Megestrol
MEGACE
Pronunciation: me-JES-trol
“Meg gestating Mega ass”
progestin used to stimulate appetite
What it isProgestin with appetite-stimulating effect; anorexia and cachexia, and hormone-responsive cancer.
Why this oneIts strong appetite effect adds mainly fat rather than lean mass or functional recovery.
What limits itThromboembolism and adrenal suppression can be severe, and cachexia treatment has not shown a survival benefit.
FDA-approved for
- anorexia and cachexia in AIDS (1993)
- breast and endometrial cancer
Off-label
- appetite stimulation in non-AIDS cachexia
- hot flashes
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Breast cancer (palliative) | Adult | 160 mg/day (40 mg QID) | 160 mg/day | |
| Endometrial carcinoma (palliative) | Adult | 40–320 mg/day in divided doses | 320 mg/day |
Renal Undefined
Hepatic Undefined
Instructions
- At least 2 months of continuous treatment is an adequate trial for determining efficacy.
Available strengths
- tab 20, 40 mg
- susp 40, 125 mg/mL
Cautions
- Thromboembolic phenomena (thrombophlebitis, pulmonary embolism, sometimes fatal).
- Glucocorticoid effects (see WARNINGS).
- Weight gain from increased appetite.
- Pregnancy Category D.
Adverse reactions
- weight gain
- thromboembolic phenomena
- heart failure
- nausea and vomiting, edema
- breakthrough menstrual bleeding
- dyspnea, tumor flare (± hypercalcemia)
- hyperglycemia/glucose intolerance, hypertension
- mood changes, hot flashes, sweating, rash
Pregnancy Pregnancy Category D.
Lactation Undefined
Cost
Megestrol (MEGACE)
What pharmacies pay · NADAC 9/30/26
Generic entry1987
⚠ BOXED WARNING
- Thromboembolic events
Classes and tags
Clinical profile
Legacy pregnancy categoryX
Defining liabilityVenous thromboembolism and hormone-related adverse effects; estrogen also lowers lamotrigine exposure.
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