Drug General Information (ID: DDIUD34EHF)
  Drug Name Acetaminophen Drug Info Imatinib Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Analgesics Antineoplastics
  Structure

 Mechanism of Acetaminophen-Imatinib Interaction (Severity Level: Moderate)
     Increased risk of hepatotoxicity Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Acetaminophen Imatinib
      Mechanism Hepatotoxicity Hepatotoxicity
      Key Mechanism Factor 1
Factor Name Hepatotoxicity
Factor Description Combination of drugs that can induce hepatotoxicity may increase the risk of liver injury. Symptoms vary depending on the level of exposure and the total extent of liver damage, and may cause few symptoms if the damage is mild, and eventually lead to liver failure in patients with severe damage.
      Mechanism Description
  • Increased risk of hepatotoxicity by the combination of Acetaminophen and Imatinib 

Recommended Action
      Management Caution is advised if imatinib is used in combination with acetaminophen, particularly at higher dosages of the latter. All patients treated with imatinib should have liver function tests (transaminases, bilirubin, and alkaline phosphatase) prior to initiation of therapy and monthly thereafter or as clinically indicated. Patients should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice. In addition, they should not take over-the-counter medications such as analgesics containing acetaminophen, flu preparations, or herbal products without first talking to their healthcare provider.

References
1 Lin NU, Sarantopoulos S, Stone JR, et al. "Fatal hepatic necrosis following imatinib mesylate therapy." Blood 102 (2003): 3455-6. [PMID: 14568907]
2 Product Information. Gleevec (imatinib mesylate). Novartis Pharmaceuticals, East Hanover, NJ.