Megestrol Acetate

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TweetMegestrol is a man-made substance called a progestin which is similar to the female hormone progesterone. It is a type of drug known as hormonal therapy. Megestrol is mainly used in the treatment of breast cancer. Its other uses are described at the end of this factsheet.

How it is taken

Megestrol is taken as a tablet. The tablets are available in two different strengths: 40mg and 160mg.

How often do you take megestrol?

For the treatment of breast cancer the usual daily dose is 160mg. It is commonly taken once a day but can be prescribed in smaller doses to be taken at regular intervals during the day.

When a single daily dose is prescribed it should be taken at the same time each day -- the actual time does not matter.

When it is prescribed in divided doses (more than once per day) the doses should be evenly spaced throughout the day.
If you forget to take your tablet, don't worry. Levels of the drug in your blood will not change very much, but try not to miss out tablets. Remember to get a new prescription a couple of weeks before you run out of tablets and make sure you have enough for holidays etc.

How it works

The way megestrol works is not yet fully understood but it is thought that in some way it interferes with the action of female hormones.

Many breast cancers are affected by hormones -- that is, they rely on supplies of specific sex hormones to grow. On the surface of the cancer cells are proteins called receptors which are sensitive to the sex hormones. The easiest way to understand the significance of these receptors is to compare the process to that of a lock and key. When the sex hormones come into contact with the receptors they unlock or activate the cancer cells to divide and the tumour grows.

Megestrol disrupts this process in some way. It may be that it prevents the cancer cells from maintaining the receptors on their surface, effectively removing the `lock'. Or it may have a more direct means of destroying cancer cells that has not, as yet, been identified.

When is megestrol prescribed?

Your doctor will consider a number of different factors before deciding whether megestrol is the most appropriate treatment for you. They will take into account studies which have looked at the effects of megestrol on women with breast cancer.

In breast cancer, megestrol is mainly used as a treatment for women whose cancer has returned after a period of time during which it has successfully been controlled with other hormonal therapies such as tamoxifen.

Megestrol may also be used in women whose cancer has not responded to other hormonal therapies, but whose cancer cells have receptors for the sex hormone oestrogen on their surface.

Possible side effects

Because people react to drugs in different ways it is not possible to predict who is going to have side effects. Many women who take megestrol have no side effects at all while others will experience them. Very rarely if side effects are severe you may have to stop taking the drug and a different hormonal drug may be prescribed.

Usually, the side effects of megestrol are considered to be few and mild.

The most commonly reported side effect is an increase in appetite, causing some people to put on weight. Dieting can help to control this but you should consult your doctor before making any changes to your diet.

Some women have experienced mild ankle swelling caused by fluid retention and occasionally feelings of sickness (nausea) for the first few weeks of taking megestrol, but often the nausea then disappears. Some women find that the nausea continues.

Women who have had any form of blood clot or inflammation of a vein should discuss this with their doctor before taking megestrol, because it may have an effect on the circulation of blood.

Very rarely allergic reactions, jaundice and raised blood pressure have been reported.

Is megestrol safe for everyone to take?

Like most drugs, megestrol should not be taken during pregnancy. Even though women may find that their periods stop while taking megestrol it is not a contraceptive, so reliable contraception must be used while having treatment with megestrol.

People with diabetes will need to monitor their blood sugar more closely and may need to adjust their anti-diabetic medication while on treatment with megestrol. They should contact their doctor if there are any problems with the control of their diabetes.

What other conditions can megestrol be used for?
As well as being used in the treatment of breast cancer, megestrol is sometimes prescribed for the treatment of endometrial cancer (cancer of the womb), and less frequently for cancer of the prostate.

It can also be prescribed for hot flushes both in women during the menopause, and for men experiencing hot flushes as a result of treatment for prostate cancer.

As megestrol is an appetite stimulant, it can sometimes be helpful for people who have loss of appetite and weight loss due to advanced cancer.

Things to remember about megestrol acetate tablets

Keep the tablets in a safe place where children cannot reach them, as megestrol acetate could harm them.
If your doctor decides to stop the treatment, return any remaining tablets to the pharmacist. Do not flush them down the toilet or throw them away.
If you are sick just after taking the tablet tell your doctor as you may need to take another one.
If you forget to take your tablet, do not take a double dose. Let your doctor or nurse know.
For more information call CancerBACUP's Cancer Support Service on 020 7739 2280 or Freephone 0808 800 1234 to speak to a cancer specialist nurse. Lines are open Monday-Friday, 9am-7pm.

Last reviewed: November 2002


This factsheet has been compiled using information from a number of reliable sources including Martindale, The Data Sheet Compendium and the British National Formulary. Each CancerBACUP factsheet is regularly reviewed and updated by cancer doctors, pharmacists, specialist nurses, other relevant health professionals and people with cancer.

© CANCERBACUP 2002, MEGESTROL ACETATE (MEGACE). All rights reserved. No part of this publication may be reproduced or transmitted, in any form or by any means, electronic or mechanical, including photocopying, recording or any information storage and retrieval system, without permission in writing from CancerBACUP. British Association of Cancer United Patients, 3 Bath Place, Rivington Street, London EC2A 3JR. Charity Registration No. 1019719. A company limited by guarantee. Registered in England and Wales. Company No. 2803321. Registered office as above.

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