Description
Details
Glivec
® 400 mg film-coated tablets
imatinib
This medicine is subject to additional monitoring. This will allow quick identification of new safety
information. You can help by reporting any side effects you may get. See the end of section 4 for how to
report side effects
Read all of this leaflet carefully before you start taking this medicine because it contains important
information for you.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor, pharmacist or nurse.
- This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even
if their signs of illness are the same as yours.
- If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side
effects not listed in this leaflet. See section 4.
What is in this leaflet
1. What Glivec is and what it is used for
2. What you need to know before you take Glivec
3. How to take Glivec
4. Possible side effects
5. How to store Glivec
6. Contents of the pack and other information
1. What Glivec is and what it is used for
Glivec is a medicine containing an active substance called imatinib. This medicine works by inhibiting the
growth of abnormal cells in the diseases listed below. These include some types of cancer.
Glivec is a treatment for adults and children for:
-
Chronic myeloid leukaemia (CML). Leukaemia is a cancer of white blood cells. These white cells
usually help the body to fight infection. Chronic myeloid leukaemia is a form of leukaemia in which
certain abnormal white cells (named myeloid cells) start growing out of control.
-
Philadelphia chromosome positive acute lymphoblastic leukaemia (Ph-positive ALL).
Leukaemia is a cancer of white blood cells. These white cells usually help the body to fight infection.
Acute lymphoblastic leukaemia is a form of leukaemia in which certain abnormal white cells (named
lymphoblasts) start growing out of control. Glivec inhibits the growth of these cells.
Glivec is also a treatment for adults for:
-
Myelodysplastic/myeloproliferative diseases (MDS/MPD). These are a group of blood diseases in
which some blood cells start growing out of control. Glivec inhibits the growth of these cells in a
certain subtype of these diseases.
-
Hypereosinophilic syndrome (HES) and/or chronic eosinophilic leukaemia (CEL). These are
blood diseases in which some blood cells (named eosinophils) start growing out of control. Glivec
inhibits the growth of these cells in a certain subtype of these diseases.
-
Gastrointestinal stromal tumours (GIST). GIST is a cancer of the stomach and bowels. It arises
from uncontrolled cell growth of the supporting tissues of these organs.
-
Dermatofibrosarcoma protuberans (DFSP). DFSP is a cancer of the tissue beneath the skin in
which some cells start growing out of control. Glivec inhibits the growth of these cells.
In the rest of this leaflet, we will use the abbreviations when talking about these diseases.
If you have any questions about how Glivec works or why this medicine has been prescribed for you, ask
your doctor.
2. What you need to know before you take Glivec
Glivec will only be prescribed to you by a doctor with experience in medicines to treat blood cancers or
solid tumours.
Follow all your doctor’s instructions carefully, even if they differ from the general information contained in
this leaflet.
Do not take Glivec:
- if you are allergic to imatinib or any of the other ingredients of this medicine (listed in section 6).
If this applies to you,
tell your doctor without taking Glivec.
If you think you may be allergic but are not sure, ask your doctor for advice.
Warnings and precautions
Talk to your doctor before taking Glivec:
- if you have or have ever had a liver, kidney or heart problem.
- if you are taking the medicine levothyroxine because your thyroid has been removed.
- if you have ever had or might now have a hepatitis B infection. This is because Glivec could cause
hepatitis B to become active again, which can be fatal in some cases. Patients will be carefully checked
by their doctor for signs of this infection before treatment is started.
If any of these apply to you,
tell your doctor before taking Glivec.
You may become more sensitive to the sun while taking Glivec. It is important to cover sun-exposed areas
of skin and use sunscreen with high sun protection factor (SPF). These precautions are also applicable to
children.
During treatment with Glivec, tell your doctor straight away
if you put on weight very quickly. Glivec
may cause your body to retain water (severe fluid retention).
While you are taking Glivec, your doctor will regularly check whether the medicine is working. You will
also have blood tests and be weighed regularly.
Children and adolescents
Glivec is also a treatment for children with CML. There is no experience in children with CML below
2 years of age. There is limited experience in children with Ph-positive ALL and very limited experience in
children with MDS/MPD, DFSP, GIST and HES/CEL.
Some children and adolescents taking Glivec may have slower than normal growth. The doctor will
monitor the growth at regular visits.
Other medicines and Glivec
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines,
including medicines obtained without a prescription (such as paracetamol) and including herbal medicines
(such as St. John’s Wort). Some medicines can interfere with the effect of Glivec when taken together.
They may increase or decrease the effect of Glivec, either leading to increased side effects or making
Glivec less effective. Glivec may do the same to some other medicines.
Tell your doctor if you are using medicines that prevent the formation of blood clots.
