Imatinib

Imatinib Brand Name– Gleevec

What is Imatinib

Imatinib is an oral BCR-ABL tyrosine kinase inhibitor.

It is indicated for the treatment of adults and pediatric patients with newly diagnosed chronic-phase Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML); chronic-phase, accelerated-phase, or myeloid or lymphoid blast-phase Ph+ CML after failure of interferon-alfa therapy; relapsed or refractory Ph+ acute lymphoblastic leukemia (ALL); myelodysplastic/myeloproliferative diseases associated with platelet-derived growth factor receptor; aggressive systemic mastocytosis without the D816V c-Kit mutation or with c-Kit mutational status unknown; and hypereosinophilic syndrome and/or chronic eosinophilic leukemia. 

It is also indicated for the treatment of unresectable, recurrent and/or metastatic dermatofibrosarcoma protuberans; Kit (CD117)-positive unresectable and/or metastatic malignant gastrointestinal stromal tumors; and in pediatric patients 1 year of age and older with newly diagnosed Ph+ ALL in combination with chemotherapy.

Severe myelosuppression, congestive heart failure, and hepatotoxicity have been reported.

Indications

  1. acute lymphocytic leukemia (ALL)
  2. chronic eosinophilic leukemia (CEL)
  3. chronic myelogenous leukemia (CML)
  4. dermatofibrosarcoma protuberans
  5. desmoid tumor
  6. gastrointestinal stromal tumors (GIST)
  7. hypereosinophilic syndrome
  8. myelodysplastic syndrome (MDS)
  9. systemic mastocytosis

For the treatment of Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML)

NOTE: The FDA has designated imatinib as an orphan drug for the treatment of CML.

