Megace

Megace,

trademark for an antineoplastic progestational agent (megestrol acetate).

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megestrol acetate Warning - Hazardous drug!

Apo-Megestrol (CA), Megace, Megace ES, Megace-OS (CA)

Pharmacologic class: Hormone

Therapeutic class: Progestin, antineoplastic, appetite stimulant

Pregnancy risk category D (tablets), X (suspension)

Action

Unknown. Thought to suppress growth of progestin-sensitive breast and endometrial tumors by inhibiting pituitary and adrenal function.

Availability

Oral suspension: 40 mg/ml

Oral suspension (concentrate): 625 mg/5 ml

Tablets: 20 mg, 40 mg

⊘Indications and dosages

➣ Breast cancer

Adults: 160 mg/day P.O. as a single dose, or 40 mg P.O. q.i.d.

➣ Endometrial cancer

Adults: 40 to 320 mg/day P.O. in divided doses

➣ Anorexia, cachexia, or unexplained significant weight loss in AIDS patients

Adults: 800 mg (oral suspension only) P.O. daily, or 5 ml (oral suspension concentrate) P.O. daily

Off-label uses

• Endometriosis, endometrial hyperplasia
• Prostatic hypertrophy
• Contraception

Contraindications

• Hypersensitivity to drug or its components
• Known or suspected pregnancy (suspension only)

Precautions

Use cautiously in:
• diabetes mellitus, severe hepatic disease, renal disease, cardiovascular disease, seizure disorders, cerebral hemorrhage, migraine, asthma, undiagnosed vaginal bleeding, depression
• history of thrombophlebitis
• breastfeeding.

Administration

• Give with meals if GI upset occurs.

Route	Onset	Peak	Duration
P.O.	Wks-1 mo	2 mo	Unknown

Adverse reactions

CNS: headache, insomnia, drowsiness, asthenia, confusion, neuropathy, hyperesthesia, abnormal thinking, paresthesias, depression, seizures

CV: hypertension, chest pain, thrombophlebitis

EENT: amblyopia, retinal thrombosis, pharyngitis

GI: nausea, vomiting, constipation, abdominal pain, flatulence, dyspepsia, dry mouth, increased salivation, oral candidiasis

GU: breast tenderness, breakthrough bleeding, decreased libido

Hematologic: anemia, leukopenia

Hepatic: hepatomegaly

Metabolic: hyperglycemia

Musculoskeletal: carpal tunnel syndrome, back pain

Respiratory: dyspnea, cough, pneumonia, pulmonary embolism

Skin: alopecia, rash, pruritus, sweating

Other: edema, fever, weight gain, herpes infection

Interactions

Drug-diagnostic tests . Lactate dehydrogenase: increased level

Patient monitoring

☞ Watch for signs and symptoms of thromboembolic disorders.
☞ Stay alert for visual disturbances, headache, abdominal pain, and hepatomegaly.
• Monitor glucose level in diabetic patients.

Patient teaching

• Inform patient that drug may cause back or abdominal pain, headache, nausea, vomiting, or breast tenderness.
☞ Tell patient to immediately report pain, swelling or redness of lower legs, chest or back pain, or shortness of breath.
• Advise patient to contact prescriber if adverse effects become pronounced or if other troublesome signs or symptoms occur.
• Urge patient to use reliable contraception.
☞ Instruct patient to immediately report suspected pregnancy.
• Caution female patient to avoid breastfeeding.
• Advise diabetic patient to monitor blood glucose level.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.

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Megace®

Megestrol acetate, see there

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Patient discussion about Megace.

Q. What do you think are the chances of an 85 year old lady that gained a lot of weight recently to lose it? She takes hormones (megace) for cancer treatment which make her hungry. She gained about 20 Kilos in the last two years. She needs to lose it. Any ideas what is the best way to handle this problem and where can I find a good dietitian that can come to her place and support her. She lives in Jerusalem, Israel.

A. Weight Loss For Seniors:
http://www.bistromd.com/Weight-Loss-For-Seniors-Advice.asp

Hope this helps.