What is the typical dosing regimen for Megace (megestrol acetate) as an appetite stimulant?

From the Guidelines

Megestrol acetate (Megace) should be prescribed at a dose of 160-480 mg daily as an appetite stimulant for patients with cachexia or anorexia associated with cancer. The medication is usually administered as an oral suspension, with the optimal dose being 160 mg daily, as there is no evidence that doses greater than 480 mg daily have a higher efficacy 1. Some key points to consider when prescribing Megace include:

• The appetite-stimulating effects may take 1-3 weeks to become noticeable
• Common side effects include fluid retention, hypertension, hyperglycemia, adrenal suppression, and increased risk of thromboembolic events
• Blood glucose should be monitored in diabetic patients, and the medication should be used cautiously in patients with a history of deep vein thrombosis
• The medication should not be stopped abruptly due to risk of adrenal insufficiency, particularly after long-term use It's also worth noting that other appetite stimulants, such as dronabinol, have been studied, but the evidence is limited and inconsistent, and they are not recommended as a first-line treatment 1. In terms of other options, ghrelin and its analogues have shown promise in increasing appetite and food intake, but more research is needed to fully understand their potential as appetite stimulants 1. Overall, Megestrol acetate remains a commonly used and effective treatment for cachexia and anorexia in cancer patients, and should be prescribed at a dose of 160-480 mg daily.

From the FDA Drug Label

The recommended adult initial dosage of Megestrol Acetate Oral Suspension, USP is 800mg/day (20 mL/day). In clinical trials evaluating different dose schedules, daily doses of 400 and 800 mg/day were found to be clinically effective.

The typical dosing regimen for Megace (megestrol acetate) as an appetite stimulant is 800mg/day.

• The dose can be administered as 20 mL/day of the oral suspension.
• Daily doses of 400 mg/day and 800 mg/day were found to be clinically effective in clinical trials 2.
• A study also showed that 800 mg/day was statistically significantly more effective than 400 mg/day and 100 mg/day in improving appetite and weight gain in AIDS patients with anorexia/cachexia and significant weight loss 2.

From the Research

Megace Dosing Regimen

The typical dosing regimen for Megace (megestrol acetate) as an appetite stimulant varies depending on the patient population and the specific condition being treated.

• For advanced cancer patients, a starting dose of 80 mg twice daily after meals is recommended 3.
• For maintenance dialysis patients, a dose of 400 mg/day has been shown to be effective in improving appetite and nutritional status 4.
• In children with malignant solid tumors, megestrol acetate therapy has been used to reverse anorexia, with significant increases in anthropometric measurements, appetite, and energy intake 5.
• In children with cancer/treatment-related cachexia, megestrol acetate has been used in patients who did not respond to cyproheptadine hydrochloride, with an average weight gain of 2.5 kg 6.
• For HIV-associated wasting, a dosage range of 400 to 800 mg/day has been recommended, with patients advised of possible adverse effects and monitored closely 7.

Key Considerations

• The dose of megestrol acetate may need to be adjusted based on the patient's response and tolerance to the medication.
• Patients should be monitored for potential side effects, such as drowsiness, low cortisol levels, and hyperlipidemia.
• Megestrol acetate may be more effective when used in combination with other therapies, such as muscle-building exercise programs and anabolic agents.