Imkeldi
Imkeldi (imatinib) is an oral solution that's FDA approved to treat certain blood cancers and other rare cancers in adults and some children. Because it comes as a liquid, it can be a good option if you have trouble swallowing tablets. Depending on the condition being treated, you take it by mouth once or twice a day. Common side effects include fluid buildup, nausea, muscle cramps, and diarrhea.
What is Imkeldi (imatinib)?
What is Imkeldi (imatinib) used for?
Certain blood cancers
- Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML)
- Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL)
- Myelodysplastic / myeloproliferative neoplasms (MDS/MPD) with certain genetic mutations
- Aggressive systemic mastocytosis (ASM)
- Hypereosinophilic syndrome (HES) or chronic eosinophilic leukemia (CEL)
Certain skin cancer
Certain tumors in the digestive tract
How Imkeldi (imatinib) works
[EDITOR|DRUG_DISPLAY_NAME|||title]] is a tyrosine kinase inhibitor. It works by blocking abnormal proteins called tyrosine kinases that tell cancer cells to grow and spread. Different types of cancer rely on different tyrosine kinases, including BCR-ABL, KIT, and PDGFR.
By blocking these proteins, Imkeldi (imatinib) helps slow or stop cancer cell growth.
Drug facts
| Common Brands | Imkeldi |
|---|---|
| Drug Class | Tyrosine kinase inhibitor |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Imkeldi (imatinib)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Newly diagnosed CML
- Fluid buildup or swelling (62%)
- Nausea (50%)
- Muscle cramps (49%)
- Bone or muscle pain (47%)
- Diarrhea (45%)
- Rash (40%)
- Tiredness (39%)
- Stomach pain (37%)
- Common cold symptoms (31%)
- Joint pain (31%)
MDS/MPD
- Nausea (57%)
- Diarrhea (43%)
- Muscle cramps (43%)
DFSP
- Nausea (42%)
- Tiredness (42%)
- Swelling around the eyes (33%)
- Swelling in the arms or legs (33%)
- Diarrhea (25%)
- Vomiting (25%)
- Rash (25%)
- More tears (25%)
- Low red blood cell count (25%)
GIST
- Fluid buildup or swelling (77%)
- Tiredness (69%)
- Nausea (58%)
- Stomach pain or cramping (57%)
- Diarrhea (56%)
- Rash or skin peeling (38%)
- Vomiting (37%)
- Muscle pain (32%)
- Low red blood cell count (32%)
- Reduced appetite (31%)
Note: Side effect rates differed across studies and conditions.
Less Common Side Effects
Newly diagnosed CML
- Bleeding
- Muscle pain
- Vomiting
- Trouble sleeping
- Weight gain
- Fever
- Dizziness
- Cough
- Sore throat
- Constipation
MDS/MPD
- Joint pain
- Swelling around the eyes
- Tiredness
- Low red blood cell count
DFSP
- Swelling in the face
- Fever
- Shortness of breath
- Stuffy or runny nose
- Reduced appetite
GIST
- Headache
- Low white blood cell count
- Cough
- Infection
- Itching
- Constipation
- Joint pain
- Hair loss
- Weight gain
Imkeldi (imatinib) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Fluid buildup: rapid weight gain, swelling, shortness of breath, chest pain
- Heart failure: shortness of breath, swelling, rapid weight gain, tiredness
- Liver problems: yellowing of the skin or eyes, dark urine, tiredness, pain in the upper right side of the stomach
- Bleeding: black or bloody stools, vomiting blood, unusual bruising
- Serious skin reactions: rash, hives, peeling skin, blisters
- Tumor lysis syndrome: muscle cramps, weakness, irregular heartbeat, urinating less
More on Imkeldi (imatinib) side effects
The following Imkeldi (imatinib) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
- Infection—fever, chills, cough, or sore throat
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Stomach bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds
- Stomach pain that is severe, does not go away, or gets worse
- Swelling of the ankles, hands, or feet, shortness of breath or trouble breathing, sudden weight gain
- Tumor lysis syndrome (TLS)—nausea, vomiting, diarrhea, decrease in the amount of urine, dark urine, unusual weakness or fatigue, confusion, muscle pain or cramps, fast or irregular heartbeat, joint pain
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Blurry vision
- Diarrhea
- Dizziness
- Fatigue
- Muscle pain or cramps
- Nausea
- Stomach pain
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Pros and cons of Imkeldi (imatinib)
Pros
- Treats several different types of cancer
- Liquid form can help if you have trouble swallowing tablets
- Approved for adults and some children, depending on the condition
Cons
- Many medication and food interactions
- Regular blood tests are usually needed
- Swelling, nausea, and diarrhea are common
Pharmacist tips for Imkeldi (imatinib)
- Take Imkeldi (imatinib) with a meal and a large glass of water. This helps lower the chance of stomach upset.
