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Drug Formulary
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iMAtinib

( i-MA-ti-nib )
Other Name(s): Gleevec®
Appearance: tablet In various strengths, shapes and sizes
pdf download imatinib patient.pdf
pdf download imatinib pour le patient.pdf

Medication Information Sheet
iMAtinib (i-MA-ti-nib)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Gleevec®

Appearance:
tablet

In various strengths, shapes and sizes

What is this medication for?
  • For treating certain blood cancers (leukemias), blood disorders, gastrointestinal stromal tumours (GIST) and sarcomas.
What should I do before I have this medication?
  • Tell your doctor and pharmacist if you have or had significant medical condition(s), especially if you have or had:
     
    • heart problems,
    • liver disease (including hepatitis),
    • kidney problems,
    • bleeding problems, 
    • a thyroid condition,
    • if you are taking blood thinners, 
    • or have any allergies.
How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding.
     
  • If applicable, you may be advised to have a pregnancy test within a week before starting treatment. 
    • If there is ANY chance that you or your partner may become pregnant, you and your partner together must:►Use 2 highly effective forms of birth control at the same time while taking this drug: Keep using birth control until 6 months after the last dose. Discuss with your healthcare team.
       
  • Do not breastfeed while taking this drug.
     
  • This medication may affect fertility (ability to get pregnant).
How is this medication given?
  • Imatinib is usually taken once a day, swallowed whole with a glass of water and a meal, to reduce stomach upset.
     
  • If you are taking the 800 mg daily dose, it should be taken as 400 mg twice a day, to prevent your body from absorbing too much iron.
     
  • Take exactly as directed by your healthcare team. Make sure you understand the instructions.
     
  • If you need tablets of more than 1 strength to make the correct dose, ensure you identify the tablets correctly to get the right dose.
     
  • The 400 mg tablet may be split in half, but do not crush or chew the tablet.
     
  • If you cannot swallow the tablet, place it in a glass of water or apple juice, (use 200 mL for 400 mg tablet or 50 mL for 100 mg tablet). Stir with a spoon to completely break up the tablet, then drink the contents right away. Rinse the glass with water or apple juice and then drink this mixture to pick up any tablet left.
     
  • If you miss a dose, skip that dose and take the next dose at your usual time.
What else do I need to know while on this medication?

  • Do not eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. They may increase side effects.

  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.

 

  • For mild aches and pain or fever:
    • If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever. 
       
    • Ask your health care team about the right medication for you.  Talk to your health care team before you start taking acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), as they may may increase your chance of bleeding or interact with your medications.
       
    • Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem).  It may still be safe to take.
       
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
How should I safely store this medication?

  • Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.

  • Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.

  • How to safely touch oral anti-cancer medications

    • If you are a patient:

      • Wash your hands before and after touching your oral anti-cancer medication.
         

    • If you are a caregiver:

      • Wear nitrile or latex gloves when touching tablets, capsules or liquids.

      • Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.

      • Throw out your gloves after each use. Do not re-use gloves.

      • Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.
         

  • What to do if oral anti-cancer medication gets on your skin or in your eyes
    • If medication gets on your skin:

      • Wash your skin with a lot of soap and water.

      • If your skin gets red or irritated, talk to your health care team.

    • If medication gets in your eyes:

      • Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.
         

What are the side effects of this medication?

The following table lists side effects that you may have when getting imatinib. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed. Read over the side effect table so that you know what to look for and when to get help. Keep this paper during your treatment so that you can refer to it if you need to.

Side effects and what to do When to contact doctor?
Very Common Side Effects (50 or more out 100 people)

Mild swelling in arms and legs; puffiness (may be severe)

To help prevent swelling :

  • Eat a low-salt diet.
  • Avoid tight fitting clothing.

If you have swelling in your legs, keep your feet up when sitting.

 Contact your health care team if no improvement or if severe

Mild joint, muscle pain (may continue for months after treatment is stopped)

  • Ask your health care team about the right medication for you to relieve muscle or joint pain.
  • Take your pain medication as prescribed by your doctor.
  • Rest often and try light exercise as it may help.
 Contact your health care team if no improvement or if severe

Nausea and vomiting (generally mild)

May occur in hours to days after your treatment. 

If you have nausea or vomiting:

  • Take anti-nausea medication(s) as prescribed to you by your doctor. 
  • Drink clear liquids and have small meals. Get fresh air and rest.
  • Do not eat spicy, fried foods or foods with a strong smell.
  • Limit caffeine (e.g. coffee, tea) and alcohol.
  • Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.

 Contact your healthcare team if no improvement or if severe

 

Side effects and what to do When to contact doctor?
Common Side Effects (25 to 49 out of 100 people)

Diarrhea

May happen days to weeks after you get your treatment.

If you have diarrhea :

  • Take anti-diarrhea medication if your health care team prescribed it.
  • Avoid foods or drinks with artificial sweetener (e.g. chewing gum, “diet” drinks), coffee and alcohol.
  • Eat many small meals and snacks instead of 2 or 3 large meals.
  • Drink at least 6 to 8 cups of liquids each day. Talk to your health care team if you can’t drink 6-8 cups of liquids each day when you have diarrhea. You may need special liquids with salt and sugar, called Oral Rehydration Therapy.
  • ​See the Diarrhea pamphlet for more information.
 Contact your health care team if no improvement or if severe

Rash; dry, itchy skin

Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away.

