6 replies to this topic

[Mschmidli]

Today I start 600mg of gleevec. Have been in 400mg for two years and have not reached MMR. Been hovering between .2 and .6 for over a year. While I know this isn't "bad" my dr wants a deeper response (so do I). She said I could split the dose up but is see on the Novartis site it recommends 600mg be taken all at once. Does it really matter? Was thinking it may be a little easier on the system to split 200/400 breakfast/dinner. Thoughts?

[Widgeonus]

I take 600mg and take it all at the same time. 

[Trey]

I split my dosage almost from the beginning, whether 400mg or 600mg (briefly).  If the side effects are an issue I would definitely split it.  There is no real evidence showing that taking it all at once provides better response, just that Novartis has no clinical trial info on splitting dosage.

[hannibellemo]

I just went back and read your previous posts? What has happened to your AST/ALT? They had increased at one point recently. I had severe liver toxicity after 9 months on Gleevec so I pay serious attention to those numbers if they start to increase. You say you have side effects already on Gleevec that probably won't improve on increased dosage.

 

What about switching? I know you didn't ask but it was suggested on a previous post if it wasn't a hardship. Tasigna might just be the ticket for you.

 

Something to think about.  Good luck!

[Gail's]

Hannibellemo I just got my latest labs and my AST is above normal a bit. ALT staying normal. I read that where the docs worry is when liver enzymes are 5-10 times normal. Did yours creep up or have a sudden very high elevation? Did you have any liver toxicity symptoms?

[Mschmidli]

Thanks Trey

Hannibellemo my alt ast were back to normal on my next lab a couple weeks later. They think it was just part of whatever kind of bug I had at the time. It's been normal ever since. I am going to ask to switch to tasigna if my PCR in July doesn't show any improvement or if the side effects of the 600 are too much.

[hannibellemo]

Gail,

 

My ALT/AST went up to 80/53 respectively on a blood test and my local onc said we would watch it but they don't really get concerned until the ALT is 100. I was at Mayo for my 3 month check up 3 weeks later and they had gone up to 1112/531. Had an ultrasound done and my liver appeared normal, I felt fine and had no hepatitis (general term for liver inflamation in this case) symptoms. They took me off Gleevec and the PPI I was taking at the time because they are also hard on the liver. My ultimate high was 1344/752.

 

Counts returned to normal range after 7 weeks and I started Sprycel. I wasn't doing anything else to cause the elevation so they felt it had to be because of Gleevec. Until then my counts had been running in the high teens, low twenties. I realized at my last blood test that it had taken over 5 years for my counts to return to that low level.

 

Glad it was just a burp for you!