Progestogen
Megestrol acetate
Brand names: Megace
Adult dose
Dose: Endometrial cancer: 40–320mg/day. Anorexia/cachexia: 160–800mg/day
Route: PO
Frequency: OD
Clinical pearls
- Advanced breast/endometrial cancer; cancer-associated cachexia
- Higher VTE risk than other progestogens at oncology doses
Contraindications
- Active VTE
- Pregnancy
- Severe hepatic impairment
- Hypersensitivity
Side effects
- Weight gain
- Fluid retention
- VTE
- Adrenal suppression (high-dose)
- Hyperglycaemia
Interactions
- Warfarin
- Insulin/sulfonylureas (hyperglycaemia)
Monitoring
- Weight
- Glucose
- Adrenal function in long-term use
Reference: BNF; SmPC; https://bnf.nice.org.uk/drugs/megestrol-acetate/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Myeloid Leukaemia Presentation · BSH; NICE — NG146
- Tumour Lysis Syndrome · Cairo-Bishop; BSH; NICE — Best Practice
- Spinal Anaesthesia Hypotension Management · AAGBI; ASA
- Pre-Eclampsia / Eclampsia in ED · NICE NG133; RCOG Green-top 10A
- Suspected Ectopic Pregnancy · NICE NG126; RCOG Green-top 21
- Polycystic Ovary Syndrome (PCOS) · International PCOS Guideline 2023; NICE CKS