Generic Name for Megace
The generic name for Megace is megestrol acetate. 1
Medication Details
Megestrol acetate is a synthetic derivative of the steroid hormone progesterone 1. It is available in oral suspension form and is FDA-approved for:
- Treatment of anorexia, cachexia, or unexplained significant weight loss in patients with AIDS 1
- Used as an appetite stimulant in cancer-related cachexia 2
Formulations and Dosing
- Standard oral suspension: 40 mg/mL 1
- Concentrated NanoCrystal Dispersion (NCD) formulation: 625 mg/5mL (Megace ES) 3
- Typical dosing range: 200-600 mg/day for appetite stimulation 2
- The liquid formulation may be less expensive and more bioavailable than tablets 2
Clinical Applications
Megestrol acetate is primarily used as an appetite stimulant in:
- AIDS-related cachexia 1
- Cancer-associated anorexia and cachexia 2, 4
- Underweight COPD patients (shown to increase weight and stimulate ventilation) 5
Efficacy
- Meta-analyses show megestrol acetate improves appetite and is associated with weight gain in cancer and AIDS patients 4, 6
- In cancer cachexia, patients gained an average of 2.25 kg compared to placebo 6
- Higher doses appear more effective for weight improvement than lower doses 7
Side Effects and Risks
Megestrol acetate is associated with several important side effects:
- Thromboembolic events (relative risk 1.84) 7
- Edema (relative risk 1.36) 7
- Increased mortality risk (relative risk 1.42) 7
- Adrenal insufficiency with prolonged use 2
- Decreased cortisol and testosterone levels 5
Cost Considerations
- Cost per month: approximately $57.41 2
- The liquid formulation may be more cost-effective than tablets 2
Monitoring Recommendations
- Regular weight monitoring to assess response
- Monitor for thromboembolic complications
- Consider discontinuation if ineffective after 4 weeks 7
- Watch for signs of adrenal insufficiency, especially with prolonged use
Megestrol acetate represents an effective option for appetite stimulation and weight gain in specific clinical scenarios, though clinicians should be aware of its potential side effects and monitor patients accordingly.