- Overview
- Properties
- Genetics
- Related Genes
- Pathways
- Related Drugs
- Related Diseases
- Datasets
- Downloads/LinkOuts
Overview
| Generic Names: | Imatinib Mesylate; Imatinib Methansulfonate |
|---|---|
| Trade Names: | Gleevec; Glivec |
| PharmGKB Accession Id: | PA10804 |
Description
Imatinib is a drug used to treat certain types of cancer. It is currently marketed by Novartis as Gleevec (USA) or Glivec (Europe/Australia) as its mesylate salt, imatinib mesilate (INN). It is occasionally referred to as CGP57148B or STI571 (especially in older publications). It is used in treating chronic myelogenous leukemia (CML), gastrointestinal stromal tumors (GISTs) and a number of other malignancies.
It is the first member of a new class of agents that act by inhibiting particular tyrosine kinase enzymes, instead of non-specifically inhibiting rapidly dividing cells.
(source:
Drug Bank)
Indication
For the treatment of newly diagnosed adult patients with Philadelphia chromosome positive chronic myeloid leukemia (CML). Also indicated for the treatment of pediatric patients with Ph+ chronic phase CML whose disease has recurred after stem cell transplant or who are resistant to interferon-alpha therapy. Also indicated with unresectable and/or metastatic malignant gastrointestinal stromal tumors (GIST). (source: Drug Bank)
ATC Therapeutic Category
- L01XE:Protein kinase inhibitors
Pharmacology, Interactions, and Contraindications
Mechanism Of Action
Imatinib mesylate is a protein-tyrosine kinase inhibitor that inhibits the Bcr-Abl tyrosine kinase, the constitutive abnormal tyrosine kinase created by the Philadelphia chromosome abnormality in chronic myeloid leukemia (CML). It inhibits proliferation and induces apoptosis in Bcr-Abl positive cell lines as well as fresh leukemic cells from Philadelphia chromosome positive chronic myeloid leukemia. Imatinib also inhibits the receptor tyrosine kinases for platelet derived growth factor (PDGF) and stem cell factor (SCF) - called c-kit. Imatinib was identified in the late 1990s by Dr Brian J. Druker. Its development is an excellent example of rational drug design. Soon after identification of the bcr-abl target, the search for an inhibitor began. Chemists used a high-throughput screen of chemical libraries to identify the molecule 2-phenylaminopyrimidine. This lead compound was then tested and modified by the introduction of methyl and benzamide groups to give it enhanced binding properties, resulting in imatinib. (source: Drug Bank)
Pharmacology
Imatinib is an antineoplastic agent used to treat chronic myelogenous leukemia. Imatinib is a 2-phenylaminopyrimidine derivative that functions as a specific inhibitor of a number of tyrosine kinase enzymes. In chronic myelogenous leukemia, the Philadelphia chromosome leads to a fusion protein of Abl with Bcr (breakpoint cluster region), termed Bcr-Abl. As this is now a continuously active tyrosine kinase, Imatinib is used to decrease Bcr-Abl activity. (source: Drug Bank)
Food Interactions
Take with food to reduce the incidence of gastric irritation. Follow with a large glass of water. A lipid rich meal will slightly reduce and delay absorption. Avoid grapefruit and grapefruit juice throughout treatment, grapefruit can significantly increase serum levels of this product. (source: Drug Bank)
Absorption, Distribution, Metabolism, Elimination & Toxicity
Biotransformation
Primarily hepatic via CYP3A4. Other cytochrome P450 enzymes, such as CYP1A2, CYP2D6, CYP2C9, and CYP2C19, play a minor role in its metabolism. The main circulating active metabolite in humans is the N-demethylated piperazine derivative, formed predominantly by CYP3A4. (source: Drug Bank)
Protein Binding
Very high (95%) (source: Drug Bank)
Absorption
Imatinib is well absorbed with mean absolute bioavailability is 98% with maximum levels achieved within 2-4 hours of dosing (source: Drug Bank)
Toxicity
Side effects include nausea, vomiting, diarrhea, loss of appetite, dry skin, hair loss, swelling (especially in the legs or around the eyes) and muscle cramps (source: Drug Bank)
Isomeric SMILES Code:
Cc1ccc(cc1Nc2nccc(n2)c3cccnc3)NC(=O)c4ccc(cc4)CN5CCN(CC5)C (source: Drug Bank)
Curated Annotations (
)
-
rs2231142
at chr4:89271347
in
ABCG2
studied allele=A; study size=46 (30 children; 16 adults);PK=significantly lower clearance (-23%) of imatinib and major metabolite in heterozygous versus wild-type homozygous patients when genotype considered with body weight, albuminemia and alpha1-acid glycoprotein covariates; significance= P < 0.05; genotype alone not associated with increased clearance- Variant Name:
- ABCG2:421C>A; ABCG2:Q141K;
- Related Drugs:
- imatinib
- Evidence:
-
PMID:18981009
-
rs2290573
at chr15:72916647
in
ULK3
A significant association between major cytogenetic response (MCyR) and the rs2290573 polymorphism mapped to 15q22.33 was observed in imatinib-treated patients (P = 0.00037, Bonferroni corrected P = 0.025). Individuals with a CC genotype had a MCyR rate of 52% compared with individuals with a CT or TT genotype that had a MCyR rate of 89% (odds ratio, 6.72; 95% confidence interval, 1.51-29.91). CO: The time to progression at 18 months was significantly different between CC and CT/TT genotype using log-rank test or Wilcoxon test (P < 0.03): Six of 29 imatinib-treated patients (21%) with a CC genotype experienced progression events vs five of 84 patients (6%) with a CT or TT genotype. Study size=113- Related Drugs:
- imatinib
- Related Diseases:
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive
- Evidence:
-
PMID:15073101
The following genes are in curated knowledge about this drug.
