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Imatinib Side Effects — RACP Adult Medicine MCQ

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EasyHaematologyImatinib Side EffectsRACP Adult Medicine

A 65-year-old man on imatinib 400 mg daily for CML-CP develops periorbital oedema, muscle cramps, nausea, and a rash. FBE shows mild neutropenia. LFTs show mildly elevated ALT. He has fluid retention with pleural effusion. What is the most likely causative drug class?

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Correct answer: B — Tyrosine kinase inhibitor (BCR-ABL)

Periorbital oedema is the most characteristic side effect of imatinib (BCR-ABL TKI), occurring in ~60% of patients. Other common side effects include muscle cramps (49%), nausea (50%), diarrhoea, rash, fluid retention (including pleural effusions), and myelosuppression. Most side effects are manageable and dose-dependent. Imatinib-related pleural effusions are more common with dasatinib (2nd-gen TKI).

Reference: ELN – 2024 – CML Guidelines; AMH 2025