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# Megestrol Acetate
## Overview
Megestrol acetate is a synthetic progestin with antineoplastic and appetite-stimulating properties.
## Primary Indications
* Palliative treatment of advanced breast cancer in postmenopausal women.
* Palliative treatment of advanced endometrial carcinoma.
* Management of anorexia, cachexia, or unexplained significant weight loss in patients with acquired immunodeficiency syndrome (AIDS).
## Adult Dosing
* **Breast Cancer:** 160 mg (160 mL) once daily.
* **Endometrial Carcinoma:** 40 mg (40 mL) to 320 mg (320 mL) once daily, or in divided doses. Doses of 40 mg (40 mL) four times daily have been used.
* **Cachexia/Anorexia in AIDS:** 400-800 mg (400-800 mL) once daily.
## Pediatric Dosing
There is no established pediatric dose. Safety and efficacy have not been determined.
## Dose Adjustments
No specific dose adjustments are listed for hepatic or renal impairment. Caution is advised in patients with pre-existing conditions.
## Contraindications
* Known or suspected pregnancy.
* Known hypersensitivity to megestrol acetate or any of its components.
## Adverse Effects
* **Common:** Weight gain, increased appetite, hypertension, hot flashes, dyspnea, nausea, vaginal bleeding, edema, rash, pain, insomnia, mood changes.
* **Serious:** Thrombophlebitis, pulmonary embolism, amenorrhea, adrenal suppression, hyperglycemia, Stevens-Johnson syndrome, toxic epidermal necrolysis, depression, seizures.
## Key Drug Interactions
* **Aminoglutethimide:** May decrease megestrol acetate levels.
* **CYP3A4 Inhibitors/Inducers:** May affect megestrol acetate concentrations.
* **Oral Antidiabetics:** Hyperglycemia may occur, requiring dose adjustment of antidiabetics.
## Monitoring
* Regular physical examinations, including blood pressure.
* Monitoring for signs of thromboembolic events.
* Electrolyte levels, glucose.
* For patients with diabetes, blood glucose monitoring.
## Clinical Pearls
* Oral suspension contains no preservatives and should be refrigerated after opening.
* Shake oral suspension well before use.
* May cause significant fluid retention; monitor patients with cardiac or renal impairment.
* Women of childbearing potential should use effective non-hormonal contraception.
* Long-term use can lead to adrenal suppression.
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**Disclaimer:** This information is for educational purposes only and does not substitute for professional medical advice. Always consult with a qualified healthcare provider and refer to the most current prescribing information for complete details before making any treatment decisions.
