Megestrol acetate (Megace)

Megestrol acetate (Megace) is a progesterone - a female sex hormone. It is an approved drug for the treatment of several forms of cancer. In the United States is also approved for treating loss of appetite, wasting or unexplained significant weight loss in men and women with AIDS, alone or in combination with other drugs. It is manufactured by Bristol-Myers Squibb.

For people with AIDS, megestrol acetate is administered in an oral suspension. The standard form for cancer is a tablet.

Megestrol acetate has been studied for treatment of low growth rate in children with HIV. Although it did increase body weight, it did not have any effect on the children’s height.1 Studies also suggest that megestrol acetate can reverse the low levels of platelets (thrombocytopenia) that can be caused by HIV and its treatment, without affecting HIV viral loads or CD4 cell counts.2

Side-effects include diarrhoea, rash, impotence, water retention, flatulence and weakness, as well as liver enzyme elevations and high blood sugar levels, which can require insulin treatment.3 4 Megestrol acetate has also been linked to bone pain and bone damage in people with HIV. It can also cause suppression of the adrenal glands, which may require replacement of glucocorticoid hormones.5 6 Megestrol acetate is not recommended during the first four months of pregnancy.

Weight gained as a result of taking megestrol acetate tends to be fat rather than muscle, and studies have shown that weight gain on megestrol treatment is not associated with improved survival.7 8

Megestrol acetate does not interact with any currently available protease inhibitors or non-nucleoside reverse transcriptase inhibitors (NNRTIs), and can be taken safely by patients taking antiretroviral therapy.9

References

  1. Clarick RH et al. Megestrol acetate treatment of growth failure in children infected with human immunodeficiency virus. Pediatrics 99: 354-357, 1997
  2. Gomez F et al. Treatment with megestrol acetate improves human immunodeficiency virus-associated immune thrombocytopenia. Clin Diagn Lab Immunol 9: 583-587, 2002
  3. Timpone JG et al. The safety and pharmacokinetics of single-agent and combination therapy with megestrol acetate and dronabinol for the treatment of HIV wasting syndrome. The DATRI 004 Study Group. Division of AIDS Treatment Research Initiative. AIDS Res Hum Retroviruses 13: 305-315, 1997
  4. Gonzalez del Valle L et al. Hyperglycemia induced by megestrol acetate in a patient with AIDS. Ann Pharmacother 30: 1113-1114, 1996
  5. Stockheim JA et al. Adrenal suppression in children with the human immunodeficiency virus treated with megestrol acetate. J Pediatr 134: 368-370, 1999
  6. Khoo SH et al. Induction of adrenal suppression by megestrol acetate. Ann Intern Med 124: 613, 1996
  7. Oster MH et al. Megestrol acetate in patients with AIDS and cachexia. Ann Intern Med 121: 400-408, 1994
  8. Batterham MJ et al. A comparison of megestrol acetate, nandrolone decanoate and dietary counselling for HIV associated weight loss. Int J Androl 24: 232-240, 2001
  9. Mwamburi DM et al. Comparing megestrol acetate therapy with oxandrolone therapy for HIV-related weight loss: similar results in 2 months. Clin Infect Dis 38: 895-902, 2004

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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.