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Microsoft Yahei,
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< , Microsoft Yahei, usage and dosage
< , Microsoft Yahei, starting dose: for chronic myeloid cells For patients in the blast phase and accelerated phase of leukemia, 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 stromal tumors that cannot be surgically removed or metastasized (), 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.
< , Microsoft Yahei, 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 (, divided into doses): The disease progresses and a satisfactory hematological response fails to be obtained after at least one month of treatment, and the hematological response that has been achieved disappears again.
< , Microsoft Yahei, 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 adverse reactions. Adjust dose according to severity.
< , Microsoft Yahei, dose adjustment in case of severe liver toxicity and side effects: If the increase in bilirubin exceeds the upper limit of the normal range or the increase in transaminase exceeds the upper limit of the normal range, the drug should be discontinued until the above indicators drop to respectively Or less than . times the upper limit of the normal range.
< , Microsoft Yahei, Dose adjustment in neutropenia or thrombocytopenia: Acceleration phase or blast phase: If severe neutropenia and thrombocytopenia occur (neutrophils&.&/and/ or platelets&& 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 neutrophils& ().&/ and platelets& () &/. The dose when re-used is/day.
<, Microsoft Yahei, &-Patients in the chronic phase after interferon treatment failure: it is appropriate to discontinue the drug when neutrophils&.&/ and/or platelets&&/ When neutrophils & ( ) .&/ and platelets & ( ) &/ are resumed, the dose is / day. If neutrophils or platelets are reduced to the above values again, the dose is reduced to / day when resuming medication. Japan.
< , Microsoft Yahei, Children and Adolescents: There are no clinical data on the safety and efficacy of imatinib mesylate treatment in patients under the age of 15.
< , Microsoft Yahei, Liver Dosage for patients with functional failure: The plasma concentration of imatinib mesylate may increase in patients with liver dysfunction, so these patients should be cautious when using this drug. Currently, there is no use of imatinib mesylate in patients with liver dysfunction. Based on the clinical data, dosage adjustment recommendations cannot be made.
< , Dosage for Microsoft Yahei, renal failure and elderly patients: Creatinine clearance is known to decrease with age, and age-related changes in imaginine mesylate There is no significant effect on the pharmacokinetics of tinib. Since clinical trials have not been conducted in patients with renal impairment, dosage adjustment recommendations cannot be made.
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< , Microsoft Yahei Hei, adverse reactions
< , Microsoft Yahei, Most patients will experience some adverse reactions while taking imatinib mesylate, but the vast majority are mild to moderate. Considering that the disease itself can also produce symptoms , it is often difficult to clarify their causal relationship. During clinical trials, those who discontinued medication due to drug-related adverse reactions accounted for only % of patients in the chronic phase of CML who failed interferon treatment, about % in the accelerated phase, and % in the accelerated phase. The granuloclastic phase accounts for %.
< , Microsoft Yahei, the most common adverse events related to drug treatment are mild nausea (-%), vomiting, diarrhea, myalgia and muscle spasm, these adverse events are easy to deal with Edema and water retention were reported in all studies, with incidence rates of -% and -%, respectively, of which severe cases were -% and -%, respectively. Most patients' edema manifested as periorbital and lower extremity edema, and pleural effusion was also reported. , ascites, pulmonary edema and rapid weight gain, the drug is usually suspended at this time, diuretics or certain supportive treatments are given. Some patients are in serious condition, even life-threatening. There are cases of patients with chronic myeloid blast due to complications of pleural effusion and congestive heart failure. and death due to complex clinical conditions of renal failure. The incidence of these adverse reactions has a certain relationship with the dose, and is more common at & ( ) every day.
< , Microsoft Yahei, classified by system organ and frequency of occurrence , adverse reactions that occur not only in individual patients are listed below. Frequency is defined as very common&%, common&%& () %, rare&.%& () %, rare&.%& () .%, very rare& () .% (taxonomy).