Side Effects

  1. abdominal pain
  2. abdominal pain
  3. acute generalized exanthematous pustulosis (AGEP)
  4. alopecia
  5. alopecia
  6. anaphylactic shock
  7. anasarca
  8. anemia
  9. anemia
  10. angina
  11. angioedema
  12. anorexia
  13. anorexia
  14. anxiety
  15. anxiety
  16. aplastic anemia
  17. appetite stimulation
  18. arrhythmia exacerbation
  19. arthralgia
  20. arthralgia
  21. ascites
  22. asthenia
  23. asthenia
  24. atrial fibrillation
  25. avascular necrosis
  26. back pain
  27. back pain
  28. bleeding
  29. bleeding
  30. blepharitis
  31. blurred vision
  32. blurred vision
  33. bone pain
  34. bone pain
  35. breast enlargement
  36. bullous rash
  37. cardiac arrest
  38. cardiac tamponade
  39. cataracts
  40. cerebral edema
  41. cheilitis
  42. chest pain (unspecified)
  43. chest pain (unspecified)
  44. chills
  45. chills
  46. clastogenesis
  47. colitis
  48. confusion
  49. conjunctivitis
  50. constipation
  51. constipation
  52. cough
  53. cough
  54. dehydration
  55. depression
  56. depression
  57. diarrhea
  58. diarrhea
  59. dizziness
  60. dizziness
  61. drowsiness
  62. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
  63. dysgeusia
  64. dyspepsia
  65. dyspepsia
  66. dysphagia
  67. dyspnea
  68. dyspnea
  69. ecchymosis
  70. edema
  71. edema
  72. elevated hepatic enzymes
  73. eosinophilia
  74. epistaxis
  75. eructation
  76. erythema
  77. erythema multiforme
  78. esophagitis
  79. exfoliative dermatitis
  80. fatigue
  81. fatigue
  82. fever
  83. fever
  84. flatulence
  85. flatulence
  86. fluid retention
  87. fluid retention
  88. flushing
  89. folliculitis
  90. gastritis
  91. gastroesophageal reflux
  92. GI bleeding
  93. GI obstruction
  94. GI perforation
  95. gout
  96. growth inhibition
  97. gynecomastia
  98. headache
  99. headache
  100. hearing loss
  101. heart failure
  102. hematemesis
  103. hematoma
  104. hematuria
  105. hemolytic anemia
  106. hepatic failure
  107. hepatic necrosis
  108. hepatitis
  109. hyperamylasemia
  110. hyperbilirubinemia
  111. hyperbilirubinemia
  112. hypercalcemia
  113. hyperglycemia
  114. hyperglycemia
  115. hyperhidrosis
  116. hyperkalemia
  117. hypertension
  118. hypertension
  119. hyperuricemia
  120. hypoalbuminemia
  121. hypoalbuminemia
  122. hypocalcemia
  123. hypocalcemia
  124. hypokalemia
  125. hypokalemia
  126. hypomagnesemia
  127. hyponatremia
  128. hypophosphatemia
  129. hypotension
  130. hypothyroidism
  131. hypoxia
  132. ileus
  133. impotence (erectile dysfunction)
  134. increased intracranial pressure
  135. increased urinary frequency
  136. infection
  137. infection
  138. influenza
  139. influenza
  140. insomnia
  141. insomnia
  142. intracranial bleeding
  143. jaundice
  144. lacrimation
  145. lethargy
  146. lethargy
  147. leukopenia
  148. leukopenia
  149. libido decrease
  150. lichen planus-like eruption
  151. lymphadenopathy
  152. lymphopenia
  153. lymphopenia
  154. macular edema
  155. malaise
  156. malaise
  157. melena
  158. memory impairment
  159. menorrhagia
  160. menstrual irregularity
  161. migraine
  162. muscle cramps
  163. muscle cramps
  164. musculoskeletal pain
  165. musculoskeletal pain
  166. myalgia
  167. myalgia
  168. myocardial infarction
  169. myopathy
  170. nail discoloration
  171. nausea
  172. nausea
  173. nephrotoxicity
  174. neutropenia
  175. neutropenia
  176. night sweats
  177. night sweats
  178. ocular hemorrhage
  179. ocular irritation
  180. ocular pain
  181. optic neuritis
  182. oral ulceration
  183. osteonecrosis
  184. palmar-plantar erythrodysesthesia (hand and foot syndrome)
  185. palpitations
  186. pancreatitis
  187. pancytopenia
  188. papilledema
  189. paresthesias
  190. paresthesias
  191. peptic ulcer
  192. pericardial effusion
  193. pericarditis
  194. peripheral edema
  195. peripheral edema
  196. peripheral neuropathy
  197. petechiae
  198. pharyngitis
  199. pharyngitis
  200. photosensitivity
  201. pleural effusion
  202. pneumonitis
  203. pruritus
  204. pruritus
  205. pseudoporphyria
  206. psoriasis
  207. pulmonary edema
  208. pulmonary fibrosis
  209. pulmonary hypertension
  210. purpura
  211. rash
  212. rash
  213. renal failure (unspecified)
  214. restless legs syndrome (RLS)
  215. retinal hemorrhage
  216. rhabdomyolysis
  217. rhinitis
  218. sinus tachycardia
  219. sinusitis
  220. sinusitis
  221. skin hyperpigmentation
  222. skin hypopigmentation
  223. Stevens-Johnson syndrome
  224. stomatitis
  225. stomatitis
  226. subdural hematoma
  227. syncope
  228. testicular swelling
  229. thrombocytopenia
  230. thromboembolism
  231. thrombosis
  232. thrombotic microangiopathy
  233. tinnitus
  234. toxic epidermal necrolysis
  235. tremor
  236. tumor lysis syndrome (TLS)
  237. urticaria
  238. vasculitis
  239. vertigo
  240. vesicular rash
  241. vomiting
  242. vomiting
  243. weakness
  244. weight gain
  245. weight gain
  246. weight loss
  247. xerophthalmia
  248. xerosis
  249. xerosis
  250. xerostomia

Monitoring Parameters

  • CBC with differential
  • LFTs
  • pregnancy testing
  • serum creatinine/BUN
  • serum electrolytes
  • serum uric acid
  • weight

Contraindications

  • ascites
  • bleeding
  • bone marrow suppression
  • breast-feeding
  • cardiac disease
  • children
  • contraception requirements
  • diabetes mellitus
  • driving or operating machinery
  • edema
  • fungal infection
  • geriatric
  • GI bleeding
  • growth inhibition
  • heart failure
  • hemochromatosis
  • hepatic disease
  • herpes infection
  • hypertension
  • immunosuppression
  • infants
  • infection
  • jaundice
  • neonates
  • nephrotoxicity
  • neutropenia
  • pericardial effusion
  • pleural effusion
  • pregnancy
  • pregnancy testing
  • pulmonary edema
  • renal disease
  • renal impairment
  • reproductive risk
  • thrombocytopenia
  • vaccination
  • varicella
  • ventricular dysfunction
  • viral infection

Interactions

  • Abciximab
  • Abemaciclib
  • Acalabrutinib
  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Alfentanil
  • Alfuzosin
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Alpha interferons
  • Alprazolam
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amobarbital
  • Amoxapine
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Anagrelide
  • Antithrombin III
  • Antithymocyte Globulin
  • Apalutamide
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Artemether; Lumefantrine
  • Artesunate
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Oxycodone
  • Atazanavir; Cobicistat
  • Atomoxetine
  • Atorvastatin
  • Atorvastatin; Ezetimibe
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Avanafil
  • Avapritinib
  • Bacillus Calmette-Guerin Vaccine, BCG
  • Barbiturates
  • Bedaquiline
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Benzhydrocodone; Acetaminophen
  • Bepridil
  • Bicalutamide
  • Boceprevir
  • Bortezomib
  • Bosutinib
  • Brexpiprazole
  • Brigatinib
  • Brimonidine; Timolol
  • Bromocriptine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Buspirone
  • Butabarbital
  • Caffeine; Ergotamine
  • Cannabidiol
  • Carbamazepine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Cariprazine
  • Carvedilol
  • Ceritinib
  • Cevimeline
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Cilostazol
  • Cimetidine
  • Ciprofloxacin
  • Cisapride
  • Clarithromycin
  • Clomipramine
  • Clonazepam
  • Clorazepate
  • Clozapine
  • Cobicistat
  • Cobimetinib
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colchicine
  • Colchicine; Probenecid
  • Conivaptan
  • Conjugated Estrogens
  • Conjugated Estrogens; Bazedoxifene
  • Conjugated Estrogens; Medroxyprogesterone
  • Crizotinib
  • Cyclophosphamide
  • Cyclosporine
  • Dabigatran
  • Daclatasvir
  • Dalteparin
  • Danaparoid
  • Dapagliflozin; Saxagliptin
  • Dapsone
  • Darifenacin
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Deflazacort
  • Delavirdine
  • Desipramine
  • Desirudin
  • Dexamethasone
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dextromethorphan
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Diazepam
  • Diclofenac
  • Diclofenac; Misoprostol
  • Dienogest; Estradiol valerate
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dihydroergotamine
  • Diltiazem
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Dipyridamole
  • Disopyramide
  • Docetaxel
  • Dofetilide
  • Dolutegravir; Rilpivirine
  • Donepezil
  • Donepezil; Memantine
  • Dorzolamide; Timolol
  • Doxepin
  • Doxercalciferol
  • Doxorubicin
  • Dronabinol
  • Drospirenone; Estradiol
  • Dutasteride
  • Dutasteride; Tamsulosin
  • Duvelisib
  • Echinacea
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix; Estradiol; Norethindrone acetate
  • Elbasvir; Grazoprevir
  • Eletriptan
  • Elexacaftor; tezacaftor; ivacaftor
  • Eliglustat
  • Eltrombopag
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Enalapril; Felodipine
  • Encainide
  • Encorafenib
  • Enoxaparin
  • Entrectinib
  • Enzalutamide
  • Eplerenone
  • Eptifibatide
  • Ergoloid Mesylates
  • Ergonovine
  • Ergot alkaloids
  • Ergotamine
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Esomeprazole; Naproxen
  • Estazolam
  • Esterified Estrogens
  • Esterified Estrogens; Methyltestosterone
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Estradiol; Levonorgestrel
  • Estradiol; Norethindrone
  • Estradiol; Norgestimate
  • Estradiol; Progesterone
  • Estropipate
  • Eszopiclone
  • Ethinyl Estradiol; Etonogestrel
  • Etodolac
  • Etonogestrel
  • Etravirine
  • Everolimus
  • Ezetimibe; Simvastatin
  • Famotidine; Ibuprofen
  • Felodipine
  • Fenoprofen
  • Fentanyl
  • Fesoterodine
  • Flecainide
  • Flibanserin
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Flurazepam
  • Flurbiprofen
  • Fluvastatin
  • Fondaparinux
  • food
  • Fostamatinib
  • Glecaprevir; Pibrentasvir
