Glivec

What is it?

A drug used in specialist chemotherapy which is a Bcr-Abi tyrosine kinase inhibitor (ie a specific enzyme inhibitor), available as orange capsules marked NVR SI, containing 100mg of imatinib as mesylate.

Medical Uses

In specialised circumstances for particular phases of Philadelphia chromosome positive (Ber-Abi) myeloid leukaemia. Dosages: under direct supervision of specialist physician adults, 400 to 600mg once each day with meal and taken with full, large glass of water. dose dependent upon phase of disease being treated.

Special Care

Pregnancy, (women should use contraception), liver or serious kidney disease, history of heart disease. body weight must be monitored and checks on blood count and liver enzymes performed.

Avoid Use

Children, breastfeeding.

Possible Drug and Food Interactions

Drugs that affect or are affected by CYP2D6 or CYP3A4, paracetamol, warfarin.

Known Side Effects

Weakness, headaches, nosebleeds, skin effects, fever, fatigue, muscle pains, anorexia, fluid retention, conjunctivitis, watering eyes, dizziness, disturbance of taste, gastrointestinal upset, insomnia, dry mouth, fluid on lungs, serious blood changes (thrombocytopenia, neutropenia) - withdraw or reduce dose. Raised bilirubin or transaminas (enzymes) - withdraw until acceptable levels achieved then re-start with lower dose. Rapid weight gain should be investigated; if side effects are severe, drug should be withdrawn and position re-evaluated -when resolved, may need to re-start at lower dose.