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Overview

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This medicine contains an important and useful components, as it consists of
Citric acid, Sodium bicarbonate, Sodium citrate, Tartaric acidis available in the market in concentration

Name

Imatinib mesylate

Precaution

Before starting **Imatinib mesylate**, it is critical to consult a healthcare provider, especially for patients with the following conditions: - **Liver Disease**: **Imatinib mesylate** is metabolized in the liver, and patients with pre-existing liver disease or compromised liver function should be monitored closely. Dosage adjustments may be required to minimize the risk of liver toxicity. - **Cardiovascular Conditions**: This drug can cause **fluid retention**, which may lead to **heart failure**, especially in patients with underlying **heart disease**. Regular monitoring of cardiac function is advised, and the use of **Imatinib mesylate** should be cautioned in patients with **hypertension** or **congestive heart failure**. - **Gastrointestinal Issues**: **Imatinib mesylate** can cause nausea, vomiting, and diarrhea. Patients with gastrointestinal problems should be monitored, and dose adjustments may be necessary. - **Childbearing and Breastfeeding**: It is classified as a **Category D** medication in pregnancy, meaning it can cause harm to the fetus. It should not be used during **pregnancy** unless absolutely necessary. It is also excreted in **breast milk**, and breastfeeding should be avoided during treatment. - **Drug Interactions**: **Imatinib mesylate** can interact with various drugs, including **CYP3A4 inhibitors** and **inducers**, which can alter its metabolism and effectiveness. Patients should inform their healthcare provider about all medications they are taking, including over-the-counter drugs and supplements. - **Hematologic Issues**: Patients should be monitored for **myelosuppression** (low blood counts), as this can occur with **Imatinib mesylate**. Blood cell counts should be checked regularly during treatment.

Indication

**Imatinib mesylate** is a targeted therapy drug that is primarily used for the treatment of the following conditions: - **Chronic Myelogenous Leukemia (CML)**: It is used in the treatment of **CML**, a type of cancer affecting the blood and bone marrow. **Imatinib mesylate** is effective in patients with **Philadelphia chromosome-positive** CML, specifically in **chronic-phase**, **accelerated-phase**, and **blast-crisis CML**. - **Gastrointestinal Stromal Tumors (GISTs)**: It is indicated for the treatment of **GISTs**, which are tumors of the gastrointestinal tract. These tumors are often associated with mutations in the **KIT gene**, and **Imatinib mesylate** inhibits the abnormal protein produced by these mutations. - **Other Malignancies**: **Imatinib mesylate** has also shown efficacy in treating **myelodysplastic/myeloproliferative diseases**, such as **hypereosinophilic syndrome** and **chronic eosinophilic leukemia**, and **dermatofibrosarcoma protuberans (DFSP)**, a rare skin cancer. - **Systemic Mastocytosis**: **Imatinib mesylate** can be used in patients with **systemic mastocytosis** who have a mutation in the **KIT** gene, reducing symptoms such as **anaphylaxis** and **flushing**.

Contra indication

**Imatinib mesylate** should not be used in the following situations: - **Hypersensitivity**: Patients with a history of severe allergic reactions (e.g., **anaphylaxis**) or hypersensitivity to **Imatinib mesylate** or any of its components should not take this medication. - **Severe Liver Dysfunction**: **Imatinib mesylate** should be avoided in patients with severe **liver impairment** (such as **cirrhosis**) due to the increased risk of **drug accumulation** and toxicity. - **Pregnancy**: **Imatinib mesylate** is contraindicated in **pregnancy** due to the risk of **fetal harm**. Women of childbearing age should be advised to use effective contraception during treatment. - **Breastfeeding**: Since **Imatinib mesylate** is excreted in breast milk, it should not be used by breastfeeding women as it can cause harm to the infant.

Side Effect

Common and serious side effects of **Imatinib mesylate** include: - **Gastrointestinal Symptoms**: Nausea, vomiting, **diarrhea**, and **abdominal pain** are frequent side effects and often occur in the initial stages of treatment. - **Fluid Retention**: **Edema** (swelling) and weight gain due to fluid retention are common. In some cases, this can lead to **heart failure**. - **Hematologic Issues**: **Myelosuppression** (low blood cell counts) is a significant risk, particularly **neutropenia**, **anemia**, and **thrombocytopenia**, which require regular blood count monitoring. - **Fatigue**: Many patients experience **fatigue** or general weakness during treatment. - **Skin Rash**: Skin rashes, including **maculopapular rashes**, are a common side effect. **Severe skin reactions** may also occur. - **Liver Toxicity**: Elevated liver enzymes and **hepatotoxicity** are potential risks, so liver function tests should be regularly monitored. - **Cardiovascular Effects**: **Fluid retention** can lead to symptoms of **heart failure**, such as shortness of breath, fatigue, and swelling. Close monitoring of heart function is necessary. - **Musculoskeletal Pain**: Patients may experience **musculoskeletal pain**, including joint pain and muscle cramps. - **Severe Allergic Reactions**: Rarely, severe allergic reactions such as **anaphylaxis**, **angioedema**, or difficulty breathing can occur.

