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Safe to split 400mg Glivec in 3 or 4 parts for easier swalloing?

Hello, im from Norway. I was diagnosed with CML earlier this week, and im having problems swallowing the big pill, so ive been dissolving it in water for now, wich works okay, but it takes about 25minutes for the pill to dissolve, and i want to save some time.

Is it possible to cut/split the pill in 4 to make it easier for me to swallow? I want to take it all down with breakfast, but im just curious if i can divide the pill and then swallow the small parts one by one.

I cannot find a split mark on the pill, im taking 400mg Glivec.

It looks like this: http://www.mims.com/resources/drugs/Singapore/pic/Glivec%20film-coated%2...

Any help would be appreciated.

I've been on the 4x100mg for three years now and they asked me if i wanted the single 400mg. After seeing that picture i'm so glad i said no. That's massive!!
Cutting it up could result in losing some of it. Would it not be best to just crush it before dissolving in water?

I sympathise as I also have trouble forcing the tablet down. After 2 and a half years I am finally getting the knack of relaxing enough. I think I read somewhere ( maybe on the slip of paper inside the tablet box) which said it could be mixed into a large glass of apple juice. Maybe it dissolves more easily in that, and why apple juice I have no idea. Maybe someone else on this site knows.
Good luck - I have already complained to my doctor about the size.

Hi.

Imatanib used to come in 100mg tablets and I believe they are still available. You might like to ask your doctor about this.
That would certainly make it easier. Some people are on 3 or even 200 mg so they would not be cutting a 400 down to size.

Hope this might help.

Steven

Thank you.

I will ask my Doctor for 100mg pills on my first checkup.

I have been cutting my 400mg pills in half for five years because it reduced the side effects. I take one half after breakfast and the other half after my evening meal.
My PCR has been zero to 0.002% for the last 18 months, so it doesn't appear to affect its efficacy.

John

Hi John,

good to hear your pcr remains stable- at 0.002% you are considered to be a CMR (complete molecular response) according to the International Scale (IS)

e.g -from 100% positive at diagnosis
Log reduction of > 4.5 is equivalent to 0.005% - CMR- on the IS.

Log reduction of > 5.0 is equal to 0.0001%

So it looks like you have held a truly deep molecular response- more or less 5 log reduction.

Congratulations ;o)

Best wishes,

Sandy

PS: Had my first checkup yesterday after starting Glivec 2.5 weeks ago, and Glivec was working well, my wbc was way down since dx. and my spleen had reduced in size :)

Good news that your spleen has reduced in size, this is important.

Your wbc (in fact all your blood counts) should be within normal ranges by 3 months if not well before that.

After that you will want to see a cytogenetic response (CyR) i.e the white cells positive for PH chromosome continue on a downward trend towards a complete cytogenetic response (CCyR)

Keep us updated as you go on.

Best wishes,
Sandy

Thats good to hear as my spleen was pretty big but my Dr assured me i was well within chronic phase, and he called my bloodwork a classic example of CML, yes, now three weeks on Glevec and i cant feel my spleen anymore, im glad to hear you say spleen reduction is important as i have had such a good response in both wbc reduction and spleen size in just 2-3 weeks on Glivec, im just hoping for the same good news in my next checkup in a few weeks.

No serious side-effects of Glivec either, just abit nausea, but that has only happend 2 times in 3 weeks, and it passed within half an hour. I try to take Glivec each day between 09:30 and 10:00 right after ive had breakfast.

Anyway, thank you again for your encouraging post:)

WBC at 5.4 (Down from 77 2.5 weeks ago)
Hemoglobin 12 (Up from 11,4 2.5 weeks ago)
Platlets normal

My Onc smiled and said it was a good result, so im happy :)
He then tried really hard to find my spleen, but had problems doing so, after a minute of hard pressing on my stomach he found it, but said it was bearly noticeable and that i could start exercising now, but to start slow.
What a relief.

I have been taking Glivec 400mg since they first became available. When they are delivered, they are in a box marked "Cytotoxic drugs, handle with care". I laughed, as if they would explode or something.

Then I accessed a web site (iPharmacyPro), which explained the reason for this warning, and why the tablets are film-coated:

"Gleevec (sic) tablets should not be crushed. Direct contact of crushed tablets with the skin or mucous membranes should be avoided. If such contact occurs, wash thoroughly . . "

As I suffer with IHD, as well as other health problems, I have to take 33 tablets every day. The 10/11 I take at 6pm, including the Glivec, are all washed down at the same time, usually with a nice glass of Corbieres or Fitou.

33 tablets every day, wow.

I got the 100mg Glivec from my Onc on my last checkup, they look easy enough to swallow, but im finishing off the last of the 400mg pills by dissolving them in water before i start on those.

I am practicing pill swallowing every day now with a box of mints that i bought, so im sure i am ready for the 100mg pills, i dont think they will be a problem but it doesnt hurt to practice abit since its been ages since i swallowed a pill :)

Anyway, my results so far have been good, so dissolving them in water seems to be just as effective, at least on the initial response.

Gleevec can be dissolved in water as the manufacturer suggests. Imatinib however is more soluble in slightly acidic aqueous milieu which is why the manufacturer also suggests apple juice, it might be quicker to dissolve and possibly tastier.

I have been using a tablet cutter ( from any pharmacy including Tesco) and cutting the 400mg boulder in half, taking both halves after breakfast. When I was on DESTINY I was easily swallowing the smaller 2x 100mgs and asked my doctor if i could take 4 of these once back on full dose. He wouldn't let me do this as, after he had checked, the price is higher for 4x100mgs than for 1x400mgs but once it goes generic i may be able to take the smaller ones.

 

Does anyone know if I should/should not be cutting the tablet? I have been feeling soreness in my oesophagus and the thought has just occurred to me that it may be swallowing the two halves??

 

Best 

Chrissie

That's interesting, Chrissie.  When you were first diagnosed and presumably put on the big 400 tablets, did you have any difficulty swallowing them then?  Have you asked about going on to 300 or 200 rather than the full 400, if you were doing OK in the first stage of Destiny?

I'm currently on 2 x 100, after nearly a year on 3 x 100, and feeling very much better for it.  However, I will have to have another test after 2 months instead of 3, and may well have to go back up again.  I just hope it's not to the full 400.

Hope it goes well for you

Olivia

Thanks for your reply, Olivia.

Yes I have always had problems swallowing the 400mgs. I was so pleased when I was on the 2x100mgs as they were easy to swallow, but after losing MMR 3 times in the year on DESTINY I went back on 400mgs last October. (Back in MMR for th epast couple of months). Don't think I shall be trying the 200mgs dosage for a while. I just hope the generics are smaller - or that my haem agrees to let me have 4x 100mgs instead of the large 400mgs.

However, in the wider scheme, we are all alive...

Best

Chrissie

Chrissie: I have also been on the 100mg for the last years now, i hope you can get them soon. The small pills are "scored" so they can be split, but i think there is a lot more Imatinib potentially coming into contact with your oesophagus when splitting the 400mg compared to the 100mg. I remember when i drank the stuff, i was also pretty sore in my throat for a while, and i could feel how "strong" imatinib was, especially if some of it was piled up in the bottom of the glass and i forgot to stir properly. In those cases i drank a bit more water after, but i never had any real problems with it, just felt a bit sore.

I have heard of other people splitting the 400mg pills as well, so i would think its pretty safe, but i am of course not a doctor :)

Hi teddyb

Thanks for you reply. I have now started taking the 400mg as one whole tablet again and the pain in my oesophagus is decreasing, so am wondering if it was taking the tablet in 2 halves.

Hope you are feeling well,

Best

Chrissie