December 22, 2014
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Drug Factsheets

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Gleevec

(imatinib)

DIN (Drug Identification Number)

02253275 GLEEVEC 100MG TABLET
02253283 GLEEVEC 400MG TABLET

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
  • blurred vision
  • bone pain
  • changes in appetite
  • constipation
  • diarrhea
  • difficulty sleeping
  • dizziness
  • dry mouth
  • fatigue
  • gas (flatulence)
  • headache
  • increased muscle tension
  • increased skin sensitivity to the sun
  • increased tear production
  • indigestion or heartburn
  • itchy, dry skin
  • itchy eyes
  • joint pain
  • joint swelling
  • loss of appetite
  • muscle pain
  • muscle spasms and cramps
  • nausea
  • night sweats
  • nosebleeds
  • numbness or tingling of the hands of feet
  • skin rash
  • slowed growth in children and adolescents
  • 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:

  • abdominal pain
  • difficult or painful breathing
  • fainting
  • fever
  • hearing problems
  • numb or cold toes and fingers
  • severe headache
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
  • signs of electrolyte imbalance (e.g., muscle pain or cramps, weakness, irregular heart beat)
  • 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 kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine)
  • 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)
  • symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
  • unexplained muscle pain, tenderness, or weakness
  • vision changes

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

  • signs of a serious allergic reaction (e.g., abdominal cramps, swelling of lips, hives, difficulty breathing, nausea, vomiting, swelling face and throat)
  • chest pain
  • 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, severe rash, skin peeling)
  • signs of bleeding in the stomach (e.g., bloody, black, or tarry stools, coughing up blood, vomiting blood or material that looks like coffee grounds)
  • signs of heart attack (e.g., sudden chest pain or pain radiating to the back, down the arm, or in the jaw; sensation of fullness of the chest; nausea; vomiting; sweating; anxiety)
  • signs of stroke due to bleeding into the brain (e.g., sudden or severe headache; sudden loss of coordination; vision changes; sudden slurring of speech; or unexplained weakness, numbness, or pain in arm or leg)
  • symptoms of heart failure (e.g., leg swelling, chest pain, or shortness of breath)

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.

Anemia: Imatinib may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired, or pale skin, contact your doctor as soon as possible.

Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.

Bleeding: Imatinib may cause a reduced number of platelets in the blood, which can make it difficult to stop cuts from bleeding. If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible. Your doctor will order routine blood tests to make sure potential problems are caught early.

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. Do not drink grapefruit juice while taking this medication.

Heart problems and heart failure: Rarely, heart problems including heart failure, have been reported with the use of imatinib. If you are at risk for heart problems such as heart failure (e.g., people with high blood pressure, diabetes, and coronary artery disease), discuss with your doctor how this medication may affect your medical condition, how your 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.

Infection: As well as killing cancer cells, imatinib can reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people with contagious infections. Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.

Kidney function: If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your 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. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your 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: If you have hypothyroidism due to removal of thyroid gland, you may need closer monitoring of your 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.

Tumour lysis syndrome: Imatinib, like many other cancer medications, causes many cancer cells to be suddenly killed when treatment is first started. This can overwhelm the body with waste products from the cells. As a result, the body may not be able to keep up with getting rid of all the waste. When this happens, you may experience nausea and shortness of breath, and notice cloudy urine or joint pain. This is called tumour lysis syndrome. Your doctor may prescribe some medications to help your body get rid of the waste products. Make sure you understand how to use these medications and report any of these signs or symptoms to your doctor immediately.

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 less than 2 years of age. Growth may be slowed in children and adolescents that take this medication.

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:

  • abiraterone
  • acetaminophen
  • almotriptan
  • alpha blockers (e.g., alfuzosin, doxazosin, silodosin, tamsulosin)
  • amiodarone
  • amphotericin B
  • anticancer medications (e.g., cabazitaxel, docetaxel, doxorubicin, etoposide, ifosfamide, irinotecan, vincristine)
  • apixaban
  • aprepitant
  • aripiprazole
  • "azole" antifungal medications (e.g.,  fluconazole, itraconazole, ketoconazole)
  • beta-blockers (e.g., atenolol, propranolol, metoprolol)
  • bacillus Calmette-Guerin (BCG)
  • barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
  • benzodiazepines (e.g., chlordiazepoxide, clonazepam, diazepam, lorazepam)
  • boceprevir
  • brinzolamide
  • buprenorphine
  • buspirone
  • calcium channel blockers (e.g., nifedipine, diltiazem, verapamil, amlodipine, felodipine)
  • carbamazepine
  • chloroquine
  • clozapine
  • cilostazol
  • codeine
  • colchicine
  • conivaptan
  • corticosteroids (e.g., dexamethasone, prednisone, methylprednisolone)
  • cyclosporine
  • dantrolene
  • dapsone
  • deferasirox
  • digoxin
  • dipyridamole
  • disopyramide
  • dofetilide
  • dronabinol
  • dronedarone
  • echinacea
  • eplerenone
  • estrogens (e.g., conjugated estrogen, estradiol, ethinyl estradiol)
  • ethosuximide
  • everolimus
  • felbamate
  • fentanyl
  • flutamide
  • fosphenytoin
  • gemfibrozil
  • ginseng
  • "gliptin" diabetes medications (e.g., linagliptin, saxagliptin, sitagliptin)
  • grapefruit juice
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
  • HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
  • leflunomide
  • lidocaine
  • losartan
  • macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
  • maraviroc
  • mefloquine
  • mestranol
  • metronidazole
  • morphine
  • mifepristone
  • mirtazapine
  • modafinil
  • montelukast
  • nateglinide
  • nefazodone
  • nilotinib
  • nitrates (e.g., isosorbide dinitrate, isosorbide mononitrate)
  • norfloxacin
  • ondansetron
  • oxcarbamazepine
  • oxycodone
  • peginterferon alfa-2b
  • perampanel
  • phenytoin
  • pimozide
  • pimecrolimus
  • prasugrel
  • prazosin
  • praziquantel
  • primaquine
  • primidone
  • progestins (e.g., dienogest, levonorgestrel, medroxyprogesterone, norethindrone)
  • propafenone
  • proton pump inhibitors (PPIs; e.g., esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole)
  • quinidine
  • quinine
  • repaglinide
  • rifabutin
  • rifampin
  • rifapentine
  • rilpivirine
  • rivaroxaban
  • romidepsin
  • St. John's wort
  • salmeterol
  • saxagliptin
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
  • sildenafil
  • simeprevir
  • sirolimus
  • "statin" anticholesterol medications (e.g., atorvastatin, lovastatin, simvastatin)
  • tacrolimus
  • tadalafil
  • tamoxifen
  • telaprevir
  • tetracycline
  • theophylline
  • ticagrelor
  • ticlopidine
  • tocilizumab
  • tolterodine
  • tolvaptan
  • trabectedin
  • tramadol
  • trazodone
  • tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
  • trimethoprim
  • other tyrosine kinase inhibitors (e.g., dasatinib, imatinib, nilotinib, sunitinib)
  • vaccines
  • venlafaxine
  • warfarin
  • zolpidem
  • zonisamide
  • zopiclone

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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