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Starting dose: For patients in the blast phase and accelerated phase of chronic myelogenous leukemia, the recommended dose of imatinib mesylate is /day. For patients in the chronic phase who have failed interferon therapy, as well as those who cannot be surgically resected or have metastasis For patients with malignant gastrointestinal stromal tumors, the recommended dose is/day, which should be taken orally once a day. It should be taken with a meal and 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 circumstances: If serious non-hematological adverse reactions (such as severe water retention) occur during treatment, the drug should be discontinued until the adverse reactions disappear, and then the dose will be adjusted according to the severity of the adverse reactions. .
) Dosage adjustment in case of severe liver toxicity: If the increase in bilirubin exceeds the upper limit of the normal range or the increase in transaminases exceeds 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 in neutropenia or thrombocytopenia: Acceleration phase or blast phase: If severe neutropenia and thrombocytopenia occur (neutrophils less than.&/and/or platelets less than&/ , it is recommended that the dose be 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 discontinue the drug until the neutrophils &. /日.
)&Patients in chronic phase after interferon treatment failure: it is advisable to discontinue the drug when neutrophils are less than.&/ and/or platelets are less than&/, only when neutrophils&.&/ and platelets&& When the medication is resumed, the dose is /day. If the neutrophils or platelets are reduced to the above values again, the dose is reduced to /day when the medication is resumed.
) Dosage for patients with liver failure: The plasma concentration of imatinib mesylate may increase in patients with liver function impairment, so these patients should be cautious when using this drug. There is no use of imatinib mesylate in patients with liver function impairment. The clinical data of imatinib acid cannot make recommendations for dose adjustment.
) Dosage in patients with renal failure and elderly patients: It is known that creatinine clearance decreases with age, and age has no significant effect on the pharmacokinetics of imatinib mesylate. Clinical trials have been conducted in impaired patients, so dosage adjustments cannot be recommended.