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Imatinib is used to treat adult and paediatric patients with chronic myeloid leukaemia (CML) that is Philadelphia chromosome–positive (Ph+) and acute lymphoblastic leukaemia (ALL) that is Ph+. Other approved uses in adults include:

-Gastrointestinal stromal tumours (GISTs) that are Kit (CD117) positive

-Myelodysplastic/myeloproliferative diseases (MDS/MPD) with platelet-derived growth factor receptor (PDGFR) gene rearrangements

-Aggressive systemic mastocytosis (ASM) without the D816V c-Kit mutation

-Hypereosinophilic syndrome and/or chronic eosinophilic leukaemia (CEL)

-Dermatofibrosarcoma protuberans (DFSP)

Dose and Schedule

It is important to take Imatinib as instructed to ensure the treatment is as effective as possible. Here are some key points to remember:

  • Your dose may vary, but the usual dose of Imatinib is:
    • 100 to 600 milligrams, to be taken by mouth once a day at a scheduled time for 4 weeks.
  • Imatinib should be taken with food, at the same time each day.
  • Imatinib should be swallowed whole and not crushed, cut, or dissolved. If you are unable to swallow Imatinib, speak to your doctor about possible alternatives.
  • If you miss a dose of Imatinib, do not take an extra dose or two doses at once. Simply take your next dose at the regularly scheduled time. Write down any missed doses and inform your doctor at your next appointment.
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Drug and Food Interactions

  • Imatinib interacts with many drugs. Inform your doctor of all prescription medications, over-the-counter medications, vitamins, and herbal products you are taking.
  • Grapefruit and grapefruit juice may interact with Imatinib; avoid consuming these during treatment.
  • Speak to your doctor or pharmacist before taking new medications, supplements, or receiving any vaccines.
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Storage and Handling

  • Handle Imatinib with care, as it can be toxic, similar to chemotherapy drugs given intravenously. Limit exposure to others.
  • Store Imatinib at room temperature (below 25°C) in a dry place, away from light.
  • Keep Imatinib out of reach of children and pets.
  • Leave Imatinib in its provided packaging until it is ready to be taken.
  • Administer Imatinib to yourself whenever possible.
  • If a family member, friend, or caregiver needs to administer Imatinib to you, they should wear gloves while handling the tablets.
  • Administer the medicine immediately by mouth with water.
  • If you have unused Imatinib, do not dispose of it in the trash or flush it down the sink or toilet. Return all unused medication to the practice for proper disposal.
  • If you are travelling, place Imatinib in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed.
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Side Effects of Imatinib

Common side effects, which occur in approximately one third of patients taking Imatinib, include:

Possible Side Effects and Management

Decreased white blood cells (WBCs) and increased risk of infection– Wash hands frequently, especially before eating and after using the bathroom. – Avoid crowds and contact with people who have fevers, flu, or other infections. – Maintain good personal hygiene.
Decreased haemoglobin (part of the red blood cells that carry iron and oxygen)– Aim for 7–8 hours of sleep per night. – Balance work and rest. – Stay active but rest when needed. – You may notice paleness.
Decreased platelet count and increased risk of bleeding– Avoid bruises, cuts, or burns. – Blow your nose gently and avoid picking it. – Brush your teeth gently with a soft toothbrush. – Use an electric razor when shaving.
Changes in liver function– Contact us if you experience yellowing of the skin or eyes, or dark urine.
Changes in kidney function– Contact us if you notice a decrease in urination or unusual swelling of your legs and feet.
Changes in electrolytes and other laboratory values (e.g., low potassium levels)– A blood test will be done before starting a new cycle of Imatinib to monitor your white blood cells, haemoglobin, platelet count, liver function, and kidney function.
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Common Side Effects and Tips

  • Nausea or vomiting:
    • Drink 8–10 glasses of water daily (unless instructed otherwise).
    • Eat small, frequent meals and avoid large, heavy meals.
    • Avoid spicy, fried, or greasy foods.
    • Don’t lie down immediately after eating.
    • Eat bland foods and avoid strong odours.
  • Fatigue:
    • Stay active, but rest when necessary.
    • Plan activities when you feel more energetic.
  • Diarrhoea (loose and/or urgent bowel movements):
    • Drink fluids regularly.
    • Eat bland, low-fibre foods like bananas, potatoes, chicken, rice, and toast.
    • Avoid raw vegetables, fruits, and whole grains.
  • Fluid retention or swelling:
    • Avoid standing for long periods.
    • Elevate your legs when sitting or lying down.
    • Avoid salty foods and tight clothing.
    • Weigh yourself daily.
    • Contact your doctor if you notice swelling, shortness of breath, or rapid weight gain.
  • Headaches:
    • Contact your doctor if your headache is severe, persistent, or accompanied by any unusual symptoms, such as vomiting, confusion, or neck stiffness.
  • Muscle or joint pain/weakness:
    • Stay as active as possible, but also take breaks when necessary.
    • Keep a diary of your pain and share it with your healthcare provider.
  • Rash or itchy skin:
    • Use moisturising lotions to reduce rash or itching.
    • Avoid excessive sun exposure. Wear protective clothing and use sunscreen.
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Handling Body Fluids and Waste

Imatinib remains in your body for several days after taking it, and traces may be present in your urine, stool, sweat, or vomit. To ensure safety, follow the instructions below:

  • Pregnant women should avoid handling body fluids from patients taking Imatinib.
  • Always close the toilet lid and flush twice to ensure waste is fully discarded.
  • Clean any soiled surfaces before use by others.
  • Wash hands thoroughly with soap and water after using the toilet.
  • Caregivers should wear gloves when assisting with clean-up, including handling bedpans.
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Pregnancy, Sexual Activity, and Contraception

  • Women should not become pregnant and men should not father a child while taking Imatinib.
  • Both men and women of childbearing age should use effective contraception during treatment and for at least 2 weeks after the last dose of Imatinib.
  • Do not breastfeed while taking Imatinib and for one month after the last dose.
  • Inform your doctor immediately if you become pregnant.
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Compiled by : Karin Mouton

Registered Oncology Nurse

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