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>Starting dose For patients with chronic myelogenous leukemia in the blast phase and accelerated phase, the recommended dose of imatinib mesylate is/day. For patients in the chronic phase who have failed interferon therapy, as well as patients with malignant gastrointestinal cancer that cannot be surgically removed or metastasized. For patients with stromal tumors, the recommended dose is 1/day, which should be taken orally once a day. It is advisable to take the medicine with meals and drink a large glass of water. As long as it is effective, it should be continued.
/>If the blood picture permits and there are no serious adverse drug reactions, the dose may be considered to be increased from /day to /day, or from /day to /day (taken in divided doses) under the following circumstances: disease progression, treatment at least After several months, satisfactory hematological response could not be obtained, and the hematological response that had been achieved disappeared again.
/>The dose must be adjusted in the following situations. If serious non-hematological adverse reactions (such as severe water retention) occur during treatment, it is advisable to discontinue the drug until the adverse reactions disappear, and then adjust the dose according to the severity of the adverse reactions. .
/>Dose adjustment when severe liver toxicity occurs, such as bilirubin elevation exceeding the upper limit of the normal range or transaminase elevation exceeding the upper limit of the normal range, the drug should be discontinued until the above indicators drop to the upper limit of the normal range respectively. Or . times or less.
/>Dose adjustment during neutropenia or thrombocytopenia during accelerated phase or blast phase. If severe neutropenia and thrombocytopenia occur (neutrophils less than ./and/or platelets less than ./or platelets less than ./) the recommended dose is reduced to / day. If the blood cells continue to decrease for weeks, the dose should be further reduced to / day. If the blood cells continue to decrease for weeks, it is advisable to stop the drug until neutrophils / and platelets /. When used again, the dose is / day.
/ >After interferon treatment fails, patients in the chronic phase should stop taking the drug when their neutrophils are less than ./ and/or platelets are less than /, and then resume medication only when their neutrophils are ./ and platelets are less than /. The dose is /day, such as neutrophils./ When the granulocytes or platelets are reduced to the above values again, the dose is reduced to /day when the drug is resumed.
/>Dose for patients with liver failure The plasma concentration of imatinib mesylate may increase in patients with liver function impairment. Therefore, these patients should be cautious when using this drug. There are no clinical data on the use of imatinib mesylate in patients with liver damage, and no recommendations for dose adjustment can be made.
/> Renal failure and elderly patients Dosage It is known that creatinine clearance can decrease with age, and age has no significant impact on the pharmacokinetics of imatinib mesylate. Since no clinical trials have been conducted in patients with renal impairment, dose adjustment cannot be proposed. suggestions.