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Nausea/Vomiting & Intestinal Cramping

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Hi everyone! 

My dad was diagnosed with CML in April 2017. He has been on 400mg imantinib since late April. Since starting he has struggled with severe vomiting and wretching. It happens towards the end of the day or in the middle of the night.

      About a month ago he was admitted to the hospital with acute onset prosatitis. During his hospitalization he discontinued his imantinib for about week and improved. A week of recovery goes by and he starts having severe vomiting and stomach cramping. He is admitted to the hospital again with a suspected bowel obstruction. Surgery of his small bowel shows no sign of obstruction. However, an endoscopy reveals a terribly irritated lower esophagus and stomach lining. He improves after week in the hospital with an NG tub and without the imantinib.

 He started back the imantinib about 5 days ago seemingly on the mend. However, early this morning he woke up with stomach cramping and vomiting again!!!! He feels awful so he took an anti emetic. Could this aggressive vomiting be related to the imantinib??? His surgeons and cardiologists are stumped. He has an appointment with his hematologist next week. 

 

Have any of y'all struggled with chronic nausea and vomiting on imantinib? How do you manage it? 

 

 

Sorry for the novel! 

 

Bryn 

 

 

My gosh Bryn, that sounds awful. 

In all honesty, the way I would manage that situation would be to demand to switch to another TKI. It seems, from what you have said, that imatinib is causing this and imatinib has previous form when it comes to causing stomach and GI tract irritations in some people. 

David. 

Hi Bryn,

May I make a few observations but perhaps I really dont know the complete answer.It might be useful to revue when the imatinib is taken and with what type of food.There have been threads on here before of the type of meal that might be best taken alongside the drug.I am on high dose imatinib/Glivec at 600mg and it is quite tough because unless I take it with certain type of foods I have severe nausea and sometimes dreadful vomiting and gastric spasms.I find that if I take it at lunchtime with a high carb food like pasta or baked beans on toast I am fine but I must combine the meal and the drug and then drink at least one glass of water and ideally two.Over the years when on a lower dose I used to be able to combine the tablet with say a banana or a slice of bread with of course water but no longer can do that.Imatinib seems to have the tendency to cause cramping -last night I lost count how many times I had to get out of bed because of muscular cramp in the legs and today driving for one hour had to stop half way to stretch for cramps.Also it gets me in the lower rib cage sometimes .I suggest that you might experiment and see if increasing water intake each day will help or if tonic water taken with food will relieve it.

As a last resort I agree with David that you might need to reconsider whether another tki might be the answer

With best wishes

John