- Take Imkeldi (imatinib) exactly the way your prescriber tells you to. Some people might need to take it once a day, while others need 2 doses a day.
- If you miss a dose of Imkeldi (imatinib), wait until your next scheduled dose. Don't take 2 doses at the same time to make up for a missed one.
- Imkeldi (imatinib) can cause dizziness, blurry vision, or sleepiness. Don't drive or operate machinery until you know how it affects you.
- Tell your care team about all the medications, vitamins, and supplements you take before starting Imkeldi (imatinib). Many medications can interact with it, and your doses might need to be adjusted.
- Avoid grapefruit and grapefruit juice while taking Imkeldi (imatinib). They can raise the amount of medication in your body and increase your risk of side effects.
- Tell your prescriber right away if Imkeldi (imatinib) causes sudden weight gain or new swelling. These can be signs of serious fluid buildup. Catching this early can help your care team change your dose or treat the problem before it gets worse.
- Children: Imkeldi (imatinib) might slow growth in children. Your child's prescriber will check their growth regularly during treatment.
- Pregnancy: If you can become pregnant, use effective birth control while taking Imkeldi (imatinib) and for 14 days after your last dose. Tell your prescriber right away if you become pregnant.
- Breastfeeding: Don't breastfeed while taking Imkeldi (imatinib) or for 1 month after your last dose. The medication can pass into breast milk and it’s not known whether that can harm a breastfed baby.
How to take Imkeldi (imatinib)
- Wear disposable gloves when you prepare or give the medication to protect yourself.
- Measure with the oral syringe and bottle adapter provided by your pharmacist. Don't use household spoons because that won't be accurate.
- If you're using a new bottle, insert the bottle adapter before the first dose. Insert the oral syringe into the adapter, turn the bottle upside down, and measure your dose.
- Place the tip of the syringe inside your cheek and slowly push the plunger to give the medication. Swallow the medication completely.
- Wash the oral syringe with water after each use and let it dry completely. Throw away your gloves and wash your hands when you're finished.
- Storage: Keep the medication at room temperature in its original bottle. Throw away any remaining medication 30 days after opening the bottle.
More on Imkeldi (imatinib) tips
Risks and warnings for Imkeldi (imatinib)
Imkeldi (imatinib) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Fluid buildup and swelling
- Risk factors: Higher dose of Imkeldi (imatinib) | Older adults
[EDITOR|DRUG_DISPLAY_NAME|||title]] can cause your body to hold too much fluid, which can lead to a condition called edema. This can lead to swelling, rapid weight gain, or, in rare cases, serious problems such as fluid around your lungs or heart. Tell your care team right away if you notice sudden weight gain, swelling in your face, hands, or legs, trouble breathing, or chest pain.
Low blood cell counts
- Risk factors: CML in accelerated phase | CML in blast crisis
Imkeldi (imatinib) can lower your red blood cells, white blood cells, and platelets. This can raise your risk of tiredness, infections, and bleeding or bruising. These changes usually happen during the first several months of treatment, so your care team will check your blood counts regularly. Tell your prescriber right away if you have a fever, unusual bleeding or bruising, or feel more tired than usual.
Heart failure
- Risk factors: Older adults | History of heart problems | History of kidney problems
Imkeldi (imatinib) can rarely cause heart failure or make existing heart problems worse. Tell your prescriber right away if you have shortness of breath, swelling in your legs or feet, sudden weight gain, or unusual tiredness.
