From the Guidelines
Megace (megestrol acetate) 160 mg does not have significant glucocorticoid activity. Megestrol acetate is a synthetic progestin primarily used as an appetite stimulant in patients with cancer or HIV-associated wasting, as seen in the study published in the Journal of the National Comprehensive Cancer Network 1. While it can cause some adrenal suppression at higher doses, this is not due to direct glucocorticoid receptor activity but rather through effects on the hypothalamic-pituitary-adrenal axis.
The main use of Megace is for the treatment of anorexia/cachexia in patients with cancer, with studies showing improved appetite and slight improvements in weight gain when using this drug 1. However, it is essential to note that Megace is not a substitute for glucocorticoid therapy, and patients requiring glucocorticoids should take appropriate corticosteroid medications as prescribed.
Some key points to consider when prescribing Megace include:
- Monitoring for possible adrenal insufficiency in patients on long-term Megace therapy who experience stress, such as surgery or severe illness
- Assessing adrenal function if Megace is abruptly discontinued after long-term use
- Being aware of the potential for thromboembolic phenomena and other side effects associated with Megace use, as reported in the study 1
- Considering combination therapy approaches, which may yield the best possible outcomes for patients with cancer cachexia, as seen in the randomized phase III trial published in the same journal 1.
From the FDA Drug Label
The glucocorticoid activity of megestrol acetate tablets has not been fully evaluated. Clinical cases of new onset diabetes mellitus, exacerbation of pre-existing diabetes mellitus, and overt Cushing's syndrome have been reported in association with the chronic use of megestrol acetate Furthermore, adrenocorticotropin (ACTH) stimulation testing has revealed the frequent occurrence of asymptomatic pituitary-adrenal suppression in patients treated with chronic megestrol acetate therapy
The glucocorticoid activity of Megace (Megestrol) 160 milligrams has not been fully evaluated. However, it has been associated with adrenal insufficiency and Cushing's syndrome in some cases, indicating potential glucocorticoid effects 2.
- Key points:
- Glucocorticoid activity not fully evaluated
- Associated with adrenal insufficiency and Cushing's syndrome
- Pituitary-adrenal suppression observed in some patients The dose of 160 milligrams does not change the fact that the glucocorticoid activity has not been fully evaluated.
From the Research
Glucocorticoid Activity of Megace (Megestrol) 160 milligrams
- The glucocorticoid activity of Megace (Megestrol) 160 milligrams is not explicitly stated in the provided studies, but it is mentioned that megestrol acetate may have 'weak glucocorticoid activity' 3.
- The study published in 1995 describes a case of Cushing's syndrome in a patient treated with megestrol acetate, suggesting that high doses of the drug may have glucocorticoid effects 3.
- However, the study does not provide specific information on the glucocorticoid activity of a 160 milligram dose of Megace.
- Other studies focus on the use of megestrol acetate in the treatment of various conditions, such as advanced breast cancer 4, anorexia, cachexia, and weight loss associated with AIDS 5, and metastatic carcinoma of the prostate 6.
- A study published in 1986 evaluated the bioequivalence of two new megestrol acetate tablet formulations, including a 160 mg tablet, but did not assess glucocorticoid activity 7.