| Gene | Relationship | Evidence | |
|---|---|---|---|
|
|
ABCB1 |
|
Publications |
|
|
ABCC1 |
|
Publications |
|
|
ABCC2 |
|
Publications |
|
|
ABCC6 |
|
Publications |
|
|
ABCG2 |
|
Publications |
|
|
ABL1 |
|
Publications |
|
|
BLK |
|
Publications |
|
|
CSF1R |
|
Publications |
|
|
CYP1A2 |
|
Publications |
|
|
CYP2C19 |
|
Publications |
|
|
CYP2C9 |
|
Publications |
|
|
CYP2D6 |
|
Publications |
|
|
CYP3A4 |
|
Publications |
|
|
CYP3A5 |
|
Publications |
|
|
DCK |
|
Publications |
|
|
DDR1 |
|
Publications |
|
|
DDR2 |
|
Publications |
|
|
FLT3 |
|
Publications |
|
|
KIT |
|
Publications |
|
|
LCK |
|
Publications |
|
|
MYC |
|
Publications |
|
|
NPM1 |
|
Publications |
|
|
NQO2 |
|
Publications |
|
|
PDGFRA |
|
Publications |
|
|
PDGFRB |
|
Publications |
|
|
SLC22A1 |
|
Publications |
|
|
SLCO1A2 |
|
Publications |
|
|
SYK |
|
Publications |
|
|
ULK3 |
|
Variants |
A list of non-curated publications that mention this drug along with other genes is available.
Drug Targets
| Gene | Description | |
|---|---|---|
| ABCB1 |
|
(source: Drug Bank) |
| ABCG2 |
|
(source: Drug Bank) |
| ABL1 |
|
(source: Drug Bank) |
| CSF1R |
|
(source: Drug Bank) |
| DDR1 |
|
(source: Drug Bank) |
| NTRK1 |
|
(source: Drug Bank) |
| PDGFRA |
|
(source: Drug Bank) |
| PDGFRB |
|
(source: Drug Bank) |
| RET |
|
(source: Drug Bank) |
| KIT |
|
(source: Drug Bank) |
PharmGKB Curated Pathways
BioCarta Pathways†
PID Pathways†
A list of non-curated publications that mention this drug along with other drugs is available.
Drug Interactions
| Drug | Description | |
|---|---|---|
| acenocoumarol |
|
Imatinib increases the anticoagulant effect (source: Drug Bank) |
| acetaminophen |
|
Increased hepatic toxicity of both agents (source: Drug Bank) |
| atorvastatin |
|
Increases the effect and toxicity of atorvastatin (source: Drug Bank) |
| carbamazepine |
|
Carbamazepine decreases levels of imatinib (source: Drug Bank) |
| cerivastatin |
|
Imatinib increases the effect and toxicity of statin (source: Drug Bank) |
| clarithromycin |
|
The macrolide increases levels of imatinib (source: Drug Bank) |
| cyclosporine |
|
Imatinib increases the effect and toxicity of cyclosporine (source: Drug Bank) |
| dexamethasone |
|
Dexamethasone decreases levels of imatinib (source: Drug Bank) |
| dicumarol |
|
Imatinib increases the anticoagulant effect (source: Drug Bank) |
| erythromycin |
|
The macrolide increases levels of imatinib (source: Drug Bank) |
| itraconazole |
|
The imidazole increases the levels of imatinib (source: Drug Bank) |
| ketoconazole |
|
The imidazole increases the levels of imatinib (source: Drug Bank) |
| lovastatin |
|
Imatinib increases the effect and toxicity of statin (source: Drug Bank) |
| mephenytoin |
|
The hydantoin decreases the levels of imatinib (source: Drug Bank) |
| nifedipine |
|
Imatinib increases the effect and toxicity of nifedipine (source: Drug Bank) |
| phenobarbital |
|
Phenobarbital decreases levels of imatinib (source: Drug Bank) |
| phenytoin |
|
The hydantoin decreases the levels of imatinib (source: Drug Bank) |
| pimozide |
|
Increases the effect and toxicity of pimozide (source: Drug Bank) |
| rifampin |
|
Rifampin decreases levels of imatinib (source: Drug Bank) |
| simvastatin |
|
Imatinib increases the effect and toxicity of statin (source: Drug Bank) |
| warfarin |
|
Imatinib increases the anticoagulant effect (source: Drug Bank) |
Curated Information
The following diseases are in curated knowledge about this drug.
| Disease | Relationship | Evidence | |
|---|---|---|---|
|
|
Cytomegalovirus Infections |
|
Publications |
|
|
Diabetes Mellitus, Type 2 |
|
Publications |
|
|
Gastrointestinal Stromal Tumors |
|
Publications |
|
|
Glioma |
|
Publications |
|
|
Heart Failure |
|
Publications |
|
|
Leukemia |
|
Publications |
|
|
Leukemia, Myelogenous, Chronic, BCR-ABL Positive |
|
Publications, Variants |
|
|
Leukemia, Myeloid |
|
Publications |
|
|
Leukemia, Myeloid, Acute |
|
Publications |
|
|
Neoplasms |
|
Publications |
Non-Curated Information
A list of non-curated publications that mention this drug along with other diseases is available.
Additional Datasets
These datasets are minimally curated and are sorted alphabetically by title.
LinkOuts
Common Searches
Search PubMed
Search Medline Plus
Search PubChem
Search CTD
Non-Curated Publications
A list of non-curated publications that mention this drug is available.
