imatinib, Gleevec (cont.)

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DOSING: The recommended dose range is 300-800 mg orally daily depending on the condition being treated. All doses should be administered with a meal and a large glass of water. A dose of 800 mg should be administered as 400 mg twice daily. Doses less than 800 mg may be administered once daily. It can be dissolved in apple juice or water for those with difficulty swallowing.

DRUG INTERACTIONS: The blood concentration of imatinib may be increased by several drugs that reduce its break down by the liver. Examples include ketoconazole, itraconazole (Sporanox), clarithromycin (Biaxin), atazanavir (Reyataz), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Invirase), telithromycin (Ketek), voriconazole (Vfend), and grapefruit juice. Increased blood concentrations of imatinib may increase the occurrence of adverse effects.

Certain drugs decrease the blood concentration of imatinib resulting in decreased blood levels and possibly reduced effect. Examples include carbamazepine, phenobarbital, rifampin, phenytoin, fosphenytoin, primidone, and St John's Wort.

Imatinib increases the blood concentration of simvastatin (Zocor) by reducing the activity of enzymes that break down simvastatin in the liver. This may increase the side effects of simvastatin. Imatinib may interact with other drugs that are broken down in a similar way as simvastatin.

PREGNANCY: Imatinib is harmful to the fetus and should not be used during pregnancy.

NURSING MOTHERS: Imatinib is excreted in human milk; therefore, nursing mothers should either discontinue imatinib or stop breastfeeding.

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