Apemeg

Indications

• Loss of appetite and marked weight loss in people with advanced cancer or AIDS (mainly the oral suspension).
• Supportive (palliative) treatment of advanced breast cancer or cancer of the womb lining (endometrial cancer), as decided by the cancer specialist (mainly the tablets).

How It Works

Megestrol Acetate is a man-made form of progesterone (a progestogen). It increases appetite and helps weight gain, although exactly how is not fully known. In some breast and womb cancers it works against the hormones that help the cancer grow.

Dosage and Administration

Only as prescribed. The doctor sets the dose and how long to take it, depending on the condition. Appetite treatment is usually taken once a day for several weeks, then reviewed. Cancer treatment is usually taken daily for at least 2 months to judge its effect.

Shake the suspension well and measure each dose with the cup or syringe provided. Do not stop suddenly after long use; the doctor will advise how to stop. Children: not for use unless a specialist advises.

Interactions

Megestrol Acetate can raise blood sugar, so diabetes medicines may need adjusting. It may increase the effect of Warfarin. It can raise the level of Dofetilide, a heart rhythm medicine, and lower the level of some HIV medicines such as Indinavir. Tell your doctor about all medicines, vitamins and herbal products you take.

Contraindications

• Pregnancy
• Allergy to Megestrol Acetate or any ingredient of the product
• Use together with Dofetilide

Side Effects

Common: weight gain, increased appetite, fluid retention and swelling, raised blood sugar, nausea, trouble sleeping, rash, hot flushes, irregular vaginal bleeding, and reduced sexual ability in men.

Less often: high blood pressure, mood changes and breathlessness.

Get medical help at once for pain, swelling or warmth in one leg; chest pain or sudden breathlessness; or severe weakness, dizziness, vomiting or fainting, especially during an illness or after stopping the medicine (this can be a sign of low adrenal hormones).

Pregnancy and Lactation

Megestrol Acetate can harm an unborn baby and must not be used in pregnancy. Women who could become pregnant should use reliable non-hormonal contraception. Do not breastfeed during treatment.

Precautions and Warnings

• Take extra care if you have diabetes, a past blood clot, heart failure, or liver or kidney disease.
• Blood sugar may need checking regularly.
• Long use can lower the body's own adrenal hormones; tell any doctor treating you that you take this medicine, especially before surgery or during a serious illness.

Overdose

Serious effects are not expected from a single large dose, but contact a doctor or go to hospital if too much is taken; treatment is supportive.

Therapeutic Class

Progestogen (hormonal anticancer medicine and appetite stimulant).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Do not freeze the suspension.