Last update Nov. 6, 2022
Likely Compatibility
We do not have alternatives for Imatinib Mesilate, Imatinib Mesylate.
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Imatinib Mesilate, Imatinib Mesylate is also known as
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Tyrosine kinase inhibitor that is used for treatment of chronic myeloid leukaemia, acute lymphoblastic leukaemia, myelodysplastic syndromes and some types of cancer. Oral administration once or twice daily.
Its pharmacokinetic data (high percentage of protein binding, wide volume of distribution and moderately high molecular weight) explain the negligible passage into breast milk observed systematically. (Terao 2021, EMA 2018, Chelysheva 2018, Burwick 2017, Gouraud 2013, Kronenberger 2009, Ali 2009, Gambacorti 2007, Russell 2007)
No problems have been observed among breastfed infants from treated mothers. (Terao 2020, Alizadeh 2015, Jiang 2012, Gambacorti 2007)
Its active metabolite has a very long elimination life (40 hours) and the product has a very high bioavailability, so it could theoretically be absorbed by the infant.
The most frequent side effects of the drug are gastroenteritis, pancytopenia, increased liver transaminases, insomnia, weight loss, respiratory infections.
It is known from pharmacokinetics that after 3 elimination half-lives (T½) 87.5% of the drug is eliminated from the body; after 4 T½ it is 94%, after 5 T½, 96.9%, after 6 T½, 98.4% and after 7 T½ it is 99%. From 7 T½ the plasma concentrations of the drug in the body are negligible. In general, a period of at least five half-lives can be considered a safe waiting period before breastfeeding again.(Anderson 2016).
Taking the longest T½ published as a reference (40 hours), these 5 T½ would correspond to 200 hours (8.3 days). Meanwhile, express and discard milk from the breast regularly. This does not allow breastfeeding during treatment and several authors advise against it. (Grunewald 2015, Jiang 2012)
Abrupt weaning can be psychologically traumatic for both the mother and the infant. (Pistilli 2013).
If used during lactation, it is advisable to monitor growth and appetite and the possible appearance of diarrhea in the infant, as well as monitor hepatic and hematological function periodically.
Given the strong evidence that exists regarding the benefits of breastfeeding for the development of babies and the health of mothers, it is advisable to evaluate the risk-benefit of any maternal treatment, including chemotherapy, individually advising each mother who wishes to continue with breastfeeding. (Koren 2013)
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