This page tells you about the biological therapy, imatinib, and its possible side effects. There are sections about
Imatinib is pronounced im-at-tin-ib and is also known by its brand name Glivec (pronounced glee-vec).
It is a treatment for
- Chronic myeloid leukaemia
- Gastro Intestinal Stromal Tumour (GIST) – a rare type of stomach cancer
- Acute lymphoblastic leukaemia that is Philadelphia chromosome positive
- A rare type of sarcoma called dermatofibrosarcoma protuberans
- Adults with myelodysplastic disorders
- Adults with myeloproliferative disorders
- Adults with advanced HES (hypereosinophilic syndrome) or chronic eosinophilic leukaemia
Imatinib is a type of biological therapy called a tyrosine kinase inhibitor (TKI). Tyrosine kinases are proteins that cells use to signal to each other to grow. They act as chemical messengers. There are a number of different tyrosine kinases and blocking them stops the cancer cells growing. Imatinib targets different tyrosine kinases, depending on the type of cancer.
You have imatinib as a tablet that you swallow whole, with a glass of water after food. If you can’t swallow the tablets, you can dissolve them in a glass of mineral water or apple juice. Drop the whole tablets into the fluid, and stir with a spoon until the tablets have broken up completely. Then drink the whole glassful.
It is very important that you take tablets according to the instructions your doctor or pharmacist gave you. Whether you have a full or empty stomach, for example, can affect how much of a drug gets into your bloodstream. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.
You have the imatinib either once or twice a day, depending on the condition that you have. You usually continue taking imatinib for as long as it works, unless the side effects get too bad.
The side effects associated with imatinib are listed below. You may have a few of them.
More than 10 in every 100 people have one or more of the side effects listed below.
- An increased risk of getting an infection from low levels of white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C. You will have regular blood tests to check your blood cell levels
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising easily due to a drop in platelets – you may have bleeding gums after brushing your teeth or nosebleeds. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechia)
- Tiredness and weakness (fatigue) during and after treatment affects about 3 out of 10 people (30%). Most people find that their energy levels are back to normal within 6 months to a year
- Fluid build up occurs in about 6 out of 10 people (60%) – it may cause weight gain, or fluid around the lungs, making you feel breathless. Rarely, you may also get fluid in your abdomen and around your eyes. Let your doctor or nurse know if you are putting on weight due to fluid build up
- Feeling sick happens in about 3 in 10 people (30%) – this is usually well controlled with anti sickness medicines
- Diarrhoea affects about 1 in 3 people (30%) – drink plenty of fluids and tell your doctor or nurse if diarrhoea becomes severe, or continues for more than 3 days
- Loss of appetite
- A skin rash occurs in about 4 out of 10 people (40%) – your skin may be dry and itchy
- Muscle cramps
- Joint pain and swelling
- Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
Between 1 and 10 in every 100 people have one or more of these.
- Constipation – your doctor or nurse may give you laxatives to help prevent this but do tell them if you are constipated for more than 3 days
- A sore mouth
- A mild effect on the liver – you are unlikely to notice any symptoms from this. Your liver will almost certainly go back to normal after the treatment finishes. You will have regular blood tests to check how your liver is working
- Taste changes
- Weight loss
- Dizziness – don't drive or operate machinery if you have this
- Difficulty sleeping (insomnia)
- Itching, redness and swelling of the eyes (conjunctivitis) or watery eyes
- Blurred vision – don't drive or operate machinery if you have this
- Pain or swelling in your tummy (abdomen)
- Wind (flatulence)
- Hair loss or thinning
- Numbness of the hands or feet
A high temperature (fever) and night sweats
Fewer than 1 in 100 people have these.
- A build up of fluid around the heart, causing low blood pressure
- Breast tenderness and swelling – doctors think this is because imatinib lowers the amount of the sex hormone (testosterone)
The side effects above may be mild or more severe. A side effect may get worse through your course of treatment, or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
- Other drugs you are having
Coping with side effects
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together. If you want to start taking any new medicine or supplement while you are taking imatinib, talk to your doctor first. Some drugs can reduce how well imatinib works. Others may increase the risk of side effects.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Don't breastfeed during this treatment because the drug may come through in the breast milk.
Children and adolescents
Some children and adolescents taking imatinib may have slower than normal growth. The treatment team will monitor this carefully.
You should not have immunisations with live vaccines while you are having treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your treatment. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This information does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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A rare type of sarcoma called dermatofibrosarcoma protuberans
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