megestrol acetate
jes´trōl as´tāt), n brand name: Megace;
drug class: antineoplastic (progestin);
action: affects endometrium by antiluteinizing effect;
uses: breast, endometrial cancer, renal cell cancer.
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.
megestrol acetate
progestational antiandrogen that blocks estrogenic effects, androgen production and androgen-mediated activity, ↓ serum gonadotropin and testosterone Oncology A progestin used to manage weight loss, anorexia in Pts with AIDs, breast, endometrial, and rarely prostate CA Adverse effects Dysmenorrhea, chest pain, depression, edema in hands, feet, brown spots on skin, hirsutism, breast tenderness, HTN, venous thrombosis
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