Hi everyone I hope you are all doing good.
Please can I ask those of you on imatinib do you take it the same time every day?
I take mine normally at 8pm every night but have had a few days that I have taken it earlier around 7 very rarely even bit earlier than that.
Ive currently had a rise in my 9 month pcr lost mmr :( and although ive been told its prob just a blip and not to worry, im starting to think could it of increased because ive not been as strict as normal with my timings?
Hi Moirah,
We should all endeavour to take out medication at the same time every day. But an hour or so deviation isn't going to really make a difference. What we need to avoid doing is taking it at 8pm one day, midday the next, 6pm the next day, etc. Consistency is key.
I really don't think fluctuating by about an hour a day would make any difference and is highly unlikely to be the cause of your recent blip.
PS. blips happen all the time. I know they're worrying, but the tests aren't always perfect and are not always comparable for reasons such as the number of cells tested. What we look for are trends. If you have 3 rises in a row, then it might be time to talk about it in detail with your doctor ... but a single rise is often followed by an even bigger fall. I know I have had my ups and downs but in the end the overall trend is downwards.
Keep a strong eye on your PCR results, but one rise is not something to get overly concerned about.
David.
Likewise, 2 hour window generally, say 7.30 to 9.30 pm no issues at all. I'm sure this little movement has no impact, particularly with Imatinib as a 24 hour drug take rather than a lesser 12 hour.
Hi Moirah, the way TKIs work most effectively is by patients taking whichever drug they are treated with consistently .. i.e this means that the chemical compound in the drug that blocks the signalling protein (Bcr-Abl1) that enables CML cells to reproduce, will be kept at or above 1000 ng (nanogram) per ml.
I agree with the others that it will not make much difference if you miss your time by one or maybe two hours either way, however it has been shown that if you miss more than 3 doses per month - i.e you are less than 90% adherent... then it is likely that this will effect your chance of reaching an optimal response.
Sandy
Thank you sandy please can i ask in terms of as u say missing a dose, on the rare days i have taken my tki earlier than my normal 8pm and more than 2 hours earlier, is that classed the same effect as missing a dose altogether?
X
Whilst I think all patients should be very familiar with the patient information leaflets and the content of them, the Glivec one isn't massively helpful in this instance.
Take the missed dose as soon as you remember, then continue with your normal schedule.
Do not take a double dose to make up for the one that you missed.
As soon as one remembers, it might be too late if you only remember you missed yesterday's when it's time to take today's. It doesn't suggest a 12 hour cut-off or anything like that, but perhaps that's a sensible rule of thumb?
David.
Mine's slightly different to that. It says
Hi again Moirah,
This topic just came up at CML Horizons 2016 conference. One of the doctor's there (Dr Rossi) spoke about he was not that concerned about taking imatinib at different times of day. In his words, taking an imatinib pill is "topping up a steady state" of the active drug in your body. His concern is completely missed doses.
Note that he was specifically talking about imatinib. Dasatinib has a shorter half-life so that advice may not apply to it or other TKIs.
That said, taking the pills at the same time each day can help you not to forget to take it at all as it forms a habit!
I hope this helps, and settles your nerves about not taking your pills at the very same time every day.
David
