IMANIX (IMATINIB) 400MG TABLETS 30`S

Imanix contains imatinib mesylate, the first molecularly targeted anti-cancer therapy. It selectively inhibits the BCR-ABL tyrosine kinase (the pathogenic kinase in CML), as well as KIT (CD117) and PDGFR kinases, making it active across a range of malignancies driven by these enzymes.

Indications:

•       Chronic myeloid leukaemia (CML): newly diagnosed chronic phase, accelerated phase, and blast phase — in adults and children

•       Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukaemia (ALL)

•       Gastrointestinal stromal tumours (GIST) expressing the KIT gene: adjuvant post-resection and unresectable/metastatic disease

•       Myelodysplastic/myeloproliferative diseases (MDS/MPD) with PDGFR gene rearrangements

•       Dermatofibrosarcoma protuberans (DFSP)

•       Chronic phase CML: 400mg once daily WITH food and a large glass of water

•       Accelerated or blast phase CML: 600mg once daily

•       GIST adjuvant (post-resection): 400mg once daily for 3 years

•       Unresectable/metastatic GIST: 400mg once daily; escalate to 800mg if insufficient response

•       Hepatic impairment (moderate-severe): reduce dose to 300mg once daily

Swallow tablets whole with food and a large glass of water. For patients unable to swallow, dissolve in water or apple juice, stir until fully dissolved, and drink immediately. Continue until disease progression or unacceptable toxicity.

•       Known hypersensitivity to imatinib or any excipient

•       Pregnancy and breastfeeding — imatinib is teratogenic. Effective contraception required during treatment and for 30 days after the last dose.

•       Moderate-severe hepatic impairment: dose reduction to 300mg required; monitor LFTs closely

•       Cardiac disease: imatinib is cardiotoxic — can cause left ventricular dysfunction; baseline cardiac assessment and regular monitoring in at-risk patients

•       Strong CYP3A4 inhibitors (ketoconazole, clarithromycin, itraconazole): increase imatinib plasma levels significantly — monitor for toxicity

•       CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, St. John's Wort): markedly reduce imatinib efficacy — avoid; consider dose increase if unavoidable

•       Warfarin: imatinib inhibits CYP2C9, increasing warfarin effect. Substitute LMWH for warfarin wherever possible in patients on imatinib. If warfarin is essential, monitor INR very frequently.

•       Simvastatin and other CYP3A4 substrates: imatinib raises their levels — consider statin switch to pravastatin or rosuvastatin (not CYP3A4-dependent)

•       Paracetamol at high doses: increased hepatotoxicity risk in combination — limit paracetamol dose

Q: Why must I take imatinib with food?

Imatinib can cause significant nausea and GI upset if taken on an empty stomach. Taking it with a full meal and a large glass of water substantially reduces this. Never take it without food.

Q: Why do I need to weigh myself every week?

Imatinib can cause fluid to accumulate in body tissues. A sudden gain of 2kg or more in one week is an early warning sign of dangerous fluid retention that may require dose adjustment or diuretic treatment. Catching this early prevents it from becoming serious.

Q: Can I take imatinib with painkillers?

Avoid high-dose paracetamol (increased liver toxicity risk) and NSAIDs (fluid retention and bleeding risk from thrombocytopenia). Discuss any pain management with your oncologist or pharmacist — safe options exist. Warfarin also interacts significantly and is best replaced with LMWH injections during imatinib treatment.