Imatinib (Gleevec, Imkeldi): Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

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Imatinib is commonly used to treat certain cancers and blood disorders. Common side effects include fluid retention, nausea and vomiting, and muscle cramps. Call your health care provider right away if you get a fever, rash, swelling, unexplained bleeding, or chest pain. Imatinib is a tablet or oral solution that you will swallow.

Uses

What is imatinib used for?

Imatinib is commonly used for the following conditions.

Chronic myeloid leukemia (CML)
Acute lymphoblastic leukemia (ALL)
Myelodysplastic syndromes (MDS)
Aggressive systemic mastocytosis (ASM)
Hypereosinophilic syndrome (HES), a type of blood disorder where there are too many white blood cells
Chronic eosinophilic leukemia (CEL), a type of leukemia where there are too many white blood cells
Dermatofibrosarcoma protuberans (DFSP), a rare type of skin cancer
Gastrointestinal stromal tumors (GIST)

Imatinib may also be used for other conditions as determined by your health care provider.

How does imatinib work (mechanism of action)?

Imatinib works by targeting specific proteins on cells. By blocking the action of these proteins, imatinib can cause cells to die and prevent the cells from growing or spreading.

How is imatinib supplied (dosage forms)?

Brands and other names

Gleevec
Imkeldi

Dosage forms and strengths

80 mg/mL oral solution
100 mg, 400 mg oral tablets

How should I store imatinib?

Imatinib should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Keep imatinib solution in the original bottle, and throw it away 30 days after it is opened.

Side Effects

What are the most common side effects of imatinib?

The most common side effects of imatinib are listed below. Tell your health care provider if you have any of these side effects that bother you.

Fluid retention (see below)
Nausea and vomiting
Muscle cramps
Muscle and bone pain
Diarrhea
Rash
Tiredness
Stomach pain

There may be other side effects of imatinib that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of imatinib?

While less common, the most serious side effects of imatinib are described below, along with what to do if they happen.

Severe Allergic Reactions. Imatinib may cause allergic reactions, which can be serious. Stop taking imatinib and get help right away if you have any of the following symptoms of a serious allergic reaction.

Breathing problems or wheezing
Racing heart
Fever or general ill feeling
Swollen lymph nodes
Swelling of the face, lips, mouth, tongue, or throat
Trouble swallowing or throat tightness
Itching, skin rash, or pale red bumps on the skin called hives
Nausea or vomiting
Dizziness, feeling lightheaded, or fainting
Stomach cramps
Joint pain

Fluid Retention (Edema). Imatinib can cause fluid retention, also called edema. Fluid retention can cause serious issues in people with certain conditions, such as heart failure or kidney problems. Call your health care provider right away if you have any of the following symptoms.

Chest pain
Irregular heartbeat
Shortness of breath
Stretched or shiny skin
Swollen body parts, such as the belly or ankles

Blood Disorders. Imatinib can cause blood disorders, such as low red blood cells (anemia), low platelet levels (thrombocytopenia), and low neutrophil levels (neutropenia). Attend all of your appointments with your health care provider to have your blood cell counts checked, and stop taking imatinib and get help right away if you have any of the following symptoms of blood disorders.

Fever
Shortness of breath
Pale or yellowish skin
Easy bruising or bleeding
Frequent infections
Unusual weakness or tiredness
Dizziness, lightheadedness, or feeling like you are about to pass out
Headache
Fast or abnormal heartbeat

Heart Failure. Imatinib may increase your risk of heart failure. Tell your health care provider right away if you have any of the following symptoms of heart failure.

Shortness of breath or trouble breathing, especially while lying down
Swelling in your feet, ankles, or legs
Unusually fast weight gain
Unusual tiredness

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking imatinib. Call your health care provider right away if you have any of the following symptoms of liver damage.

Nausea or vomiting
Stomach or belly pain
Fever
Weakness or unusual tiredness
Itching
Loss of appetite
Light-colored poop
Dark-colored urine (pee)
Your skin or the whites of your eyes turning yellowish (also called jaundice)

Severe Bleeding. Imatinib can increase your risk of severe bleeding that can lead to death. Some people with serious bleeding may need a blood transfusion or surgery. Call your health care provider right away if you have any of the following signs of severe bleeding while taking imatinib.

Pink, red, or brown urine (pee)
Vomit with blood that looks like coffee grounds
Red or black stools (looks like tar)
Coughing up blood or blood clots

Stomach Bleeding or Irritation. Imatinib can increase your risk of stomach and digestive irritation, bleeding, ulcers, and tears (perforation) in your gut. Stop taking imatinib and get emergency help if you have any of the following symptoms.

Vomit blood
Black or tarry poop
Stomach pain that does not go away
Upset stomach
Feel faint

Severe Skin Reactions. Imatinib can cause severe skin reactions, called Stevens-Johnson syndrome (SJS), that can lead to death if not treated. If you develop a rash, stop taking imatinib and call your health care provider right away. Get emergency help if you have any of the following symptoms of SJS.

Painful red or purple skin that looks burned and peels off
Flat red rash or blisters on your skin, mouth, nose, and genitals
Red, painful, watery eyes
Flu-like symptoms, including fever, chills, and muscle aches

Slowed Growth in Children. Imatinib can cause slowed growth in children and teenagers. The risk of long-term use of imatinib in children and teenagers is not known. Talk with your health care provider if this is a concern for you.

Tumor Lysis Syndrome. Imatinib can cause a fast breakdown of cancer cells. This can lead to a condition called tumor lysis syndrome, which can be serious. It is important to drink plenty of water while taking imatinib, and keep all appointments for blood tests so your health care provider can see how your body is responding to imatinib. Tell your health care provider right away if you have any of the following signs of tumor lysis syndrome while taking imatinib.

Nausea and vomiting
Weakness
Swelling or fluid retention
Shortness of breath
Muscle cramps
Seizures

Kidney Damage. Kidney damage can happen when taking imatinib. Call your health care provider right away if you have any of the following symptoms of kidney damage.

Reduced need to pee
Swelling in your feet, ankles, or legs
Weakness or unusual tiredness
Difficulty catching your breath or chest pain/pressure
Confusion
Nausea
Seizures

Warnings & Precautions

Who should not use imatinib?

Allergies to Ingredients. People who are allergic to any of the following should not take imatinib.

Gleevec
Imatinib
Imkeldi
Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific imatinib products they stock.

What should I know about imatinib before using it?

Do not take imatinib unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share imatinib with other people, even if they have the same condition as you. It may harm them.

Keep imatinib out of the reach of children.

Do not crush or chew imatinib tablets. If you are unable to swallow the tablets, talk with your pharmacist about how to dissolve them in a glass of water or apple juice. Take imatinib tablets with food and a full glass of water. This helps prevent stomach and digestive problems.

Your pharmacist or health care provider will show you how to take imatinib oral solution. Use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist what measuring device to use. It is important to follow their directions closely and never open the bottle or take the medicine without wearing disposable gloves. Right after swallowing the solution, you should drink a large glass of water and eat a meal to help prevent stomach and digestive problems.

Imatinib can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how imatinib affects you

What should I tell my health care provider before using imatinib?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if imatinib is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Liver problems
Kidney problems
Bleeding problems
Thyroid problems
Heart problems, including a heart attack or heart failure
Stomach or digestive problems

Other Medicines and Supplements. Imatinib may interact with other medicines and supplements. Before taking imatinib, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Imatinib may cause harm to a fetus. People who can become pregnant should use birth control while taking imatinib and for 14 days after your last dose. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if imatinib passes into breast milk. You should not breastfeed while taking imatinib and for one month after your last dose. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does imatinib interact with foods or drinks?

Imatinib should be taken with a meal. This helps to lower the risk of dangerous stomach and digestive side effects.

Grapefruit interacts with imatinib. It is important to avoid eating grapefruit or drinking grapefruit juice while taking imatinib. This is because grapefruit can interfere with your body’s ability to break down imatinib, which can lead to high levels of the medicine and an increased risk of side effects.

It is unknown if drinking alcohol will affect imatinib, but heavy drinking can slow your immune response and make it harder for your body to fight cancer. Both imatinib and alcohol can increase your risk of bleeding. It is best to limit the amount of alcohol you drink.

Does imatinib interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking imatinib.

St. John’s wort, which is a supplement that may be used to treat depression
Itraconazole (Sporanox, Tolsura), ketoconazole, or voriconazole (Vfend), which are medicines used for fungal infections
Rifampin (Rifadin) or rifapentine (Priftin), which are medicines commonly used to treat an infection called tuberculosis
Clarithromycin, which is a medicine used for bacterial infections
A protease inhibitor, such as atazanavir (Reyataz), nelfinavir (Viracept), or ritonavir (Norvir), which is a medicine commonly used to treat HIV
Any medicine for seizures, such as carbamazepine, phenobarbital, or phenytoin
Warfarin, which is a blood thinner

Some other medicines may alter the blood levels of imatinib and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with imatinib. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker