What gastrointestinal problem... Video Transcript

Participants

, Carolyn Blasdel RN, Gwen L. Nichols MD

Summary

Patients sometimes experience gastrointestinal problems, particularly nausea and diarrhea, with Gleevec. Learn some medical and common-sense treatments that can help.

Webcast Transcript

Patients on Gleevec sometimes do experience particularly nausea. It's especially a problem if you don't take your Gleevec immediately after or with a fairly substantial meal that includes protein. My experience is something like having a donut and orange juice in the morning just doesn't cut it. So you need to have a more substantial meal. It can be minimized by taking Gleevec with the most substantial meal of the day, whether that's—some people like to take it with breakfast, but other people don't eat too much breakfast so lunch or dinner is more practical.

If necessary, your doctor can prescribe antinausea medicines. And, interestingly enough, sometimes if you feel a bit nauseous after taking your Gleevec, if you eat something like toast or saltine crackers, bland food, that often helps.

Vomiting sometimes will happen quite suddenly, almost without warning. And, in that case, it's right after taking Gleevec. And it's usually when people first start their Gleevec and haven't learned yet what foods to take it with and how much to eat. And, once again, you can talk to your doctor about getting antinausea medicine if that's a problem.

Some people do better by splitting their doses. So you can ask if it's okay—say, if your dose is 600 mg and you're having trouble with nausea or vomiting. Ask your doctor if you can split it, 300 and 300. The disadvantage is it's harder to remember, but that often minimizes nausea. Some people even split it up 200 mg with each meal, breakfast, lunch and dinner. And people who are taking 800 mg should never take it 800 all at once because that's likely to lead to nausea, so split it up, 400 and 400.

Diarrhea is a really common side effect with Gleevec. Some people describe it as just having more stools and looser stools and greater quantity, other people have actual watery diarrhea. And a few people actually have urgency where they can hardly get to the bathroom in time. Sometimes this happens fairly quickly right after they take Gleevec.

The best thing that we've found (but you would need to check with your doctor to be sure this is okay) is Imodium, that's the brand name, loperamide. And you can learn to take the amount that's right for your system. So you might need to take one or two tablets in the beginning. Sometimes people complain, they say, "Oh, I got constipated," well, you took too much. So, after a few tries, you can figure out exactly how much you need for your situation. And so some people successfully manage it by taking a half a tablet a day or one tablet a day.

And other people, the diarrhea only happens with certain foods, like if they go out to dinner and eat spicy food. So once you kind of know that, then, if necessary, you can take some—an Imodium as a preventative measure.