Megestrol

Structural formula
General
Non-proprietary name	Megestrol
other names	17-Hydroxy-6-methylpregna-4,6-diene-3,20-dione acetate ( megestrol acetate ); (8 R , 9 S , 10 R , 13 S , 14 S , 17 R ) -17-acetyl-17-hydroxy-6,10,13-trimethyl-2,8,9,11,12,14,15, 16-octahydro-1 H -cyclopenta [ a ] phenanthren-3-one ( Megestrol according to IUPAC );
Molecular formula	C 22 H 30 O 3
External identifiers / databases
EC number	222-628-6
ECHA InfoCard	100.020.571
PubChem	19090
ChemSpider	18023
DrugBank	DB00351
Wikidata	Q410513
Drug information
ATC code	G03 DB02 ; G03 AC05 ; L02 AB01 ;
Drug class	Progestin
properties
Molar mass	342.47 g · mol -1 ; (Megestrol acetate: 384,51 g · mol -1 );
Physical state	firmly
Melting point	213–219 ° C (megestrol acetate)
solubility	almost insoluble in water (2 mg l −1 at 37 ° C for megestrol acetate )
safety instructions
	Please note the exemption from the labeling requirement for drugs, medical devices, cosmetics, food and animal feed
GHS labeling of hazardous substances Caution
H and P phrases	H: 351-373
	P: 281
Toxicological data	56 mg kg −1 ( LD 50 , mouse , iv , megestrol acetate)
	As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions .

Megestrol is an artificially produced derivative of the natural sex hormone progesterone . As megestrol acetate , it is used as a drug for metastatic breast cancer . Since the compound also shows an appetite stimulating effect, it is often administered for the palliative care of cachectic patients. The mechanism of action for stimulating the appetite is still largely unclear.

In veterinary medicine megestrol is among other things to prevent the heat in bitches used.

Side effects

The administration of megestrol acetate over a period of one to two weeks can lead to impaired function of the adrenal glands in patients ( adrenal insufficiency , Addison's disease), as a result of which fewer adrenal hormones - in particular cortisol - are released. This undesirable side effect can be counteracted by the additional administration of glucocorticoids . The effect is also observed in veterinary medicine, for example in cats. If Megestrol is discontinued, normal cortisol levels will return after a few weeks. The inhibition of the adrenal cortex is caused by the suppression of the signal chain hypothalamus - pituitary- adrenal cortex .

Trade names

Monopreparations

Megace IT
Ovaban (veterinary medicine)

Individual evidence

↑ ^a ^b D. C. Plumb: Veterinary Drug Handbook. PharmaVet Publishing, 1995, ISBN 0-8138-2352-8 .
↑ ^a ^b Megace at RxList, accessed October 10, 2009.
↑ ^a ^b Data sheet Megestrol acetate from Sigma-Aldrich , accessed on November 7, 2016 ( PDF ).
↑ Entry on Megestrol. In: Römpp Online . Georg Thieme Verlag, accessed on September 30, 2014.
^ B. Zernikow: Palliative care for children, adolescents and young adults. Verlag Springer, 2008, ISBN 3-540-48875-8 , p. 135.
↑ TA Splinter: cachexia and cancer: a clinician's view. In: Ann Oncol 3, 1992, pp. 25-27, PMID 1382553 .
↑ AP Lopez et al.: Systematic review of megestrol acetate in the treatment of anorexia-cachexia syndrome. In: J Pain Sympt Manag 27, 2004, pp. 360-369, PMID 15050664 .
↑ ^a ^b entry to megestrol at Vetpharm, accessed on 23 June 2012 found.
^ EW Allen and GCW England: Endocrinology of reproduction in the bitch. In: Compendium of Endocrinology - Dog and Cat M. Hutchison (Editor), Schlütersche Verlagsanstalt, 1996, pp. 124-137, ISBN 3-87706-470-1 .
↑ D. Bulchandani et al: Megestrol acetate-associated adrenal insufficiency. In: Am J Geriatr Pharmacother 6, 2008, pp. 167-172. PMID 18775392 .
↑ JA Stockheim et al.: Adrenal suppression in children with the human immunodeficiency virus treated with megestrol acetate. In: J Pediatr 134, 1999, pp. 368-370. PMID 10064680 .
↑ EC Feldmann and RW Nelson: Canine and Feline Endocrinology and Reproduction. WB Saunders Company, Philadelphia (USA), 1996, ISBN 0-7216-3634-9 .
↑ DB Church et al .: Effects of proligestone and megestrol on plasma adrenocorticotrophic hormone, insulin and insulin-like growth factor-1 concentrations in cats. In: Res Vet Sci 56, 1994, pp. 175-178, PMID 8191007 .

Web links

Megestrol at MedlinePlus (English)

[plumb-1] D. C. Plumb: Veterinary Drug Handbook. PharmaVet Publishing, 1995, ISBN 0-8138-2352-8 .

[rxlist-2] Megace at RxList, accessed October 10, 2009.

[Sigma-3] Data sheet Megestrol acetate from Sigma-Aldrich , accessed on November 7, 2016 ( PDF ).

[RÖMPP_Online-4] Entry on Megestrol. In: Römpp Online . Georg Thieme Verlag, accessed on September 30, 2014.

[5] B. Zernikow: Palliative care for children, adolescents and young adults. Verlag Springer, 2008, ISBN 3-540-48875-8 , p. 135.

[PMID1382553-6] TA Splinter: cachexia and cancer: a clinician's view. In: Ann Oncol 3, 1992, pp. 25-27, PMID 1382553 .

[PMID15050664-7] AP Lopez et al.: Systematic review of megestrol acetate in the treatment of anorexia-cachexia syndrome. In: J Pain Sympt Manag 27, 2004, pp. 360-369, PMID 15050664 .

[vetpharm-8] try to megestrol at Vetpharm, accessed on 23 June 2012 found.

[9] EW Allen and GCW England: Endocrinology of reproduction in the bitch. In: Compendium of Endocrinology - Dog and Cat M. Hutchison (Editor), Schlütersche Verlagsanstalt, 1996, pp. 124-137, ISBN 3-87706-470-1 .

[10] D. Bulchandani et al: Megestrol acetate-associated adrenal insufficiency. In: Am J Geriatr Pharmacother 6, 2008, pp. 167-172. PMID 18775392 .

[11] JA Stockheim et al.: Adrenal suppression in children with the human immunodeficiency virus treated with megestrol acetate. In: J Pediatr 134, 1999, pp. 368-370. PMID 10064680 .

[12] EC Feldmann and RW Nelson: Canine and Feline Endocrinology and Reproduction. WB Saunders Company, Philadelphia (USA), 1996, ISBN 0-7216-3634-9 .

[13] DB Church et al .: Effects of proligestone and megestrol on plasma adrenocorticotrophic hormone, insulin and insulin-like growth factor-1 concentrations in cats. In: Res Vet Sci 56, 1994, pp. 175-178, PMID 8191007 .