megestrol acetate


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megestrol acetate

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

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. 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

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.

Adverse reactions

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

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

Endocrinology
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.

Oncology
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.

Adverse effects
Dysmenorrhoea, chest pain, depression, oedema in hands and feet, brown spots on skin, hirsutism, breast tenderness, hypertension, venous thrombosis.

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
References in periodicals archive ?
Delitala, "Primary symptomatic adrenal insufficiency induced by megestrol acetate," The Netherlands Journal of Medicine, vol.
According to the company, Megace ES (megestrol acetate) is a concentrated suspension indicated for the treatment of anorexia (loss of appetite), cachexia (severe malnutrition), or an unexplained, significant weight loss in people with a diagnosis of AIDS.
After informed consent was obtained, Megestrol acetate (Megace; Bristol- Myers Squibb, Princetone, NJ) 320mg/day for three months was commenced.
Rutkowski, "Influence of megestrol acetate on nutrition and inflammation in dialysis patients: preliminary results," Acta Biochimica Polonica, vol.
A randomised trial comparing two doses of the new selective aromatase inhibitor anastrozole (Arimidex) with megestrol acetate in postmenopausal patients with advanced breast cancer.
In another study, megestrol acetate was administered for 6 months to 17 patients on dialysis.
You should not take Megace ES if you are hypersensitive to megestrol acetate or any component of the formulation.
Materials and Methods: The efficacy and safety of a new formulation of megestrol acetate concentrated suspension (575 mg/5 mL; MA-CS) was compared with traditional megestrol acetate oral suspension (800 mg/20 mL; MA-OS) in 63 HIV-infected adults with weight loss in South Africa, India, and the United States.
Afzal, 2005 (b) Antigenotoxic Effects of Ascorbic Acid Against Megestrol Acetate Induced Genotoxicity in Mice.
Trials have shown that megestrol acetate (MA) increases peripheral platelet counts and improves platelet survival.
The same study found that most plans covered the following drugs, with median copays ranging from $5-$40: lomustine, thioguanine, bexarotene, erlotinib, exemestane, anastrozole, megestrol acetate, tamoxifen, chlorambucil, procarbazine, altretamine, and others.