Imatinib (Glivec): side effects and what to do

Slightly raised temperature

A slightly raised temperature, otherwise well.

Fever: always an emergency during chemotherapy

A temperature of 38.0°C (100.4°F) or more, even once. Or shivering, chills, or feeling suddenly very unwell.

• Keep a thermometer at home. Check your temperature whenever you feel unwell, hot, cold or shivery.
• Do not take paracetamol before checking: it can hide a fever.
• Wash hands often; avoid crowds and people with colds, cough or chickenpox.
• Eat freshly cooked food; avoid raw salads, cut fruit and street food when counts are low.
• Brush gently, keep cuts clean, and do not squeeze pimples.

• Growth factor injections (G-CSF) may be given after chemotherapy to raise white cells.
• Antibiotics are given by us when needed. Do not start antibiotics from home without telling us.

Mild (grade 1)

Feeling sick and eating a little less than usual, no vomiting.

Moderate (grade 2)

Eating much less than usual, or vomiting 1 to 3 times in a day.

Severe (grade 3 or 4)

Vomiting more than 3 times in 24 hours, or cannot keep down water or medicines, or feeling dizzy.

• Take your anti-sickness tablets on time for the days advised, even if you feel well.
• Eat small, plain meals often: idli, toast, rice, biscuits. Avoid oily, spicy food and strong smells.
• Sip fluids through the day: water, ORS, lemon water, coconut water.
• Ginger tea or lemon may help.
• Sit up for 30 minutes after eating.

• Ondansetron or granisetron, aprepitant, dexamethasone, olanzapine and metoclopramide.
• If you still feel sick, tell us: the medicines can be changed or added for the next cycle.

Mild (grade 1)

1 loose stool more than usual in a day, otherwise well.

Moderate (grade 2)

2 to 3 loose stools in a day, or tummy cramps.

Severe (grade 3 or 4)

4 or more loose stools in 24 hours, or any loose stools with blood, fever, or dizziness.

• Drink plenty: ORS, buttermilk, rice water, coconut water, clear soups.
• Eat soft, low-fibre food: curd rice, idli, khichdi, banana, toast.
• Avoid milk, oily and spicy food, raw salads and fruit juices until better.
• Keep the skin around the bottom clean and dry.

• Loperamide, as advised by your doctor. Do not take it if you have fever or blood in the stools, without asking us.
• On immunotherapy, loose stools may need steroids: always tell us.

Mild (grade 1)

Dry skin, mild rash or redness, without pain.

Moderate (grade 2)

Painful redness or peeling of the hands or feet, or a rash over a large area, that affects daily work.

Severe (grade 3 or 4)

Blisters, skin peeling off, a rash with fever, a rash in the mouth or eyes, or a red, hot, swollen area with pus.

• Moisturise twice a day with a fragrance-free cream; urea cream for hands and feet.
• Use sunscreen and cover up in the sun.
• Bathe with lukewarm water and mild soap.
• Avoid tight shoes, hot water and long walks if hands and feet are sore.
• Keep nails short; wear gloves for housework.

• Antibiotic tablets and creams for EGFR rash; steroid creams; a short break or dose change for sore hands and feet.