Pregnancy, breast-feeding and fertility
- If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask
your doctor for advice before taking this medicine.
- Glivec is not recommended during pregnancy unless clearly necessary as it may harm your baby.
Your doctor will discuss with you the possible risks of taking Glivec during pregnancy.
- Women who might become pregnant are advised to use effective contraception during treatment.
- Do not breast-feed during the treatment with Glivec.
- Patients who are concerned about their fertility while taking Glivec are advised to consult with their
doctor.
Driving and using machines
You may feel dizzy or drowsy or get blurred vision while taking this medicine. If this happens, do not drive
or use any tools or machines until you are feeling well again.
3. How to take Glivec
Your doctor has prescribed Glivec because you suffer from a serious condition. Glivec can help you to
fight this condition.
However, always take this medicine exactly as your doctor or pharmacist has told you. It is important that
you do this as long as your doctor or pharmacist tells you to. Check with your doctor or pharmacist if you
are not sure.
Do not stop taking Glivec unless your doctor tells you to. If you are not able to take the medicine as your
doctor prescribed or you feel you do not need it anymore, contact your doctor straight away.
How much Glivec to take
Use in adults
Your doctor will tell you exactly how many tablets of Glivec to take.
If you are being treated for CML:
Depending on your condition the usual starting dose is either 400 mg or 600 mg:
-
400 mg to be taken as one tablet once a day,
-
600 mg to be taken as one tablet of 400 mg plus 2 tablets of 100 mg once a day.
If you are being treated for GIST:
The starting dose is 400 mg, to be taken as one tablet
once a day.
For CML and GIST, your doctor may prescribe a higher or lower dose depending on how you respond to
the treatment. If your daily dose is 800 mg (2 tablets), you should take one tablet in the morning and a
second tablet in the evening.
-
If you are being treated for Ph-positive ALL:
The starting dose is 600 mg to be taken as one tablet of 400 mg plus 2 tablets of 100 mg
once a day.
-
If you are being treated for MDS/MPD:
The starting dose is 400 mg to be taken as one tablet
once a day.
-
If you are being treated for HES/CEL:
The starting dose is 100 mg, to be taken as one tablet of 100 mg
once a day. Your doctor may decide
to increase the dose to 400 mg, to be taken as one tablet of 400 mg
once a day, depending on how
you respond to treatment.
-
If you are being treated for DFSP:
The dose is 800 mg per day (2 tablets), to be taken as one tablet in the morning and a second tablet in
the evening.
Use in children and adolescents
The doctor will tell you how many tablets of Glivec to give to your child. The amount of Glivec given will
depend on your child’s condition, body weight and height. The total daily dose in children must not exceed
800 mg with CML and 600 mg with Ph+ALL. The treatment can either be given to your child as a oncedaily
dose or alternatively the daily dose can be split into two administrations (half in the morning and half
in the evening).
When and how to take Glivec
-
Take Glivec with a meal. This will help protect you from stomach problems when taking Glivec.
-
Swallow the tablets whole with a large glass of water.
If you are unable to swallow the tablets, you can dissolve them in a glass of still water or apple juice:
Use about 200 ml for each 400 mg tablet.
Stir with a spoon until the tablets have completely dissolved.
Once the tablet has dissolved, drink everything in the glass straight away. Traces of the dissolved
tablets may be left behind in the glass.
How long to take Glivec
Keep taking Glivec every day for as long as your doctor tells you.
If you take more Glivec than you should
If you have accidentally taken too many tablets, talk to your doctor
straight away. You may require
medical attention. Take the medicine pack with you.
If you forget to take Glivec
- If you forget a dose, take it as soon as you remember. However if it is nearly time for the next dose,
skip the missed dose.
- Then continue with your normal schedule.
- Do not take a double dose to make up a forgotten dose.
If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. They are
usually mild to moderate.
Some side effects may be serious. Tell your doctor straight away if you get any of the following:
Very common
(may affect more than 1 in 10 people) or common (may affect up to 1 in 10 people):
Rapid weight gain. Glivec may cause your body to retain water (severe fluid retention).
Signs of infection such as fever, severe chills, sore throat or mouth ulcers. Glivec can reduce the
number of white blood cells, so you might get infections more easily.
Unexpected bleeding or bruising (when you have not hurt yourself).
Uncommon
(may affect up to 1 in 100 people) or rare (may affect up to 1 in 1,000 people):
Chest pain, irregular heart rhythm (signs of heart problems).
Cough, having difficulty breathing or painful breathing (signs of lung problems).
Feeling light-headed, dizzy or fainting (signs of low blood pressure).
