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Pharmacologic class: Hormone
Therapeutic class: Progestin, antineoplastic, appetite stimulant
Pregnancy risk category D (tablets), X (suspension)
Unknown. Thought to suppress growth of progestin-sensitive breast and endometrial tumors by inhibiting pituitary and adrenal function.
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. given as 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 625 mg (oral suspension concentrate) P.O. daily
• Endometriosis, endometrial hyperplasia
• Prostatic hypertrophy
• Hypersensitivity to drug or its components
• Known or suspected pregnancy (suspension only)
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
• Give with meals if GI upset occurs.
CNS: headache, insomnia, drowsiness, asthenia, confusion, neuropathy, hyperesthesia, abnormal thinking, paresthesias, depression, seizures
CV: hypertension, chest pain, thrombophlebitis, deep vein thrombosis
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
Musculoskeletal: carpal tunnel syndrome, back pain
Respiratory: dyspnea, cough, pneumonia, pulmonary embolism
Skin: alopecia, rash, pruritus, sweating
Other: edema, fever, weight gain, herpes infection
Drug-diagnostic tests. Lactate dehydrogenase: increased level
☞ Watch for signs and symptoms of thromboembolic disorders.
☞ Stay alert for visual disturbances, headache, abdominal pain, and hepatomegaly.
• Monitor glucose level in diabetic patients.
• 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.
A synthetic progestin/progestational anti-androgen that blocks oestrogenic effects, androgen production and androgen-mediated activity, reducing serum gonadotropin and testosterone. It reduces hot flushes by 85% in menopausal women and androgen-deprived men compared to 20% in placebo group.
Megestrol acetate is used to manage weight loss and anorexia in patients with AIDs and breast, endometrial and prostate cancer. In combination with oestradiol, it maintains castrate levels of testosterone in patients with metastatic prostate cancer.
Dysmenorrhoea, chest pain, depression, oedema in hands and feet, brown spots on skin, hirsutism, breast tenderness, hypertension, venous thrombosis.
Megace®Megestrol acetate, see there.
MegaceA brand name for MEGESTROL.
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.