Megestrol
MEGACE
What it isProgestin with appetite-stimulating effect; anorexia and cachexia, and hormone-responsive cancer.
Why this oneIts strong appetite effect adds mainly fat rather than lean mass or functional recovery.
What limits itThromboembolism and adrenal suppression can be severe, and cachexia treatment has not shown a survival benefit.
FDA-approved for
- anorexia and cachexia in AIDS (1993)
- breast and endometrial cancer
Off-label
- appetite stimulation in non-AIDS cachexia
- hot flashes
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Breast cancer (palliative) | Adult | 160 mg/day (40 mg QID) | 160 mg/day | |
| Endometrial carcinoma (palliative) | Adult | 40–320 mg/day in divided doses | 320 mg/day |
Renal Undefined
Hepatic Undefined
Instructions
- At least 2 months of continuous treatment is an adequate trial for determining efficacy.
Cautions
- Thromboembolic phenomena (thrombophlebitis, pulmonary embolism, sometimes fatal).
- Glucocorticoid effects (see WARNINGS).
- Weight gain from increased appetite.
- Pregnancy Category D.
Adverse reactions
- weight gain
- thromboembolic phenomena
- heart failure
- nausea and vomiting, edema
- breakthrough menstrual bleeding
- dyspnea, tumor flare (± hypercalcemia)
- hyperglycemia/glucose intolerance, hypertension
- mood changes, hot flashes, sweating, rash
Pregnancy Pregnancy Category D.
Lactation Undefined
⚠ BOXED WARNING
- Thromboembolic events
Cost, est. cash$5–$150/month
Generic entry1987
Classes and tags
Clinical profile
Legacy pregnancy categoryX
Defining liabilityVenous thromboembolism and hormone-related adverse effects; estrogen also lowers lamotrigine exposure.
Mechanism of action: Megestrol ballicule
Open Megestrol in the interactive console ↗
Memory aids: mascots and interaction avatars
progestin used to stimulate appetite