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • grapefruit juice
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guanfacine
  • Halofantrine
  • Haloperidol
  • Heparin
  • Homatropine; Hydrocodone
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Ibrutinib
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Idelalisib
  • Ifosfamide
  • Imipramine
  • Indomethacin
  • Influenza Virus Vaccine
  • Interferon Alfa-2a
  • Interferon Alfa-2b
  • Interferon Alfa-2b; Ribavirin
  • Interferon Alfa-n3
  • Interferon Alfacon-1
  • Intranasal Influenza Vaccine
  • Isavuconazonium
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Isradipine
  • Itraconazole
  • Ivabradine
  • Ivacaftor
  • Ivosidenib
  • Ixabepilone
  • Ketoconazole
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Lefamulin
  • Lemborexant
  • Lesinurad
  • Lesinurad; Allopurinol
  • Letermovir
  • Levobupivacaine
  • Levomethadyl
  • Lidocaine
  • Lidocaine; Prilocaine
  • Live Vaccines
  • Lomitapide
  • Loperamide
  • Loperamide; Simethicone
  • Losartan
  • Lovastatin
  • Lovastatin; Niacin
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Lumateperone
  • Lurasidone
  • Lurbinectedin
  • Maprotiline
  • Maraviroc
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Measles/Mumps/Rubella Vaccines, MMR
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Mefloquine
  • Meloxicam
  • Mephobarbital
  • Metformin; Repaglinide
  • Metformin; Saxagliptin
  • Methadone
  • Methamphetamine
  • Methohexital
  • Methylergonovine
  • Methysergide
  • Metoprolol
  • Mexiletine
  • Midazolam
  • Mifepristone
  • Mitotane
  • Nabumetone
  • Naloxegol
  • Nanoparticle Albumin-Bound Paclitaxel
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nebivolol
  • Nebivolol; Valsartan
  • Nefazodone
  • Neratinib
  • Netupitant, Fosnetupitant; Palonosetron
  • Nevirapine
  • Niacin; Simvastatin
  • Nicardipine
  • Nifedipine
  • Nilotinib
  • Nimodipine
  • Nisoldipine
  • Nortriptyline
  • Olaparib
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Oritavancin
  • Osimertinib
  • Oxaprozin
  • Oxybutynin
  • Oxycodone
  • Paclitaxel
  • Paricalcitol
  • Paroxetine
  • Pazopanib
  • Peginterferon Alfa-2a
  • Peginterferon Alfa-2b
  • Pemigatinib
  • Pentobarbital
  • Pentosan
  • Pergolide
  • Perindopril; Amlodipine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Pexidartinib
  • Phenobarbital
  • Phentermine; Topiramate
  • Pimozide
  • Piroxicam
  • Ponatinib
  • Porfimer
  • Posaconazole
  • Prednisone
  • Primidone
  • Propafenone
  • Propoxyphene
  • Propranolol
  • Protease inhibitors
  • Protriptyline
  • Quazepam
  • Quetiapine
  • Quinidine
  • Ramelteon
  • Ranolazine
  • Repaglinide
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifamycins
  • Rifapentine
  • Rilpivirine
  • Rimegepant
  • Rivaroxaban
  • Rolapitant
  • Romidepsin
  • Rotavirus Vaccine
  • Rubella Virus Vaccine Live
  • Rufinamide
  • Ruxolitinib
  • Safinamide
  • Sapropterin
  • Saxagliptin
  • Secobarbital
  • Segesterone Acetate; Ethinyl Estradiol
  • Selpercatinib
  • Selumetinib
  • Sertraline
  • Sibutramine
  • Sildenafil
  • Silodosin
  • Simeprevir
  • Simvastatin
  • Simvastatin; Sitagliptin
  • Siponimod
  • Sirolimus
  • Smallpox and Monkeypox Vaccine, Live, Nonreplicating
  • Smallpox Vaccine, Vaccinia Vaccine
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Sonidegib
  • St. John’s Wort, Hypericum perforatum
  • Sufentanil
  • Sulindac
  • Suvorexant
  • Tacrolimus
  • Tadalafil
  • Tafamidis
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  • Tasimelteon
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  • Tedizolid
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  • Telotristat Ethyl
  • Terbinafine
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  • Vorapaxar
  • Voriconazole
  • Warfarin
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  • Zanubrutinib
  • Ziprasidone
  • Zolpidem
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