How it is administered

Imatinib is taken by mouth as a tablet or oral solution. Tablets are available in 100 mg and 400 mg strengths, and the oral solution contains 80 mg/mL. All doses should be taken with a meal and a large glass of water to reduce stomach upset. For those unable to swallow tablets, they can be dissolved in water or apple juice. The oral solution should be measured with an accurate dosing syringe, not a household spoon.

How it works

Imatinib is a type of medicine called a tyrosine kinase inhibitor. It works by blocking specific proteins (called kinases) that help cancer cells grow and survive. In blood cancers like chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL), imatinib targets the abnormal BCR-ABL protein produced by the Philadelphia chromosome. By blocking this protein, imatinib stops the cancer cells from growing and causes them to die.

Imatinib also blocks other proteins involved in cancer growth, such as c-Kit and PDGFR, which are important in some other rare blood disorders. By targeting these proteins, imatinib can help control the disease and reduce symptoms. It is usually taken daily, and treatment continues as long as it is effective and side effects are manageable.

Who Should take it

Imatinib is used to treat several blood cancers and related conditions:

• Newly diagnosed adults and children with Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML) in chronic phase.
• Patients with Ph+ CML in blast crisis, accelerated phase, or chronic phase after interferon-alpha therapy has failed.
• Adults with relapsed or refractory Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL).
• Children with newly diagnosed Ph+ ALL (in combination with chemotherapy).
• Adults with myelodysplastic/myeloproliferative diseases (MDS/MPD) linked to PDGFR gene changes.
• Adults with aggressive systemic mastocytosis (ASM) without the D816V c-Kit mutation or with unknown c-Kit status.
• Adults with hypereosinophilic syndrome (HES) or chronic eosinophilic leukemia (CEL) with certain genetic features.

Your doctor will decide if imatinib is right for you based on your diagnosis, genetic test results, and previous treatments.

Who should not take it

There are no absolute contraindications listed for imatinib, but it should be avoided in people who are allergic to imatinib or any of its ingredients.

Caution is needed in:

• Pregnant women, as imatinib can harm the unborn baby.
• Breastfeeding women, as imatinib can pass into breast milk and may harm the baby.
• People with severe liver or kidney problems, as dose adjustments may be needed.

If you have heart, liver, or kidney disease, or are taking certain other medicines, your doctor will monitor you closely or may adjust your dose. Always tell your healthcare provider about all your health conditions and medications before starting imatinib.

Commonly used with

In pediatric Ph+ ALL, imatinib is commonly used in combination with chemotherapy. In other blood cancers, it is often used alone, but your doctor may combine it with other treatments based on your specific situation.

If you require anticoagulation (blood thinners), low-molecular weight or standard heparin is preferred over warfarin, as imatinib can interact with warfarin.

Commonly tested with

Imatinib is often studied and compared with other tyrosine kinase inhibitors (such as nilotinib) in clinical trials for CML and Ph+ ALL. It may also be tested in combination with chemotherapy in pediatric ALL. In research, it is sometimes studied along with other targeted therapies or supportive medications to manage side effects or improve outcomes.