megestrol acetate
Megace

Available forms
Available by prescription only
Suspension: 200 mg/5 ml
Tablets: 20 mg, 40 mg

Indications and dosages
Dosage and indications may vary. Check current literature for recommended protocol.
 Palliative treatment of breast carcinoma. Adults: 40 mg (tablets) P.O. q.i.d.
 Palliative treatment of endometrial carcinoma. Adults: 10 to 80 mg (tablets) P.O. q.i.d.
 Anorexia, cachexia, or weight loss in patients with AIDS. Adults: 800 mg (suspension) P.O. daily; 100 to 400 mg for AIDS-related cachexia.
 Anorexia or cachexia in patients with neoplastic disease ◇. Adults: 480 to 600 mg P.O. daily.

Pharmacodynamics
Antineoplastic action: Megestrol inhibits growth and causes regression of progestin-sensitive breast and endometrial cancer tissue by an unknown mechanism.
Weight-raising action: Mechanism for weight gain is unknown. Drug may stimulate appetite by interfering with the production of mediators such as cachectin.

Pharmacokinetics
Absorption: Well absorbed across the GI tract.
Distribution: Appears to be stored in fatty tissue and is highly bound to plasma proteins.
Metabolism: Completely metabolized in the liver.
Excretion: Metabolites are eliminated primarily through the kidneys.

Contraindications and precautions
Contraindicated in patients hypersensitive to drug and in pregnant women (especially during first 4 months). Use cautiously in patients with history of thrombophlebitis.

Interactions
None reported.

Adverse reactions
CV: thrombophlebitis, hypertension, edema, chest pain.
EENT: pharyngitis.
GI: increased appetite, nausea, vomiting, diarrhea, flatulence.
GU: breakthrough menstrual bleeding, impotence.
Hepatic: hepatomegaly.
Metabolic: weight gain, hyperglycemia.
Musculoskeletal: carpal tunnel syndrome.
Respiratory: pulmonary embolism, dyspnea, pneumonia, cough.
Skin: alopecia, rash, pruritus, candidiasis.
Other: decreased libido.

Effects on lab test results
• May increase glucose levels.

Overdose and treatment
No information available.

Special considerations
• Investigational uses include prevention of pregnancy, treatment of prostatic hypertrophy, endometriosis, and endometrial hyperplasias.
• Glucose levels may increase in diabetic patients.
• Drug is relatively nontoxic with a low risk of adverse effects.
• For patients with cancer, 2 months is an adequate trial period.
• Monitor hematopoietic function and liver function.
• Store tablets at 59° to 86° F (15° to 30° C) and oral suspension at 77° F (25° C) or less.

Patient education
• Inform patient that therapeutic response isn’t immediate.

Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE THREATENING.
◆ Canada only
◇ Unlabeled clinical use