megestrol acetate

megestrol acetate

[məjes′trōl]

an antineoplastic progestational agent.

indications It is prescribed to treat endometrial cancer and more commonly to palliate advanced endometrial and breast cancer. It is also used to stimulate appetite and to promote weight gain in cachexia patients.

contraindication Hypersensitivity to the drug prohibits its use.

adverse effects Adverse effects include edema and breakthrough bleeding.

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megestrol acetate

(mjes´trōl as´tāt),
n brand name: Megace;
drug class: antineoplastic (progestin);
action: affects endometrium by antiluteinizing effect;
uses: breast, endometrial cancer, renal cell cancer.

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megestrol acetate

a synthetic progestational agent, commonly used for estrus control in dogs and cats and also in the treatment of behavioral abnormalities and a variety of inflammatory skin diseases, including miliary dermatitis and eosinophilic granuloma.

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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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megestrol acetate

Megace^® Endocrinology A synthetic progestin/
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