megestrol (Rx)

Brand and Other Names:Megace, Megace ES
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 20mg
  • 40mg

oral suspension

  • 200mg/5mL
  • 625mg/5mL
more...

AIDS-Related Cachexia

Megace: 800 mg/day PO

Megace ES: 312.5-625 mg/day PO

Breast Cancer

40 mg PO q6hr

Endometrial Cancer

40-320 mg/day PO in divided doses; evaluate efficacy after 2 months of treatment; up to 800 mg/day may be used

Cancer-Related Cachexia (Off-label)

480-600 mg/day PO

Dosing Modifications

Renal impairment: Use with caution; in normal renal function, 57-78% is excreted in urine within 10 days

Safety and efficacy not established

Next:

Interactions

Interaction Checker

and megestrol

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            Adverse Effects

            Frequency Not Defined

            Common

            • Hypertension
            • Insomnia, mood swings
            • Rash, sweating
            • Amenorrhea, breakthrough bleeding, change in menstrual flow, hot sweats, impotence, spotting
            • Diarrhea, flatulence, indigestion, nausea, vomiting, weight gain

            Serious

            • Deep vein thrombosis (DVT)
            • Pulmonary embolism
            • Thrombophlebitis
            • Anemia
            • Adrenal insufficiency

            Postmarketing report

            Asthenia, rash, impotence

            Overdose may cause shortness of breath, cough, unsteady gait, listlessness, chest pain

            Previous
            Next:

            Warnings

            Contraindications

            Known or suspected pregnancy

            Acute thrombophlebitis, thromboembolic disorder, breast cancer

            Undiagnosed abnormal genital bleeding

            Prophylaxis of weight loss

            Documented hypersensitivity

            May induce vaginal bleeding in women

            Cautions

            Diabetes mellitus

            History of thromboembolic disease

            Not to be used as prophylaxis against weight loss or as diagnostic test for pregnancy

            Adrenal insufficiency may occur in patients receiving or being withdrawn from long-term megestrol treatment

            Megestrol is a progesterone derivative which may induce vaginal bleeding in women

            Cushing syndrome reported with thearpy

            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy

            Obtain a pregnancy test in females of reproductive potential prior to initiating treatment; advise females of reproductive potential to use effective contraception while taking drug

            There are no available human data to assess for any drug-associated risks of miscarriage, birth defects, or adverse maternal or fetal outcomes; advise a pregnant women of potential risk to fetus

            Pregnancy testing is recommended prior to treatment

            Contraception

            • Therapy may cause fetal harm when administered during pregnancy; advise females of reproductive potential to use effective contraception during treatment

            Animal data

            • Based on animal data, megestrol acetate may cause fetal harm when administered to a pregnant woman and is contraindicated during pregnancy; there are no adequate animal developmental toxicity data at clinically relevant doses; pregnant rats treated with low doses resulted in reduction in fetal weight and number of live births, and feminization of male fetuses at doses below maximum recommended clinical dosing based on body surface area

            Lactation

            The Centers for Disease Control and Prevention recommend that HIV-1 infected mothers not breastfeed their infants to avoid risking postnatal transmission of HIV-1; the drug is present in human milk; there are no data on effects of drug on breastfed infant or on milk production; because of potential for HIV transmission and adverse effects on a breastfed infant, instruct mothers not to breastfeed if they are receiving therapy

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Progestin derivative with antiestrogenic properties; interferes with estrogen cycle, resulting in lower luteinizing hormone (LH) titer; antineoplastic properties may come from direct effect on endometrium through anti-LH effect mediated via pituitary

            Absorption

            Bioavailability: Well absorbed PO

            Peak plasma time: 1-3 hr (tablet); 3-5 hr (suspension)

            Metabolism

            Metabolized by liver

            Metabolites: Sulfate and glucuronide metabolites (inactive)

            Elimination

            Half-life: 13-105 hr (mean, 34 hr)

            Excretion: Urine (57-78%), feces (8-30%)

            Previous
            Next:

            Images

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.