From the FDA Drug Label
DOSAGE AND ADMINISTRATION Breast cancer: 160 mg/day (40 mg q.i.d.). Endometrial carcinoma: 40 to 320 mg/day in divided doses. At least 2 months of continuous treatment is considered an adequate period for determining the efficacy of megestrol acetate. The FDA drug label does not answer the question.
From the Research
Megestrol acetate (Megace) should be prescribed at a dose of 800 mg daily for male patients with COPD experiencing weight loss and decreased appetite, as this dose has been shown to stimulate weight gain and ventilation in underweight COPD patients 1. The medication comes as an oral suspension (40 mg/mL) or tablets, with the suspension often preferred for better absorption.
- Treatment duration usually ranges from 8-12 weeks, with periodic reassessment of weight gain and appetite improvement.
- Patients should take the medication consistently at the same time each day, preferably with food to minimize gastrointestinal side effects.
- Megestrol acetate works by stimulating appetite through multiple mechanisms, including antagonizing inflammatory cytokines and modulating neuropeptide Y pathways that regulate hunger.
- It's essential to monitor for potential side effects, including fluid retention, hyperglycemia, adrenal suppression, and increased risk of thromboembolism, particularly in COPD patients who may already have cardiovascular risk factors 2.
- Additionally, nutritional supplementation therapy has been shown to be effective for maintaining and improving muscle strength and exercise tolerance in poorly nourished COPD patients, thereby decreasing morbidity and mortality 3, 4.
- However, the most recent and highest quality study 1 supports the use of Megestrol acetate at a dose of 800 mg daily, which should be the primary consideration for treatment.