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Gleevec (Imatinib)

Warning: Serious side effects of Gleevec are rare but should receive immediate and appropriate treatment as complications can occur.  This includes stomach or intestinal bleeding, heart failure, reduced liver function and fluid in the lungs.  You may also experience fever associate with a lower white blood cell count, reduced platelets and red blood cell counts.  Some of the more common side effects include headache, diarrhea, weakness, nausea, loss of appetite, rash, itching, fever, dizziness and swelling of the arms and legs.  This is not a full list of side effects so be sure to ask your doctor or pharmacist for a more detailed list of side effects.

 

Indications: This drug treats adult and pediatric patients who have been diagnosed with certain cancers such as chronic myeloid leukemia (Ph+CML); adults with myeloproliferative or myelodysplastic diseases, mastocytosis, hypereosinophillic syndrome, chronic eosinophillic luekemia, gastrointestinal stromal tumors, and dermatofibrosarcoma protuberans that has spread to other parts of the body, or has come back after surgery.   

Dosage: Gleevec comes as a tablet to be taken by mouth. The dosage is determined by your doctor but the general recommendation is 300-800 mg daily taken orally and depending on the cancer being treated. Take the dosage with food and a glass of water.  If you have been prescribed an 800 mg daily dose, it should be taken as 400 mg twice daily to avoid an overdose of iron.  This pill can also be dissolved in apple juice or water for people who have difficulty swallowing pills. Do not dissolve in grapefruit juice because it may reduce the breakdown of this medication by the liver.

Gleevec should be taken by mouth with meals with a full glass of water. Swallow the tablets whole without chewing it. It’s likely that you experience side effects during the treatment; do not stop or modify the way you are told to take the medication. Most patients develop side effects when and after a treatment with Gleevec.  

Storage: store Gleevec at room temperature (15-25 ° C), away from heat above 40 ° C, light and moisture. Keep the medication out of the reach of children. Gleevec and other drugs should not be used beyond the expiration date printed on the container.  

Overdose: Gleevec overdose can cause life threatening problems. Chemotherapy drugs including Gleevec tend to damage the bone marrow, and lead to a decrease in white blood cells and platelets, which can cause serious infections in some patients. If you take a Gleevec overdose, contact your doctor or the poison control center nearest you immediately.  

Missing dose: take Gleevec and all medications as prescribed. In case you forget to take a dose, take the missed one as soon as you remember it. However, if it is almost time for your next dose, do not double the next dose to recover the missing; it can be dangerous. Contact your doctor or wait to go back to your regular schedule. This applies not only to Gleevec but also any other drug.

Mechanism of action (MOA): Gleevec is an anticancer drug belongs to the family of tyrosine kinase inhibitors. It works by preventing the development, and selectively inducing cancer cell death. 

Interactions: There are certain drugs that may reduce the liver break down of this medication. Tell your doctor if you are taking medications such as ketoconazole, itraconazole, clarithromycin, atazanavir, indinavir, nelfinavir, ritonavir, saquinavir and others.   Other medications may decrease the blood concentrations of Gleevec and could result in decreased blood levels and reduced effect of the drug.  These include carbamazepine, phenobarbital, rifampin, phenytoin, fosphenytoin, primidone and St. John’s Wort. Tell your doctor all of the medications you are taking to prevent drug interactions.

 

Contraindications: Gleevec should not be taken by women her are pregnant or planning to become pregnant. This drug is harmful to a fetus. Talk to your doctor about birth control options. It is not clear whether this drug can be excreted in human milk so nursing mothers should consult their doctor before taking this medication while breast feeding.  Be sure to tell your doctor if you have any allergies to certain medications.  If you experience any swelling of the face, tongue or throat while taking this medication, you may be experiencing an allergic reaction and should see a doctor immediately.

 

Side effects: Gleevec also affects healthy cells when it attacks cancer cells. This causes the development of the following side effects:

  • hair loss
  • fatigue
  • headache
  • muscle cramps and pain
  • nausea and vomiting
  • decreased appetite
  • weight loss
  • mouth blistering
  • drying or darkening of the skin or nails
  • joint pain
  • night sweats
  • teary eyes
  • Bowel disorders (diarrhea, indigestion, constipation) 

Contact your oncologist or a health care provider if you experience severe adverse reactions such as:

  • fever
  • chills
  • dizziness
  • shortness of breath
  • puffy face
  • fainting
  • chest pain
  • weight gain
  • blood in the stool
  • skin problems such as rash or blisters
  • severe depression symptoms
  • yellowing of the skin or eyes
  • swelling of the hands, feet, ankles, or lower legs
  • fast or irregular heartbeat
  • difficulty falling asleep or staying asleep
  • persistent coughing associated with bloody mucus
  • urgent need to urinate, especially at night
  • unusual bruising or bleeding
  • Excessive tiredness or weakness
  • sudden low or high blood pressure