Hemator

Chronic myeloid leukaemia (CML) & acute lymphoblastic leukaemia w/ Philadelphia chromosome +ve (Ph +ve ALL) in adults & childn/adolescents. Myelodysplastic/myeloproliferative diseases (MDS/MPD) in adults. Hypereosinophilic syndrome (HES) &/or chronic eosinophilic leukaemia (CEL) in adults. Dermatofibrosarcoma protuberans (DFSP) in adults. GI stromal tumours (GIST) in adults.

Adult CML 400-600 mg daily. Max: 800 mg daily. Ph +ve ALL 600 mg daily. MDS/MPD Initially 400 mg. HES/CEL Initially 400 mg, may be 100 mg for some patients. DFSP Initially 800 mg daily. GIST 400 mg daily. Childn CML & Ph +ve ALL Dose depends on the size of the child.

Should be taken with food: Take w/ water & food. If unable to swallow, put contents of cap in water or apple juice & stir until completely disintegrated, then immediately drink mixt.

Hypersensitivity.

Caution in patients w/ kidney, liver or heart problems & in patients who have undergone thyroidectomy. Risk of HBV reactivation in patients who are chronic HBV carriers. Test for HBV infection before treatment initiation. Caution before treatment is initiated in patients w/ +ve HBV serology (including those w/ active disease) & for patients who test +ve for HBV infection during treatment. Closely monitor HBV carriers for signs & symptoms of active HBV infection throughout therapy & for several mth following termination of therapy. Regularly perform blood tests, wt checks, & urine tests. Regularly monitor growth in childn & adolescents. Risk of increased sensitivity to sunlight. Avoid drinking grapefruit juice & taking paracetamol-containing medicines while on treatment. May impair ability to drive or operate machinery. Use contraception to prevent pregnancy during treatment & for 15 days after ending treatment. Discuss risks & benefits if treatment is necessary during pregnancy. Breastfeeding is not recommended during treatment. Not enough information to recommend use in childn <3 yr. No experience w/ use in CML for childn <2 yr. No experience w/ use in Ph +ve ALL for childn <1 yr.

Swelling of fingers, eyelids, face or lower legs due to fluid buildup; indigestion, upset stomach, wind, feeling of bloating; nausea or vomiting; diarrhoea; constipation; dry mouth; swelling, aching, cramping or stiffness in joints or muscles; musculoskeletal pain after stopping treatment (including muscle pain, limb pain, joint pain, bone pain & back pain); pain in the bones or along veins; headache; dizziness, lightheadedness or vertigo; tiredness, weakness, feeling generally unwell; numbness, coldness or tingling in fingers & toes; difficulty sleeping, feeling anxious, depressed, confused or forgetful; change in sense of taste; rash, eczema, itching, dry skin, darkening or lightening of skin; sunburn symptoms which happen more quickly than normal; irritated, red, runny or itchy eyes, blurred vision; ringing in the ears; changes in appetite & wt; hair loss; sweating during the night; throat pain; cough or cold symptoms; loss of interest in sex, problems w/ sexual function; breast enlargement, nipple pain, painful periods; reddening &/or swelling on the palms of the hands & soles of the feet which may be accompanied by tingling sensation & burning pain; slowing of growth in childn & adolescents.

Potential interaction w/ St. John's wort; paracetamol; antibiotics eg, rifampicin, ketoconazole, erythromycin, clarithromycin, itraconazole; antivirals for HIV/AIDS; dexamethasone; medicines for high cholesterol eg, simvastatin; antiepileptics eg, phenytoin, carbamazepine, phenobarb; warfarin; some medicines for mental disorders & depression; some medicines for high BP & heart problems; cyclosporine; grapefruit juice.

Targeted Cancer Therapy

L01EA01 - imatinib ; Belongs to the class of BCR-ABL tyrosine kinase inhibitors. Used in the treatment of cancer.

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