Imatinib

Details About Generic Salt ::  Imatinib 

Main Medicine Class:: #N/A   Sub Medicine Class ::  #N/A

18A. ANTI-NEOPLASTIC AGENTS in 18. ANTI-NEOPLASTIC AGENTS
IMATINIB
PROTEIN-TYROSINE KINASE INHIBITOR | ANTI-NEOPLASTIC
PK: A: Rapid M: Hepatic E: Feces, urine

Indications & Dose: ACUTE LYMPHOBLASTIC LEUKEMIA (Ph+) PO Adult Relapsed/refractory: 600mg/day as single dose | AGGRESSIVE SYSTEMIC MASTOCYTOSIS PO Adult 400mg/day as single dose for patients without D816V c-Kit mutation | CHRONIC MYELOID LEUKEMIA (Ph+) Second-line therapy PO Child Recurrence after stem cell transplantation/resistant to interferon a therapy: 260mg/m2/day | First-line therapy PO Adult Chronic phase: 400mg/day as single dose, may be increased to 600mg/day. Accelerated phase/blast crisis: 600mg/day as single dose may be increased to 400mg BID. Doses are increased after 3 months only if tolerated/ for disease progression/lack of hematologic or increased after 6-12 months in case of lack of cytogenetic response/loss of previous hematologic/cytogenetic response Child Chronic phase: 340mg/m2/day in single/two divided doses, max 600mg | DERMATOFIBROSARCOMA PROTUBERANS PO Adult 800mg/day given in 2 divided doses | GASTROINTESTINAL STROMAL TUMORS PO Adult Unresectable/metastatic malignant: 400-600mg/day | HYPEREOSINOPHILIC SYNDROME/CHRONIC EOSINOPHILIC LEUKEMIA PO Adult 400mg/day as single dose | MYELODYSPLASTIC/MYELOPROLIFERATIVE DISEASES PO Adult 400mg/day as single dose | NEWLY DIAGNOSED CHRONIC MYELOID LEUKEMIA (Ph+) PO Child >2 yr: Chronic phase: 340mg/m2/day, max 600mg/day in single/two divided doses

Contra: Hypersensitivity

Precautions: Hypereosinophilic syndrome, renal/hepatic impairment, children <2 yr, CVD

ADR: Serious: Edema/fluid retention, chest pain, hypokalemia, hemorrhage, blood disorders, hepatotoxicity, muscle cramps, rigors, SeCr increased, URTI, infect without neutropenia, flushing, CNS/cerebral hemorrhage, GI hemorrhage, Alkaline phosphatase/AST/bilirubin increased, Others: paresthesia, erythema, hyperglycemia, night sweats, bone pain, lacrimation increased, myalgia, weakness, nausea, diarrhea, vomiting, abdominal pain, anorexia, weight gain, dyspepsia, constipation, fatigue, fever, headache, dizziness, insomnia, depression, anxiety, chills, rash, alopecia

DDI: Serious CCBs (dihydropyridine-type) levels are increased, Paracetamol (high dose) may cause hepatotoxicity, Levothyroxine causes hypothyroidism in thyroidectomy patients, Asparaginase increases hepatotoxicity, Simvastatin level & risk of toxicity are increased, Tacrolimus level increased, Phenobarbital/Carbamazepine/Rifampicin markedly reduces drug level, Ketoconazole modestly increases drug level

Diet: With food

Monitor: CBC, LFTs, renal function, serum electrolytes, thyroid function tests, fatigue, weight & edema/fluid status, echocardiogram & serum troponin levels, glucose, albumin level, CHF