Gleevec-Imatnib Mesylate

 

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

Uses For This Medication
  • Imatinib is used to treat adults with a particular type of leukemia (chronic myeloid leukemia, CML) gastrointestinal stromal tumors (GIST), Dermatofibrosarcoma protruberans (DFSP), Myelodysplastic/ Myeloproliferative diseases (MDS/MPD), Aggressive systemic mastocytosis (ASM), Hypereosinophilic syndrome/chronic eosinophilic leukemia, Relapsed or refractory acute lymphoblastic leukemia (ALL).
  • Imatinib is being studied for the treatment of other tumors and blood-based cancers, including melanoma, brain tumors, lung cancer, ovarian cancer, stomach cancer, and certain types of leukemia (acute lymphoblastic leukemia).
  • This medication may also be given for other conditions as determined by your doctor.
  How This Medication Works Imatinib is a chemotherapy medication that belongs to a group of medications known as tyrosine kinase inhibitors. Tyrosine kinase inhibitors are a new kind of treatment known as “targeted therapy” that is different from traditional chemotherapy. Most chemotherapy medications work by killing rapidly dividing cells in the body. Tyrosine kinase inhibitors work by blocking a protein called tyrosine kinase. This protein helps cancer cells divide and grow. Imatinib blocks this protein which prevents further growth of cancer cells and leads to tumor cell death.   Benefits Of This Medication Imatinib has been shown to lower the number of white blood cells circulating throughout the body. In addition, it blocks the growth of white blood cells that carry an abnormal protein linked to chronic myeloid leukemia (CML). Imatinib has been shown to slow the progress of chronic myeloid leukemia (CML) and help prevent the development of a more severe form of leukemia.   Who Should Not Take This Medication You should not take this medication if you are allergic to imatinib or any of its components.   Precautions To Be Aware Of Before Taking This Medication

Blood related precautions

  • This medication may temporarily reduce the number of platelets in your blood. This can increase your risk of bleeding. Contact your doctor or healthcare provider if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. If your platelet levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a platelet transfusion, and/or that you take medication to help increase the number of platelets in your blood. To lower your chance of bleeding, do not use aspirin, aspirin-containing medications, or aspirin-like medications (for example ibuprofen, naproxen). Use caution with sharp objects like razors and nail cutters, and avoid activities that can cause cuts, bumps and bruises. Do not floss your teeth if you have low platelets as this can increase the risk of bleeding and infection.
  • This medication may temporarily reduce the number of germ fighting white blood cells in your blood. This can increase your risk of infection. Contact your doctor or healthcare provider promptly if you develop any signs of an infection such as fever, painful urination, chills or a sore throat that doesn’t go away. If your white blood cell levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed and/or you receive medication to increase the number of white cells in your blood. To lower your risk of infection, stay away from crowds and people with colds or other illnesses, wash your hands well and often with soap and water, and brush and floss your teeth daily, unless you have been told your platelets are low.
  • This medication may temporarily lower the number of red cells in your blood. This can increase your risk of anemia. If your red blood cell level becomes low, you may feel tired and weak. If your red blood cell level becomes too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a red blood cell transfusion, and/or you receive a medication to help increase the red cells in your blood.
 

Gastrointestinal related precautions

This medication may cause nausea, vomiting, and/or diarrhea which can lead to dehydration. Eat small frequent meals, bland foods (for example bananas, rice, apples, toast), and drink plenty of water and fluids that contain electrolytes (e.g. Gatorade, Pedialyte) to avoid dehydration. Contact your doctor or healthcare provider if you have moderate to severe nausea, vomiting or diarrhea. These side effects can be treated with medications.  

Organ related precautions

  • Rarely, this medication can cause changes in the ability of your liver to work normally. In addition, this medication is broken down by enzymes (chemicals) in the liver and cleared from the body. In patients with severe liver disease, imatinib may not break down normally which can lead to high levels of this medication in the body and a greater chance of side effects. Your doctor or healthcare provider will check your liver regularly, usually through blood tests, while you are on this medication to make sure that your liver is working properly. If you have any liver problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects.
  • Rarely, this medication can cause changes in the ability of your kidneys to work normally. Your doctor or healthcare provider will check your kidneys regularly, usually through blood tests, while you are on this medication to make sure that your kidneys are working properly. If you have any kidney problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects.
  • Rarely, this medication can cause severe allergic skin reactions. These can be serious and can cause symptoms such as skin lesions, itching, fever, joint aches, mouth sores, eye burning, itching, pain and discharge, and vision changes. Contact your doctor or healthcare provider right away if you have any of these symptoms.
 

