August 21, 2014

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What side effects are possible with Gleevec?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal pain or bloating
  • anxiety
  • back pain
  • blurred vision
  • bone pain
  • changes in appetite
  • constipation
  • diarrhea
  • difficulty sleeping
  • dizziness
  • dry mouth
  • fatigue
  • gas (flatulence)
  • headache
  • increased blood pressure
  • increased muscle tension
  • increased tear production
  • indigestion or heartburn
  • itchy, dry skin
  • joint pain
  • joint swelling
  • loss of appetite
  • mild skin rash
  • muscle pain
  • muscle spasms and cramps
  • nausea
  • night sweats
  • nosebleeds
  • numbness or tingling of the hands of feet
  • reflux
  • taste disturbance
  • unusual hair loss or thinning
  • vomiting
  • weakness
  • weight gain

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • coughing
  • fainting
  • pain while deep breathing
  • red, itchy eye
  • signs of depression (e.g., changes in sleeping or appetite, loss of interest in activities, poor concentration, feelings of guilt)
  • signs of fluid retention (e.g., rapid weight gain and swelling)
  • signs of infection (e.g., fever, severe chills, sore throat, mouth ulcers)
  • signs of liver damage (e.g., yellow skin or eyes, abdominal pain, dark urine, clay-coloured stools, loss of appetite, or nausea and vomiting)
  • signs of low blood pressure (e.g., dizziness, lightheadedness)
  • unexplained muscle pain, tenderness, or weakness
  • vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • allergic reaction (e.g., swelling of lips, hives, difficulty breathing)
  • blood in stool (dark tarry stool), urine, or phlegm (mucus)
  • blood in vomit
  • chest pain
  • coughing up of blood
  • seizures
  • severe abdominal pain
  • severe painful swelling of an extremity (i.e., arms or legs)
  • severe skin reactions on a large area of the body or on the lips (e.g., ulcers, blisters, pain, redness, skin peeling)
  • symptoms of heart failure (e.g., leg swelling, chest pain, or shortness of breath)
  • unexpected bleeding or bruising without suffering from any injury

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for Gleevec?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood counts: This medication can decrease the number of neutrophils (a type of white blood cell that helps fight infection) and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. If you notice any signs of infection (e.g., fever, chills, or sore throat) or unusual bleeding or bruising, contact your doctor immediately.

Drowsiness/reduced alertness: This medication is not expected to make you drowsy and impair your ability to drive or use machinery. However, it may make some people feel weak. Do not drive or use machinery until you know how this medication affects you.

Fluid retention: This medication can cause serious fluid retention. If you experience unexpected rapid weight gain or swelling in your feet, ankles, lower legs, or hands, contact your doctor immediately. Your doctor will weigh and monitor you regularly for signs of fluid retention while you are taking this medication.

Grapefruit juice: Grapefruit juice affects how imatinib is removed from the body and may cause too much of the medication to build up in the body. People should not drink grapefruit juice while taking this medication.

Heart problems and heart failure: People at risk for heart problems such as heart failure (e.g., people with high blood pressure, diabetes, and coronary artery disease) should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Contact your doctor immediately if you have symptoms of heart failure such as leg swelling, chest pain, or shortness of breath.

Kidney function: People with kidney problems should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Imatinib may affect liver function. People with liver problems should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function with blood tests regularly while you are taking this medication.

Stomach problems: Imatinib may cause stomach irritation or bleeding. To reduce stomach irritation, take this medication with food and a large glass of water. If you experience signs of stomach bleeding (e.g., severe stomach pain, black stools, vomiting blood, dizziness) get immediate medical attention.

Thyroid: People who are hypothyroid due to removal of thyroid gland may need closer monitoring of their thyroid levels. Let your doctor know if you are experiencing unusual tiredness, weight gain, hair loss, unusually dry skin, mood changes, and intolerance to cold temperatures.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. Women of childbearing age who are taking imatinib should use an effective method of birth control during treatment.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking imatinib, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under 2 years of age.

Seniors: Seniors have a greater risk of fluid retention than younger patients. Contact your doctor if you experience a sudden increase in weight or swelling of the ankles, lower legs, or hands. Your doctor will weigh and monitor you closely.

What other drugs could interact with Gleevec?

There may be an interaction between imatinib and any of the following:

  • acetaminophen
  • alfuzosin
  • almotriptan
  • antifungal medications (e.g.., amphotericin B, fluconazole, itraconazole, ketoconazole)
  • beta-blockers (e.g., atenolol, propranolol, metoprolol)
  • bacillus Calmette-Guerin (BCG)
  • bortezomib
  • brinzolamide
  • busulfan
  • calcium channel blockers (e.g., nifedipine, diltiazem, verapamil, amlodipine, felodipine)
  • carbamazepine
  • ciclesonide
  • codeine
  • colchicine
  • corticosteroids (e.g., dexamethasone, prednisone, methylprednisolone)
  • cyclophosphamide
  • cyclosporine
  • dasatinib
  • deferasirox
  • dextropropoxyphene
  • digoxin
  • doxorubicin
  • dronedarone
  • dutasteride
  • echinacea
  • eplerenone
  • etoposide
  • everolimus
  • fentanyl
  • fludarabine
  • fosphenytoin
  • ginseng
  • grapefruit juice
  • ifosfamide
  • leflunomide
  • macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
  • maraviroc
  • metronidazole
  • morphine
  • nilotinib
  • oxcarbamazepine
  • oxycodone
  • proton pump inhibitors (PPIs; e.g., esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole)
  • phenobarbital
  • phenytoin
  • pimozide
  • prasugrel
  • primidone
  • quinidine
  • retinoic acid
  • rifampin
  • salmeterol
  • saxagliptin
  • simvastatin
  • sorafenib
  • St. John's wort
  • tadalafil
  • tamoxifen
  • tamsulosin
  • teniposide
  • thioridazine
  • topotecan
  • tramadol
  • trastuzumab
  • vaccines
  • vinblastine
  • vincristine
  • vinorelbine
  • warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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