Imitab

Indications

Imatinib is a targeted cancer medicine. It is mainly used for chronic myeloid leukaemia (CML) and some cases of acute lymphoblastic leukaemia (ALL) that carry the Philadelphia chromosome, and for gastrointestinal stromal tumours (GIST), both when the tumour cannot be removed and after surgery to lower the chance of it coming back. Specialists also use it for a few rarer blood and skin conditions. It is started and monitored by a cancer or blood specialist.

How It Works

Imatinib is a tyrosine kinase inhibitor. It blocks abnormal enzymes (such as BCR-ABL in CML and KIT in GIST) that send constant "grow" signals to cancer cells, so the cancer cells stop multiplying and die.

Dosage and Administration

As prescribed by the specialist; the dose depends on the condition and how you respond. Take it once or twice a day with a meal and a large glass of water to reduce stomach upset. Swallow tablets whole. If you cannot swallow them, the tablet can be stirred into a glass of water or apple juice and drunk straight away. Do not take a double dose to make up for a missed one. Treatment is usually long term; do not stop or change the dose without speaking to your specialist.

Interactions

Many medicines affect imatinib. Ketoconazole, Itraconazole, Clarithromycin and grapefruit juice can raise its levels; Rifampicin, Carbamazepine, Phenytoin, Phenobarbital, Dexamethasone and St John's wort can lower them and make it less effective. Imatinib can raise the levels of Simvastatin, Ciclosporin and some other medicines. Warfarin is usually avoided during treatment; your doctor may choose another blood thinner. Avoid regular high doses of Paracetamol, as liver strain is possible. Tell your doctor about all medicines and herbal products.

Contraindications

Allergy to imatinib or any ingredient of the product. It should not be used in pregnancy unless the specialist decides it is essential.

Side Effects

Common: swelling around the eyes or in the legs (fluid retention), weight gain, nausea, vomiting, diarrhoea, muscle cramps and aches, tiredness, rash, and low blood counts (which can cause infections, anaemia or bleeding). Regular blood tests check blood counts, liver and kidney function.

Get urgent medical help if you have fast weight gain or sudden swelling, shortness of breath or chest pain, fever or signs of infection, unusual bleeding or bruising, black or bloody stools, vomiting blood, severe stomach pain, a severe or blistering rash, or yellow skin or eyes.

Pregnancy and Lactation

Imatinib can harm an unborn baby. Women who could become pregnant should use effective contraception during treatment and for at least 15 days after the last dose, and tell the doctor at once if pregnancy occurs. Do not breastfeed during treatment and for at least 15 days after stopping.

Precautions and Warnings

Tell your doctor about heart, liver or kidney disease, hepatitis B infection (it can become active again), or thyroid problems. Weigh yourself regularly and report fast weight gain. Children taking imatinib need their growth checked. It can cause dizziness or blurred vision, so take care when driving. Carers should avoid touching crushed tablets.

Overdose

An overdose can cause severe nausea, vomiting, swelling, muscle pain, rash and low blood counts. Go to hospital straight away and take the pack with you.

Therapeutic Class

Antineoplastic agent; tyrosine kinase inhibitor (targeted cancer therapy).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Keep in the original pack.