Miscellaneous precautions

  • This medication can cause you to retain water. Your doctor or healthcare provider will weigh you regularly and check you for water retention. Contact your doctor or healthcare provider right away if you experience sudden weight gain or other signs of fluid build-up such as swollen legs or feet.
  • Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent.
Patient specific precautions
  • It is not known if this medication is safe and effective in children under 3 years of age. This medication is approved for use in children over 3 years of age with chronic myelogenous leukemia (CML).
  • Older patients (more than 65 years of age) receiving imatinib may be more likely to retain water than younger patients (see Precautions To Be Aware Of Before Taking This Medication).
 

Pregnancy and breastfeeding precautions

  • This medication may cause fetal harm. When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant.
  • It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
  • Many anti-cancer therapies can cause sterility. Notify your doctor or healthcare provider if you want to have children in the future.

Medication And Food Interactions

Before using this medication, tell your doctor or healthcare provider of all prescription or over-the-counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with imatinib and the following foods or medications:
  • Amiodarone (Cordarone?)
  • Aprepitant (Emend?)
  • Atazanavir (Reyataz?)
  • Carbamazepine
  • Citalopram (Celexa®)
  • Clarithromycin (Biaxin®)
  • Cyclophosphamide
  • Cyclosporine
  • Daunorubicin
  • Dexamethasone (Decadron®)
  • Docetaxel (Taxotere?)
  • Doxorubicin
  • Erythromycin
  • Fluconazole (Diflucan®)
  • Fluoxetine (Prozac®)
  • Fluvoxamine
  • Grapefruit or grapefruit juice
  • Idarubicin
  • Indinavir (Crixivan®)
  • Irinotecan (Camptosar®)
  • Itraconazole (Sporonox®)
  • Ketoconazole (Nizoral®)
  • Metronidazole
  • Nefazodone (Serzone?)
  • Nelfinavir (Viracept?)
  • Omeprazole (Zofran?)
  • Paclitaxel (Taxol?)
  • Phenytoin (Dilantin?)
  • Phenobarbital
  • Pimozide (Orap®)
  • Rifampin (Rifadin?)
  • Ritonavir (Norvir®)
  • Saquinavir
  • Sertraline (Zoloft®)
  • St. John’s Wort
  • Simvastatin (Zocor®)
  • Tacrolimus (Prograf®)
  • Tamoxifen (Nolvadex®)
  • Vinblastine
  • Vincristine
  • Vinorelbine (Navelbine?)
  • Voriconazole (Vfend?)
  • Warfarin (Coumadin?)
NOTE: This list may not include all medications that can have interactions with imatinib.

Side Effects

  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • Side effects can occur when imatinib is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with imatinib alone.
 

More common side effects

  • Decreased platelet, red blood cell, and/or white blood cell levels (see Precautions To Be Aware Of Before Taking This Medication)
  • Nausea, vomiting, diarrhea, stomach pain (see Precautions To Be Aware Of Before Taking This Medication)
  • Swelling around the eyes or feet (edema) (see Precautions To Be Aware Of Before Taking This Medication)
  • Muscle cramps, aches and pains, joint and bone pain
  • Skin rash
  • Tiredness (fatigue), headache, fever
 

Less common side effects

  • Heartburn, constipation, loss of appetite
  • Dizziness, weakness
  • Weight increase
  • Itching
  • Shortness of breath, cough, nose bleeds, sore throat
  • Difficulty sleeping, night sweats
  • Low blood level of potassium (symptoms include muscle weakness, fatigue, muscle cramps)
  • Fluid in the lining of the lungs (pleural effusion), heart (pericardial effusion), or abdomen (ascites)
 

Rare side effects

This is not a complete list of the rare side effects reported with imatinib. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert. 
  • Liver damage (see Precautions To Be Aware Of Before Taking This Medication) 
  • Serious allergic skin reactions (see Precautions To Be Aware Of Before Taking This Medication)
  • Kidney failure (see Precautions To Be Aware Of Before Taking This Medication)
  • Swelling or scarring of the lungs (symptoms include cough, difficulty breathing, wheezing)
 

How To Take This Medication

  • This medication is taken by mouth (orally) with a meal and a large glass of water. This may greatly reduce the nausea and/or vomiting that can happen with imatinib treatment. Take this medication exactly as directed by your doctor or healthcare provider. If you do not understand these instructions, ask your doctor or healthcare provider to explain them to you. This medication can be given in different doses depending on the type of condition being treated.
  • It is important that you only use this medication when it’s been prescribed for you. Sharing this medication with someone for whom it is not prescribed could cause harm.
  • There are two different strengths of imatinib – a 100mg film-coated tablet which is dark yellow and round; and a 400mg film-coated tablet which is dark yellow and oval.
  • If you accidentally take too many pills or someone else accidentally takes your medication, contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
 

Proper Storage

  • Store this medication at room temperature and keep in its original container.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.