MEGESTROL ACETATE
| MEGESTROL ACETATE (me-jess'trole) Megace, Megace ES Classifications: antineoplastic; hormone; progestin; Therapeutic: antineoplastic; progestin Prototype: Progesterone Pregnancy Category: X (oral suspension) and D (tablets) |
Availability
40 mg/mL, 125 mg/mL suspension; 20 mg, 40 mg tablets
Action
Progestational hormone with antineoplastic properties. Mechanism of action unclear; however, an antiluteinizing effect mediated via the pituitary has been postulated.
Therapeutic Effect
Antineoplastic agent effective for treating breast, renal cell, or endometrial carcinoma. Also effective as an appetite enhancer. Has a local effect when instilled directly into the endometrial cavity.
Uses
Palliative agent for treatment of advanced carcinoma of breast or endometrium. AIDS-related wasting or cachexia.
Contraindications
Diagnostic test for pregnancy; pregnancy category X (oral suspension) and category D (tablet); lactation.
Cautious Use
Older adults; severe hepatic disease; diabetes mellitus; renal impairment; thromboembolic disease.
Route & Dosage
| Palliative Treatment for Advanced Breast Cancer Adult: PO 40 mg q.i.d. Palliative Treatment for Advanced Endometrial Cancer Adult: PO 40–320 mg/d in divided doses Appetite Stimulation Adult: PO 200 mg q6h HIV-Related Cachexia Adult: PO (suspension) 800 mg q.d. or 625 mg of Megace ES |
Administration
Oral- Give with meals or food if GI distress occurs.
- Shake oral suspension well before use.
- Store at 15°–30° C (59°–86° F) in tightly closed container.
Adverse Effects (≥1%)
Urogenital: Vaginal bleeding. Body as a Whole: Breast tenderness, headache, increased appetite, weight gain, allergic-type reactions (including bronchial asthma). GI: Abdominal pain, nausea, vomiting. Hematologic: DVT.Interactions
Drug: May increase levels of warfarin; may decrease renal clearance of dofetilide.Pharmacokinetics
Absorption: Appears to be well absorbed from GI tract. Onset: Onset of objective response in breast cancer in 6–8 wk. Peak: 1–3 h. Duration: 3–12 mo. Metabolism: Completely metabolized in liver. Elimination: 57–78% of dose excreted in urine within 10 d.Nursing Implications
Assessment & Drug Effects
- Monitor weight periodically.
- Notify physician if abdominal pain, headache, nausea, vomiting, or breast tenderness become pronounced.
- Monitor for allergic reactions, including breathing distress characteristic of asthma, rash, urticaria, anaphylaxis, tachypnea, anxiety. Stop medication if they appear and notify physician.
Patient & Family Education
- Use contraception measures during therapy for carcinoma.
- Learn breast self-examination.
- Learn S&S of thrombophlebitis (see Appendix F).
- Review package insert to ensure understanding of megestrol therapy.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug