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Usage and Dosage Edit
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, and For patients with malignant gastrointestinal stromal tumors that cannot be surgically removed or have metastasized, the recommended dose is 1/day, which should be taken orally once a day. They should 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 for at least 3 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.
Adjustment of dose in case of severe liver toxicity: If the increase in bilirubin exceeds 3 times 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 /, the recommended dose Reduce 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.
- Patients in the chronic phase after interferon treatment failure: it is advisable to stop taking the drug when the neutrophils are less than ./ and/or the platelets are less than /, and then resume the drug only when the neutrophils are ./ and the platelets are less than /, the dose is /day, such as When the neutrophils or platelets are reduced to the above values again, the dose is reduced to /day when the drug is resumed.
Dosage for patients with liver failure: The plasma concentration of imatinib mesylate in patients with liver failure can be 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.
Dosage for patients with renal failure and elderly patients : It is known that creatinine clearance can decrease with aging, 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