.
2. Resume therapy at previous dose (i.e., before severe adverse reaction).

Dose adjustments for HES/CEL with FIP1L1-PDGFR alpha fusion kinase (starting dose 100 mg):
ANC less than 1 x 10(9)/L and/or platelets less than 50 x 10(9)/L:
1. Stop therapy until ANC greater than or equal to 1.5 x 10(9)/L and platelets greater than or equal to 75 x 10(9)/L.
2. Resume therapy at previous dose (i.e., before severe adverse reaction).

Dose adjustments for Chronic Phase CML (starting dose 400 mg):
ANC less than 1 x 10(9)/L and/or platelets less than 50 x 10(9)/L:
1. Stop therapy until ANC greater than or equal to 1.5 x 10(9)/L and platelets greater than or equal to 75 x 10(9)/L.
2. Resume therapy at the original starting dose of 400 mg.
3. If recurrence of ANC less than 1 x 10(9)/L and/or platelets less than 50 x 10(9)/L, repeat step 1 and resume therapy at a reduced dose of 300 mg.

Dose adjustments for MDS/MPD (starting dose 400 mg):
ANC less than 1 x 10(9)/L and/or platelets less than 50 x 10(9)/L:
1. Stop therapy until ANC greater than or equal to 1.5 x 10(9)/L and platelets greater than or equal to 75 x 10(9)/L.
2. Resume therapy at the original starting dose of 400 mg.
3. If recurrence of ANC less than 1 x 10(9)/L and/or platelets less than 50 x 10(9)/L, repeat step 1 and resume therapy at a reduced dose of 300 mg.

Dose adjustments for ASM (starting dose 400 mg):
ANC less than 1 x 10(9)/L and/or platelets less than 50 x 10(9)/L:
1. Stop therapy until ANC greater than or equal to 1.5 x 10(9)/L and platelets greater than or equal to 75 x 10(9)/L.
2. Resume therapy at the original starting dose of 400 mg.
3. If recurrence of ANC less than 1 x 10(9)/L and/or platelets less than 50 x 10(9)/L, repeat step 1 and resume therapy at a reduced dose of 300 mg.

Dose adjustments for HES/CEL (starting dose 400 mg)
ANC less than 1 x 10(9)/L and/or platelets less than 50 x 10(9)/L:
1. Stop therapy until ANC greater than or equal to 1.5 x 10(9)/L and platelets greater than or equal to 75 x 10(9)/L.
2. Resume therapy at the original starting dose of 400 mg.
3. If recurrence of ANC less than 1 x 10(9)/L and/or platelets less than 50 x 10(9)/L, repeat step 1 and resume therapy at a reduced dose of 300 mg.

Dose adjustments for Ph+ CML: Accelerated Phase and Blast Crisis (starting dose 600 mg):
ANC less than 0.5 x 10(9)/L and/or platelets less than 10 x 10(9)/L:
1. Check if cytopenia is related to leukemia (marrow aspirate or biopsy).
2. If cytopenia is unrelated to leukemia, reduce dose to 400 mg.
3. If cytopenia persists 2 weeks, reduce dose further to 300 mg.
4. If cytopenia persists 4 weeks and is still unrelated to leukemia, stop therapy until ANC greater than or equal to 1 x 10(9)/L and platelets greater than or equal to 20 x 10(9)/L and then resume therapy at 300 mg.

Dose adjustments for Ph+ ALL (starting dose 600 mg):
ANC less than 0.5 x 10(9)/L and/or platelets less than 10 x 10(9)/L:
1. Check if cytopenia is related to leukemia (marrow aspirate or biopsy).
2. If cytopenia is unrelated to leukemia, reduce dose to 400 mg.
3. If cytopenia persists 2 weeks, reduce dose further to 300 mg.
4. If cytopenia persists 4 weeks and is still unrelated to leukemia, stop therapy until ANC greater than or equal to 1 x 10(9)/L and platelets greater than or equal to 20 x 10(9)/L and then resume therapy at 300 mg.

Precautions

CONTRAINDICATIONS:


Safety and efficacy have not been established in patients younger than 1 year.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:


Monitoring:

Frequently asked questions

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.