$251.25

IMATINIB

Take imatinib only as directed by your doctor. Do not use more or less of it, and do not use it more often than your doctor ordered. The exact amount of medicine you need has been carefully worked out. Taking too much may increase the chance of side effects, while taking too little may not improve your condition.

This medicine should be taken with a tall glass of water and a meal.

Do not take imatinib with grapefruit, grapefruit juice, or grapefruit-containing foods or supplements.

Dosing

The dose of imatinib will be different for different patients. The dose that is used may depend on a number of things, how you are responding to the medicine and whether or not it is affecting your blood cells. If you are taking imatinib at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of imatinib, ask your doctor.

Missed dose

If you miss a dose of this medicine, do not take the missed dose at all and do not double the next one. Instead, go back to your regular dosing schedule and check with your doctor.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For imatinib, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to imatinib. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Imatinib has not been studied in pregnant women. However, studies in animals have shown that imatinib causes birth defects and other problems with pregnancy. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant. This medicine may be needed in serious diseases or other situations that threaten the mother's life. Be sure you have discussed this with your doctor.

Breast-feeding It is not known whether imatinib passes into human breast milk. However, imatinib is not recommended during breast-feeding, because it may cause unwanted effects in nursing babies.

Children Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of imatinib in children with use in other age groups. Safety and effectiveness have not been established in children under 18 years of age.

Older adults This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults. Fluid retention may be more likely to occur in elderly patients, who may be more sensitive than younger adults to the effects of imatinib.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking imatinib, it is especially important that your doctor and pharmacist know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antineoplastics (cancer medicines) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Cyclophosphamide (e.g., Cytoxan) or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Rheumatrex) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) Concurrent use of these medicines with imatinib increases the risk of infection.

• If you have ever been treated with x-rays or other cancer medicines Imatinib may increase the effects of these medicines or radiation therapy on the blood.

• Carbamazepine (e.g., Tegretol) or
• Dexamethasone (e.g., Decadron) or
• Phenobarbital (e.g., Luminal) or
• Phenytoin (e.g., Dilantin) or
• Rifampicin (e.g., Rifampin) or
• St. John's Wort These medications may decrease the amount of imatinib in your body.

• Clarithromycin (e.g., Biaxin) or
• Erythromycin (e.g., E-Mycin, Erythrocin) or
• Itraconazole (e.g., Sporanox) or
• Ketoconazole (e.g., Nizoral) These medications may increase the amount of imatinib in your body.

• Cyclosporine (e.g., Sandimmune) or
• Pimozide (e.g., Orap) Imatinib may increase the amount of these medications in your blood to possibly harmful levels.

• Warfarin (e.g., Coumadin) Imatinib may interfere with the metabolism of warfarin, which can cause clotting problems.

• Grapefruit or
• Grapefruit juice or
• Grapefruit-containing food or vitamin These foods or vitamins may increase the amount of imatinib in your body. This may increase the chance of side effects.

• Anemia or
• Platelet problems or
• White blood cell problems May worsen and affect the decision to continue therapy

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles) Risk of severe disease affecting other parts of the body

• Liver disease Effects may be increased because of slower removal of imatinib from the body

• Infection Imatinib may decrease your body's ability to fight infection