To prevent and treat dry skin,

  • Use skin moisturizer.
  • Protect your skin from the sun and the cold.
  • Use sunscreen with UVA and UVB protection and a SPF of at least 30.
 Contact your health care team if no improvement or if severe

Fatigue (tiredness)

  • Be active and aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days. Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Eat well and stay hydrated by drinking at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired.
  • See our Fatigue pamphlet for more information. 
 Contact your health care team if no improvement or if severe

Pains or cramps in the belly

  • If you have constipation or diarrhea it may be causing the pain in your belly.
  • If the pain is severe, gets worse or doesn’t go away, talk to your health care team about other possible causes.
 Contact your health care team if no improvement or if severe

Headache

  • Ask your health care team about the right medication for you to relieve headache.
  • Take your pain medication as prescribed by your doctor.
  • Rest often and try light exercise as it may help.
 Contact your health care team if no improvement or if severe

Fever, chills, infection

(includes infections that happen when the immune system is impaired such as viral infections)

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting treatments:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Do not take medications that may treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil®, Motrin® or ibuprofen).  If you take these medications before you check for fever, they may lower your termperature and you may not know you have an infection.
  • Wash your hands often.
  • Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 

 Get emergency medical help right away

 

Side effects and what to do When to contact doctor?
Less Common Side Effects (10 to 24 out of 100 people)

Salt imbalances

It may cause muscle twitching, severe weakness or cramping, confusion and irregular heartbeat.

 Get emergency medical help right away

Cough; feeling short of breath

You may have cough and feel short of breath without any signs of infection, such as a sore throat or a stuffed nose.

 Contact your health care team if no improvement or if severe

Dizziness

  • You may feel light headed.
  • Lay down if this happens.
  • Get up and move slowly once you feel better.
  • Do not drive a motor vehicle or use machinery if you feel dizzy.

 

 Contact your health care team if no improvement or if severe

Heartburn; stomach upset

To help prevent heartburn:

  • Avoid fatty or spicy foods.
  • Remain upright after eating.
  • Drink clear liquids and eat small meals.
 Contact your health care team if no improvement or if severe

Flu-like symptoms

  • You may have fever, chills and muscle pain without any signs of infection, such as a sore throat, cough or skin rash.
  • It may happen at any time after you receive your treatment and it usually goes away as your body gets used to the medication.
  • Contact your health care team if these feelings bother you.
  • Check your temperature to make sure you don’t have a fever. If you do not have a fever, you may take acetaminophen (Tylenol®) tablets to help you feel better.  Ask your health care team for the correct dose for you. If you do have a fever, speak to your health care team or go to the nearest emergency room. 
 Contact your health care team if no improvement or if severe

Depression

Everyone feels sad sometimes and having cancer can cause you to feel down. Depression is when these feelings last for weeks or months.

To help prevent depression : 

  • Eating well and exercising may give you more energy and help you feel better.  Always check with your health care team before starting a new exercise program to make sure it is safe for you.
  • Get support from your family, friends, community and health care team.

If you have suicidal thoughts or think about hurting yourself contact your health team or go to your closest Emergency Department right away. See our Depression pamphlet for more information.

 Contact your health care team if no improvement or if severe

Trouble falling asleep

  • This may be caused by one of your medications and may improve once your body gets used to the medication or when your treatment ends.
  • Talk to your doctor if this bothers you.
 Contact your health care team if no improvement or if severe

Abnormal liver lab tests

  • You may have yellowish skin or eyes, unusually dark pee or pain on the right side of your belly. Talk to your health care team if this happens.
  • Your doctor may monitor your liver regularly with a blood test.
 Contact your health care team if no improvement or if severe

Constipation

To help prevent constipation :

  • Drink more liquids and eat well. Drink at least 6 to 8 cups of liquids each day unless you have been told otherwise.
  • Be Active. Exercise can help to keep you regular.
  • Try to eat more fiber (e.g. fruits with skin, leafy greens and whole grains). If you take opioid pain medication, ask your health care team if eating more fibre is right for you.

To help treat constipation :

  • If you have not had a bowel movement in 2 to 3 days you may need to take a laxative. Ask your health care team what to do.

See the Constipation Pamphlet for more information.

 Contact your health care team if no improvement or if severe

Unusual bleeding or bruising

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 


See our Neutropenia (Low white blood cell count) pamphlet for more information.

 Get emergency medical help right away

 

Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:

  • chest pain, shortness of breath, coughing up blood, pain in your arm or belly
  • feeling confused, sudden loss of vision, trouble speaking or moving your arms or legs
  • severe pain, swelling and hardening of a vein in your arm or leg
  • severe pain in a bone or joint
  • irregular heartbeat, fainting spells or swelling in your legs, ankles or belly
  • any problems with your vision
  • severe rash with fever, swollen glands, yellow skin or eyes, shortness of breath or chest pain
  • sudden, severe pain in your belly (may extend to your back)
  • signs of thyroid problems such as feeling very tired, dry skin, brittle nails or hair and intolerance to the cold
  • signs of kidney problems such as lower back pain, swelling, peeing less than usual and unusual weight gain
  • severe muscle pain or weakness and dark pee

Talk to your health care team about your risk of getting other cancers after this treatment. 
 

Who do I contact if I have questions or need help?          

My cancer health care provider is: ______________________________________________

During the day I should contact:________________________________________________

Evenings, weekends and holidays:______________________________________________

 

Other Notes:

____________________________________________________________________________

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____________________________________________________________________________

____________________________________________________________________________

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For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.

Funding & Reimbursement

Several payment sources exist for cancer drugs in Ontario, depending on the drug, disease indication, and how and where it is delivered.

View Funding & Reimbursement

Symptom Management

Many people living with cancer experience nausea, diarrhea and other symptoms from their treatment or disease.

View Symptom Management

Drug Safety and Administration

Find documents on drug safety and administration for healthcare providers, including calculations and recommendations.

View Drug Safety and Administration