Feeling sick (nausea), with loss of appetite, dark-coloured urine, yellow skin or eyes (signs of liver
problems).
Rash, red skin with blisters on the lips, eyes, skin or mouth, peeling skin, fever, raised red or purple
skin patches, itching, burning sensation, pustular eruption (signs of skin problems).
Severe abdominal pain, blood in your vomit, stools or urine, black stools (signs of gastrointestinal
disorders).
Severely decreased urine output, feeling thirsty (signs of kidney problems).
Feeling sick (nausea) with diarrhoea and vomiting, abdominal pain or fever (signs of bowel
problems).
Severe headache, weakness or paralysis of limbs or face, difficulty speaking, sudden loss of
consciousness (signs of nervous system problems such as bleeding or swelling in skull/brain).
Pale skin, feeling tired and breathlessness and having dark urine (signs of low levels of red blood
cells).
Eye pain or deterioration in vision, bleeding in the eyes.
Pain in your hips or difficulty walking.
Numb or cold toes and fingers (signs of Raynaud’s syndrome).
Sudden swelling and redness of the skin (signs of a skin infection called cellulitis).
Difficulty hearing.
Muscle weakness and spasms with an abnormal heart rhythm (signs of changes in the amount of
potassium in your blood).
Bruising.
Stomach pain with feeling sick (nausea).
Muscle spasms with a fever, red-brown urine, pain or weakness in your muscles (signs of muscle
problems).
Pelvic pain sometimes with nausea and vomiting, with unexpected vaginal bleeding, feeling dizzy or
fainting due to low blood pressure (signs of problems with your ovaries or womb).
Nausea, shortness of breath, irregular heartbeat, clouding of urine, tiredness and/or joint discomfort
associated with abnormal laboratory test results (eg. high potassium, uric acid and calcium levels and
low phosphorous levels in the blood).
Not known
(frequency cannot be estimated from the available data):
Combination of a widespread severe rash, feeling sick, fever, high level of certain white blood cells
or yellow skin or eyes (signs of jaundice) with breathlessness, chest pain/discomfort, severely
decreased urine output and feeling thirsty etc. (signs of a treatment-related allergic reaction).
Chronic renal failure.
Recurrence (reactivation) of hepatitis B infection when you have had hepatitis B in the past (a liver
infection).
If you get any of the above,
tell your doctor straight away.
Other side effects may include:
Very common
(may affect more than 1 in 10 people):
Headache or feeling tired.
Feeling sick (nausea), being sick (vomiting), diarrhoea or indigestion.
Rash.
Muscle cramps or joint, muscle or bone pain, during Glivec treatment or after you have stopped
taking Glivec.
Swelling such as round your ankles or puffy eyes.
Weight gain.
If any of these affects you severely,
tell your doctor.
Common
(may affect up to 1 in 10 people):
Anorexia, weight loss or a disturbed sense of taste.
Feeling dizzy or weak.
Difficulty in sleeping (insomnia).
Discharge from the eye with itching, redness and swelling (conjunctivitis), watery eyes or having
blurred vision.
Nose bleeds.
Pain or swelling in your abdomen, flatulence, heartburn or constipation.
Itching.
Unusual hair loss or thinning.
Numbness of the hands or feet.
Mouth ulcers.
Joint pain with swelling.
Dry mouth, dry skin or dry eye.
Decreased or increased skin sensitivity.
Hot flushes, chills or night sweats.
If any of these affects you severely,
tell your doctor.
Not known
(frequency cannot be estimated from the available data):
Reddening and/or swelling on the palms of the hands and soles of the feet which may be
accompanied by tingling sensation and burning pain.
Painful and/or blistering skin lesions.
Slowing of growth in children and adolescents.
If any of these affects you severely,
tell your doctor.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects
not listed in this leaflet. You can also report side effects directly (see details below). By reporting side
effects you can help provide more information on the safety of this medicine.
5. How to store Glivec
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton after EXP.
Do not store above 30°C.
Store in the original package in order to protect from moisture.
Do not use any pack that is damaged or shows signs of tampering.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to
throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Glivec contains
- The active substance is imatinib mesilate. Each tablet of Glivec contains 400 mg imatinib (as
mesilate).
- The other ingredients are microcrystalline cellulose, crospovidone, hypromellose, magnesium
stearate and anhydrous colloidal silica.
- The tablet coating is made of red iron oxide (E172), yellow iron oxide (E172), macrogol, talc and
hypromellose.
What Glivec looks like and contents of the pack
Glivec 400 mg film-coated tablets are very dark yellow to brownish-orange oval tablets. They have
“glivec” on one side.
They are supplied in packs containing 10, 30 or 90 tablets, but these may not all be available in your
country.