Pregnancy Category ID

Information not available

Mode of Action

**Imatinib mesylate** is a **tyrosine kinase inhibitor** that works by targeting and inhibiting specific enzymes called **tyrosine kinases** that are involved in the growth and spread of cancer cells. Its primary mechanism of action includes: - **Inhibition of BCR-ABL**: In **CML**, **Imatinib mesylate** specifically inhibits the **BCR-ABL tyrosine kinase**, a fusion protein produced by the **Philadelphia chromosome**. This protein is responsible for uncontrolled cell proliferation. By inhibiting BCR-ABL, **Imatinib** helps to restore normal cell growth and division in CML. - **Inhibition of KIT and PDGFRA**: **Imatinib** also inhibits **KIT** and **PDGFRA** (platelet-derived growth factor receptor alpha), which are mutated or overactive in **GISTs**, helping to reduce tumor growth. - **Apoptosis Induction**: By blocking these tyrosine kinases, **Imatinib mesylate** promotes **apoptosis** (programmed cell death) in cancer cells, thereby reducing tumor mass and controlling disease progression.

Interaction

**Imatinib mesylate** can interact with a variety of drugs, foods, and other substances. Some key interactions include: - **CYP3A4 Inhibitors and Inducers**: **Imatinib mesylate** is metabolized by **CYP3A4**, so drugs that inhibit this enzyme (e.g., **ketoconazole**, **ritonavir**) can increase its levels in the blood, raising the risk of side effects. Conversely, **CYP3A4 inducers** (e.g., **rifampin**, **phenytoin**) can lower its effectiveness. - **Antacids**: **Antacids** or drugs that reduce stomach acid, such as **H2 blockers** or **proton pump inhibitors**, may reduce the absorption of **Imatinib mesylate**, potentially decreasing its effectiveness. - **Warfarin**: Caution is needed when taking **Imatinib mesylate** with **warfarin** (a blood thinner), as it can increase the effects of warfarin and increase the risk of bleeding. - **Immunosuppressants**: When combined with **immunosuppressive drugs**, such as **cyclosporine** or **tacrolimus**, there is an increased risk of **infections** or adverse effects, so close monitoring is required. - **Grapefruit**: Grapefruit and grapefruit juice can inhibit the metabolism of **Imatinib mesylate**, increasing blood levels of the drug and leading to increased toxicity.

Pregnancy Category Note

Information not available

Adult Dose

The typical adult dosage of **Imatinib mesylate** depends on the condition being treated: - **Chronic Myelogenous Leukemia (CML)**: For **CML in chronic phase**, the recommended dose is **400 mg per day**. In **accelerated phase** or **blast crisis**, the dose may be increased to **600 mg per day**. - **Gastrointestinal Stromal Tumors (GISTs)**: The typical starting dose for **GISTs** is **400 mg per day**. This dose can be increased to **600 mg per day** based on response. - **Other Conditions**: For conditions like **dermatofibrosarcoma protuberans (DFSP)**, the dose is usually **400 mg per day**. - Dosing is generally taken once daily with food to minimize gastrointestinal side effects. The dose may be adjusted based on clinical response and side effects.

Child Dose

**Imatinib mesylate** is approved for use in pediatric patients (2 years and older) for the treatment of **CML** and **GISTs**. The typical pediatric dosing regimen is based on body weight: - For **CML** and **GISTs** in children, the usual dose is **260 mg/m² per day**, with a typical maximum dose of **400 mg per day**. The dose may be adjusted depending on response and side effects. - For **ph+ ALL (Philadelphia chromosome-positive acute lymphoblastic leukemia)**, the dose is typically **340 mg/m² per day**, again with adjustments based on tolerance. As with adults, treatment in children requires regular monitoring of side effects and disease progression. Always consult a healthcare provider before administering this medication to pediatric patients.

Renal Dose

For patients with **renal impairment**, **Imatinib mesylate** does not require a dose adjustment based solely on kidney function. However, in patients with severe renal dysfunction or end-stage renal disease, it is essential to monitor for **toxicity**, and dose adjustments may be considered based on individual responses.

Administration

Information not available