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z Usage and Dosage Edit
Starting dose: The recommended dose of imatinib mesylate for patients in the blast phase and accelerated phase of chronic myelogenous leukemia is/day. For patients in the chronic phase who have failed interferon therapy and who cannot The recommended dose for patients with malignant gastrointestinal stromal tumors that have been surgically resected or metastasized is 2 times per day. It should be taken orally with meals and drink a large glass of water. It should be continued as long as it is effective.
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): the disease progresses and treatment cannot be obtained after at least three months. Satisfactory hematological response had been achieved and the hematological response 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 should be adjusted according to the severity of the adverse reactions.
Adjustment of dosage 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 . or . times the upper limit of the normal range respectively. the following.
Dose adjustment in neutropenia or thrombocytopenia: Acceleration or blast phase: If severe neutropenia and thrombocytopenia occur (neutrophils less than./ and/or platelets less than/) dose reduction is recommended To / day. If the blood cells continue to decrease for weeks, further reduce the dose to / day. If the blood cells continue to decrease for weeks, it is advisable to stop the drug until neutrophils. Patients in the post-chronic phase: When neutrophils are less than ./ and/or platelets are less than When the above values are reached, the dose is reduced to /day when the drug is resumed.
Dosage in patients with liver failure: The plasma concentration of imatinib mesylate can be increased in patients with liver failure, so these patients should use this drug. Caution: There are no clinical data on the use of imatinib mesylate in patients with hepatic impairment and dosage adjustments cannot be recommended.
Dosage in renal failure and elderly patients: Creatinine clearance is known to decrease with age. Age has no significant effect on the pharmacokinetics of imatinib mesylate. Since no clinical trials have been conducted in patients with renal impairment, no dosage adjustment recommendations can be made