Imatinib Accord (Imatinib)

Imatinib acts on malignant cells that depend on BCR‑ABL, c‑KIT or PDGFR signaling pathways.

• Chronic myeloid leukemia (CML): provides disease control by inhibiting leukemic cell proliferation.
• Gastrointestinal stromal tumor (GIST): reduces tumor growth and stabilises disease progression.
• Philadelphia‑positive acute lymphoblastic leukemia (Ph+ ALL): achieves remission by targeting the same tyrosine‑kinase drivers.

• Imatinib selectively inhibits the ATP‑binding sites of BCR‑ABL, c‑KIT and platelet‑derived growth factor receptor (PDGFR) tyrosine kinases. By blocking these enzymes, it prevents downstream phosphorylation events that drive uncontrolled cell division, thereby suppressing malignant cell proliferation and inducing apoptosis in susceptible cancer cells.

Adverse reactions may occur with imatinib therapy.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Edema: swelling of the hands, feet or face.
• Muscle cramps: occasional tightness or pain in muscles.
• Fatigue: general tiredness or lack of energy.
• Diarrhoea: loose stools occurring intermittently.
• Rash: skin irritation or redness.

Serious or Rare Side Effects

• Neutropenia: significant reduction in white blood cells, increasing infection risk.
• Hepatotoxicity: elevated liver enzymes or liver injury.
• Cardiac failure: signs of reduced heart function such as shortness of breath.
• Severe fluid retention: rapid weight gain or pleural effusion.
• Anaphylaxis: rare but potentially life‑threatening allergic reaction.

Patients receiving imatinib should be monitored for safety and efficacy.

• Blood counts: regular CBC to detect neutropenia or thrombocytopenia.
• Liver function: periodic tests for hepatotoxicity.
• Cardiac assessment: evaluate for heart failure signs, especially in at‑risk individuals.
• Hypersensitivity: discontinue if severe allergic reactions develop.
• Renal impairment: adjust monitoring in patients with reduced kidney function.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Imatinib may interact with other medicines, altering its effectiveness or safety.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): can raise imatinib plasma levels and increase toxicity.
• Strong CYP3A4 inducers (e.g., rifampin, phenytoin): may lower imatinib concentrations, reducing therapeutic effect.

Moderate Interactions (Monitor Closely)

• Proton‑pump inhibitors (e.g., omeprazole): may affect gastric pH and reduce absorption.
• Warfarin: requires INR monitoring due to potential anticoagulant effect changes.
• CYP2C8 inhibitors (e.g., gemfibrozil): can modestly increase imatinib exposure.
• Vaccines (live attenuated): assess risk‑benefit before administration.