Liver problems
Imkeldi (imatinib) can cause serious liver problems, including liver failure in rare cases. Your prescriber will check your liver function with blood tests before and during treatment. Tell your care team right away if you notice yellowing of your skin or eyes, dark urine, pain in the upper right side of your stomach, unusual bleeding or bruising, loss of appetite, or severe tiredness.
Bleeding
Imkeldi (imatinib) can raise your risk of serious bleeding, including bleeding in your stomach or intestines. Tell your prescriber right away if you have black or bloody stools, vomit that looks like coffee grounds, cough up blood, unusual bruising, or bleeding that won't stop.
Stomach problems
Imkeldi (imatinib) can irritate your stomach and, in rare cases, cause a hole in your stomach or intestines. Take it with food and a large glass of water to help lower the chance of stomach upset. Get medical help right away if you have severe stomach pain, fever, or black or bloody stools.
Heart problems in certain conditions
- Risk factors: Blood conditions with high eosinophil levels
If you have hypereosinophilic syndrome (HES), chronic eosinophilic leukemia (CEL), or certain other rare blood conditions with high eosinophil levels, Imkeldi (imatinib) can rarely cause serious heart problems when you first start treatment.
Your prescriber might check your heart before you begin treatment and might prescribe other medications to help lower this risk. Tell your care team right away if you have chest pain, trouble breathing, dizziness, or a fast heartbeat.
Serious skin reactions
Imkeldi (imatinib) can rarely cause serious skin reactions, including Stevens-Johnson syndrome (SJS). Get medical help right away if you develop a severe rash, blistering or peeling skin, sores in your mouth, or a rash with fever. Your prescriber might have you stop the medication until the reaction gets better.
Low thyroid hormone levels
- Risk factors: Thyroid removal surgery and taking levothyroxine
If you've had your thyroid removed and take levothyroxine, Imkeldi (imatinib) can lower your thyroid hormone levels. Your prescriber might check your thyroid blood tests during treatment and adjust your levothyroxine dose if needed.
Harm to unborn baby
Imkeldi (imatinib) shouldn't be used during pregnancy, since it can harm your unborn baby. If you can get pregnant, use effective birth control during treatment and for 14 days after your last dose. Let your care team know right away if you become pregnant while taking this medication.
Slowed growth in children
Imkeldi (imatinib) might slow growth in children and teenagers. Your child's prescriber will check their height and growth regularly during treatment. It's not known whether this medication affects growth over the long term.
Tumor lysis syndrome
- Risk factors: Fast-growing cancers | Large amount of cancer in the body
Imkeldi (imatinib) can rarely cause tumor lysis syndrome, a serious condition that happens when cancer cells break down too quickly. Your risk might be higher if you have fast-growing cancers or a very large amount of cancer in their body before starting treatment.
Your prescriber might check your blood tests and make sure you're well hydrated before you begin treatment. Tell your prescriber right away if you have nausea, vomiting, muscle cramps, weakness, or changes in how much you urinate.
Kidney problems
- Risk factors: History of kidney problems | Diabetes | High blood pressure | Congestive heart failure
Imkeldi (imatinib) can affect how well your kidneys work, especially with long-term use. Your prescriber will check your kidney function before and during treatment. Your risk might be higher if you have kidney problems, diabetes, high blood pressure, or heart failure. Tell your care team if you notice swelling, urinate less than usual, or have sudden weight gain.
Imkeldi (imatinib) dosage
Bottle of oral solution| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 140ml of 80mg/ml | 1 bottle | $2,448.91 | $2,448.91 |
Typical dosage for Imkeldi (imatinib)
Adults
- Most conditions: The typical starting dose is 400 mg or 600 mg by mouth once a day.
- DFSP: The recommended dose is 400 mg by mouth twice a day.
Children
- CML or ALL: The dose is based on your child’s height and weight. The typical dose is 340 mg/m² per day, taken by mouth once a day or divided into 2 doses. The maximum dose is 600 mg per day.
The dose might be different if you have kidney problems, serious liver problems, or take other medications that interact with Imkeldi (imatinib).
How much does Imkeldi (imatinib) cost?
$2,448.91
What are alternatives to Imkeldi (imatinib)?
Certain blood cancers
Certain skin cancer
Certain tumors in the digestive tract
Imkeldi (imatinib) images
