Imatinib

What is imatinib?

Imatinib is a medicine used to prevent and stop the growth of cancer cells. Imatinib is used to treat some types of leukaemias and gastrointestinal stromal tumours (GIST). It may also be used to treat other types of cancer.

You may hear imatinib called STI 571 or by its brand name, Gleevec. Imatinib comes in tablet form.

Before giving imatinib to your child

Tell the doctor if your child has ever reacted badly to imatinib or to any other medication, food, preservative, or colouring agent.

Talk with the doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• infection or recent exposure to infection (for example chickenpox)
• liver problems
• low blood counts
• heart problems

How should you give your child imatinib?

• Give your child imatinib exactly as your doctor tells you to, even if your child seems better. Talk to your doctor before you stop giving this medicine for any reason.
• Give imatinib with a large glass of water and some food. Your child should avoid lying down for at least 30 minutes after a dose to avoid irritation of the throat.
• Your child should swallow the tablets whole if possible. If your child is not able to swallow the tablets whole, review the options with your pharmacist.
• Do not give your child grapefruit or grapefruit juice during treatment with this medicine.
• Have your child drink plenty of liquid every day, unless your doctor tells you not to.
• If your child throws up less than 30 minutes after a dose of imatinib, the dose of imatinib should be repeated. If you are not sure what to do, call your doctor or nurse during office hours.

What should you do if your child misses a dose of imatinib?

• Give the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose. Call your doctor or contact nurse if you are not sure what to do.

What are the possible side effects of imatinib?

Your child may have some of these side effects while they take imatinib. Check with your child's doctor if your child continues to have any of these side effects and they do not go away, or they bother your child:

• mild stomach pain
• nausea (upset stomach) and vomiting (throwing up)
• indigestion (heartburn)
• flatulence (passing gas or wind)
• loose and frequent stools
• headache
• dizziness
• feeling tired
• trouble sleeping
• muscle or joint pain
• mild skin rash

Call your child's doctor during office hours if your child has any of these side effects:

• unusual tiredness or weakness
• yellow skin or yellow eyes
• dark urine
• swelling (puffiness) around the eyes
• night sweats

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:

• fever and chills
• cough or sore throat
• lower back or side pain
• severe stomach pain
• severe skin rash
• bloating or swelling of the face, hands, lower legs, and/or feet
• rapid weight gain
• blood in the urine or stools
• vomiting blood or material that looks like coffee grounds
• black, tarry stools
• unusual bleeding or bruising
• chest pain
• pain or trouble urinating
• shortness of breath or trouble breathing
• seizures
• uneven heartbeat
• numbness or tingling in hands, feet, or lips
• blurred vision
• slurred speech or difficulty speaking
• sudden weakness in one part or side of the body

What safety measures should you take when your child is using imatinib?

Imatinib can lower the number of white blood cells in the blood temporarily, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the blood count is low:

• Avoid people with infections, such as a cold or the flu.
• Avoid places that are very crowded with large groups of people.
• Be careful when brushing or flossing your child's teeth. Your doctor, nurse, or dentist may suggest different ways to clean your child's mouth and teeth.
• You and your child should not touch your child's eyes or inside the nose without washing hands first.
• Your child's nurse will review with you what to do in case of fever.

Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child and anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child's doctor if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine. Other live vaccines that your child should not get include measles, mumps, and rubella (MMR) vaccine and chickenpox vaccine.

Imatinib can lower the number of platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:

• Be careful not to cut your child when using a razor, fingernail scissors, or toenail clippers.
• Be careful when shaving or waxing.
• Your child should avoid contact sports where bruising or injury could occur.
• Your child should not receive a permanent tattoo or any kind of body piercing.
• Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking imatinib.

Your child may lose their hair. It will grow back once your child is no longer receiving imatinib. Its colour and texture may change. Use a gentle shampoo and a soft brush.

There is a chance that imatinib may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy. If your child is sexually active, it is best that they use some kind of birth control while receiving imatinib. Tell the doctor right away if your child may be pregnant.

While your child is taking imatinib, and for several months afterwards, they will be more sensitive to the sun. The skin will burn more easily than normal. To prevent sunburn, your child should wear sunscreen and protective clothing when outdoors.

Imatinib may affect how the body handles other medicines, including acetaminophen (Tylenol). Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products).

DO NOT give grapefruit, grapefruit juice, or fruit punches with grapefruit juice to your child when they are receiving imatinib treatment.

What other important information should you know about imatinib?

• You should arrange a supply of imatinib before leaving the hospital. Not all pharmacies will carry this medicine.
• Keep a list of all medications your child is on and show the list to the doctor or pharmacist.
• Do not share your child's medicine with others. Do not give anyone else's medicine to your child.
• Make sure you always have enough imatinib to last through weekends, holidays, and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills.
• Keep imatinib at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
  

Keep imatinib out of your child’s sight and reach and locked up in a safe place. If your child takes too much imatinib, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.