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Precautions and Warnings With Imatinib

Specific Imatinib Precautions and Warnings

Some warnings and precautions to be aware of prior to taking this medication include the following:
 
  • People who take imatinib may experience fluid retention and swelling (edema). In some cases, the fluid retention can be serious, such as when fluid builds up around the lungs or heart. The risk for edema is higher in older adults and people taking higher doses of imatinib. If you experience severe swelling, your healthcare provider may give you diuretics ("water pills") or temporarily stop your imatinib treatment.
     
  • Imatinib may cause abnormally low blood cell counts, such as low red blood cells, white blood cells, or platelets, which can increase your risk for anemia, infection, and bleeding problems. Your healthcare provider will monitor your blood counts (with a simple blood test) every week for the first month, every other week during the second month, and then periodically for the remainder of treatment. If you develop problems, your healthcare provider may need to reduce your imatinib dose or temporarily stop treatment.
     
  • This medication can cause congestive heart failure (CHF) and left ventricular dysfunction (when the left ventricle of the heart doesn't function normally). If you have heart disease or risk factors for heart failure, your healthcare provider will monitor you closely for these problems, and treat you if necessary.
     
  • Imatinib may cause serious liver problems that could lead to liver failure or death. Your healthcare provider will monitor your liver function with a blood test before you start treatment and monthly during treatment. If you begin to develop liver problems, your healthcare provider may lower your dose or temporarily stop imatinib treatment. Contact your healthcare provider right away if you experience signs of liver disease, including:
     
    • Fatigue or extreme tiredness
    • Dark urine
    • Loss of appetite
    • Pain in the right upper part of the stomach
    • Yellowing of the skin or whites of the eyes (jaundice).
 
  • People with high eosinophils (a type of white blood cell) and heart dysfunction may be at risk for heart disease (including potentially life-threatening heart problems) when first starting imatinib. If you have a high eosinophil count, your healthcare provider may assess your heart function before you start imatinib. Your healthcare provider may choose to treat you with a steroid medication for your first one or two weeks of treatment to help lower your risk for this reaction.
     
  • This medication has been reported to cause bleeding, including serious bleeding of the gastrointestinal (GI) tract. GI perforation (a hole or tear in the lining of the stomach or intestines) has also been reported. Let your healthcare provider know if you develop any signs of bleeding, such as:
     
    • Unusual bruising
    • Black, tarry stools, bright-red blood in the stool, or vomiting of blood (signs of gastrointestinal bleeding)
    • Signs of a bleeding in the brain, such as vision or speech changes, weakness or numbness in an arm or leg, or a severe headache.
 
  • Skin reactions, including serious and potentially life-threatening skin rashes, have been reported with imatinib use. Let your healthcare provider know if you develop a rash while taking this medicine.
     
  • There have been reports of hypothyroidism (an underactive thyroid) in people who were taking thyroid replacement medicines during treatment with imatinib. Your healthcare provider will monitor your thyroid hormone levels closely if this is a concern for you.
     
  • Long-term use of imatinib may lead to liver, kidney, and heart problems. It can also decrease the ability of your body's immune system to fight off infections.
     
  • Imatinib may stunt the growth of children. Therefore, children who receive this medicine should have their growth carefully monitored.
     
  • There have been reports of tumor lysis syndrome (the development of metabolic and electrolyte disturbances caused by the breakdown of tumor cells in people undergoing cancer treatment) in people taking imatinib. Tumor lysis syndrome can be life-threatening. People who have many tumors, or whose tumors are fast-growing, are at a higher risk for tumor lysis syndrome and should be monitored closely.
     
  • Do not receive a vaccination during imatinib treatment without first checking with your healthcare provider. Some vaccinations may be less effective. You could also become infected with the bacteria or viruses used to make "live" vaccines (see Drug Interactions With Imatinib).
     
  • Imatinib can interact with a number of other medications (see Drug Interactions With Imatinib).
     
  • Imatinib is considered a pregnancy Category D medication, which means it may harm an unborn child. Talk to your healthcare provider about the risks and benefits of using this medication during pregnancy (see Gleevec and Pregnancy).
     
  • Imatinib passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Gleevec and Breastfeeding).
     
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