From the Guidelines
Megace (megestrol acetate) is a synthetic form of the hormone progesterone that is primarily used to stimulate appetite and promote weight gain in patients with cancer or HIV/AIDS-associated wasting syndrome, with a typical dosing range of 400-800 mg daily for adults. The medication works by affecting the hunger center in the brain and may also have anti-inflammatory effects that help reduce the metabolic changes causing weight loss in chronic diseases [ 1 ]. Some of the key benefits of megestrol acetate include improvements in appetite, weight, and quality of life, as shown in a 2020 study published in the Journal of Clinical Oncology [ 1 ]. However, it's essential to consider the potential side effects, such as fluid retention, increased blood sugar, blood clots, and menstrual changes in women [ 1 ]. Patients with diabetes should monitor their blood sugar closely while taking this medication, and those with a history of blood clots should discuss the risks with their doctor before starting treatment [ 1 ]. Results from megestrol acetate therapy typically begin within a few weeks of starting treatment [ 1 ]. In terms of clinical use, megestrol acetate can be used to manage anorexia and cachexia in patients with advanced cancer, as outlined in the 2016 palliative care guidelines published in the Journal of the National Comprehensive Cancer Network [ 1 ]. The guidelines recommend considering appetite stimulants like megestrol acetate (400-800 mg/d) for patients with an estimated life expectancy of months to years [ 1 ]. Overall, megestrol acetate is a valuable treatment option for patients with significant weight loss due to chronic diseases, and its benefits and risks should be carefully considered in clinical practice. Some key points to consider when prescribing megestrol acetate include:
- Typical dosing range: 400-800 mg daily for adults
- Potential side effects: fluid retention, increased blood sugar, blood clots, and menstrual changes in women
- Benefits: improvements in appetite, weight, and quality of life
- Clinical use: management of anorexia and cachexia in patients with advanced cancer.
From the FDA Drug Label
Megestrol acetate oral suspension, USP is indicated for the treatment of anorexia, cachexia, or an unexplained, significant weight loss in patients with a diagnosis of acquired immunodeficiency syndrome (AIDS). Megestrol Acetate Oral Suspension, USP contains megestrol acetate, a synthetic derivative of the steroid hormone, progesterone.
Megace (Megestrol acetate) is a progesterone derivative used for the treatment of:
- Anorexia
- Cachexia
- Unexplained, significant weight loss in patients with AIDS 2
From the Research
What is Megace (Megestrol acetate)
- Megestrol acetate (MA) is a progestational agent used to improve appetite and increase weight in cancer-associated anorexia 3, 4, 5, 6, 7.
- It is also used to treat anorexia, cachexia, or unexplained weight loss in patients with AIDS 3, 4.
Clinical Use
- MA is used to palliate anorexia-cachexia syndrome in patients with cancer, AIDS, and other underlying pathologies 3, 4.
- It has been shown to improve appetite and weight gain in cancer patients 3, 4, 6, 7.
- MA has also been found to improve quality of life in patients with cancer anorexia/cachexia syndrome 5.
- The optimal dose of MA is not well defined, but higher doses have been associated with greater weight gain 4, 7.
- Common side effects of MA include oedema, thromboembolic phenomena, and death 4.
Efficacy
- Meta-analysis has shown a benefit of MA compared with placebo in improving appetite and weight gain in cancer patients 3, 4.
- MA has also been found to be effective in improving appetite and weight gain in patients with AIDS and other underlying pathologies 4.
- However, the evidence for the use of MA in these patient populations is limited, and more research is needed to fully understand its efficacy and safety 3, 4.