Glivec

Generic Name: Imatinib mesylate
Product Name: Glivec

Indication

Glivec is used in the treatment of:

• Patients in chronic or accelerated phases of Philadelphia chromosome positive chronic myeloid leukaemia (CML)
• Adult patients with a metastatic or unresectable malignant GI stromal tumour.

Action

Glivec works by interfering effects of a tumour protein called tyrosine kinase which constantly induces the production of abnormal white blood cells in patients with chronic myeloid leukaemia. Glivec also targets a tumour protein that is the suspected cause of gastrointestinal stromal tumours (GIST) by blocking the growth of cancerous cells.

Dose advice

The initial doses below have been used. However, further doses will depend on your response to Glivec.

Chronic phase of chronic myeloid leukaemia

Adult:

• 400-600 mg once daily.

Child > 3 years:

• 340 mg/m2 once daily, maximum 400mg.

Accelerated phase or blast crisis of chronic myeloid leukaemia

Adult:

• 600-800 mg daily (800mg dose should be given in 2 divided doses)

Child > 3 years:

• 340 mg/m2 once daily, maximum 400mg (daily dose may be given in 2 divided doses, morning and evening)

Gastrointestinal Stromal Tumours (GIST)

400-600 mg daily

• Glivec tablets should be taken with food and a large glass of water to avoid stomach upset. Alternatively, Glivec tablet may be dispersed in a glass of water or juice and drink it straight away.
• Glivec doses are usually taken as a daily single dose. In children, the dosage may be divided into two daily doses, morning and evening.
• Can effect ability to drive or operate machinery. You may experience undesirable effects such as dizziness or blurred vision during treatment with imatinib. Therefore, you should avoid driving or operating machinery until you know how it affects you.

Gastrointestinal effects

You should take Glivec with food and a large glass of water to minimize the risk of gastrointestinal upset.

Schedule

Schedule 4

Common side effects

The following side effects have relatively common occurrence (i.e. greater than 10%) in patients treated with Glivec. If you experience any of the adverse effects mentioned, you should advise your doctor about it.

• Myelosuppression
• Nausea and vomiting
• Diarrhoea
• Anorexia nervosa
• Severe fluid retention
• Muscle cramp
• Arthralgia
• Elevation of bilirubin or transaminases
• Rash
• Gastrointestinal bleeding
• Dyspnoea
• Headache

Uncommon side effects

Glivec is often associated with oedema and occasionally serious fluid retention. These side effects have occurrences less than or equal to 0.1% to 1%. You should seek medical advice if you have an unexpected rapid weight gain or any signs and symptoms of fluid retention.

References

1. Australian Medicines Handbook, Adelaide, Pharmaceutical Society of Australia, 2007.
2. MIMS Online [online]. 2003 [cited 2007 October 14]. Available from: [URL Link]

For further information talk to your doctor.