Megestrol is indicated for:

▶️ Oncology Use (Tablets)

• Advanced/metastatic breast cancer: 160 mg/day

• Recurrent/inoperable endometrial carcinoma: 40–320 mg/day (divided doses)

Requires ≥2 months of continuous therapy for efficacy assessment

▶️ Supportive Care (Oral Suspension)

• Treatment of AIDS-related cachexia (unexplained weight loss >10%)

• Cancer-associated anorexia-cachexia syndrome

Pharmacology & Mechanism

• Progestational Agent: Synthetic antineoplastic with dual action:

  1. Suppresses pituitary gonadotropins → reduces estrogen-driven tumor growth

  2. Direct cytotoxic effect on hormone-sensitive cancer cells

• Pharmacokinetics:

  • Peak plasma concentration: 2–3 hours post-dose

  • Half-life: 33–38 hours

  • Excretion: Urine (66%), Feces (20%)

Dosage & Administration

*Minimum 8-week trial recommended for cachexia response*

Contraindications & Safety Alerts

❌ Absolute Contraindications:

• Pregnancy (Category X - Fetal abnormalities risk)

• Hypersensitivity to megestrol acetate

• History of thromboembolism (DVT/PE)

⚠️ Critical Precautions:

• Fluid retention: Exacerbates CHF, hypertension, or renal disease

• Adrenal suppression: Monitor for Cushingoid symptoms with long-term use

• Hepatic impairment: Requires dose reduction (primary metabolism route)

• Elderly patients: Increased risk of renal/toxicity (adjust for CrCl <30 mL/min)

Adverse Effects

Special Populations

• Pregnancy/Lactation:

  • Contraindicated - Virilization of female fetuses

  • Discontinue breastfeeding (excretion unknown)

• Pediatrics: Safety/efficacy not established

• Renal Impairment: Reduce dose if CrCl <30 mL/min

• Hepatic Impairment: Avoid in severe disease

Drug Interactions & Warnings

• Fluid Retention Risk: Avoid concurrent NSAIDs/corticosteroids

• Diabetic Patients: Monitor glucose (progestins reduce insulin sensitivity)

• No Known Pharmacokinetic Interactions - Limited interaction data available

Overdose Management

• Symptoms: Severe nausea, dyspnea, lethargy

• Treatment: Supportive care (no specific antidote)

*Maximum tested dose: 1600 mg/day for 6+ months*

Storage & Handling

• Store below 30°C in original packaging

• Protect from light/humidity

• Keep out of children’s reach

Medical Notice: Use only under specialist supervision. Not a substitute for surgery/chemotherapy.
Registered চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন