Megestrol acetate is a synthetic progestational hormone initially developed as a contraceptive. Nowadays, it is used as a drug to treat anorexia and cachexia (or unexplained weight loss) and as an antineoplastic agent to treat inoperable breast cancer, endometrial cancer, and prostate cancer (palliative treatment). Megestrol has the same physiologic effects as natural progesterone: induction of secretory changes in the endometrium, increase in basal body temperature, and pituitary inhibition. By inhibiting the release of GnRH in the hypothalamus, there is a decrease in LH and FSH synthesis in the anterior pituitary gland. This results in a low level of LH, because the ovaries need a surge of this hormone to release the egg, there is no ovulation. The mechanism of action of megestrol's antianorexic and anticachetic is undetermined. It is thought to act by stimulating the appetite or by its metabolic effects (via interferences with the production or action of mediators like cachectin; inhibition of the adipocyte lipogenic enzymes). This drug is administered as an oral tablet.
References
Megestrol acetate Pathway References
Wishart DS, Feunang YD, Guo AC, Lo EJ, Marcu A, Grant JR, Sajed T, Johnson D, Li C, Sayeeda Z, Assempour N, Iynkkaran I, Liu Y, Maciejewski A, Gale N, Wilson A, Chin L, Cummings R, Le D, Pon A, Knox C, Wilson M: DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic Acids Res. 2018 Jan 4;46(D1):D1074-D1082. doi: 10.1093/nar/gkx1037.
Pascual Lopez A, Roque i Figuls M, Urrutia Cuchi G, Berenstein EG, Almenar Pasies B, Balcells Alegre M, Herdman M: Systematic review of megestrol acetate in the treatment of anorexia-cachexia syndrome. J Pain Symptom Manage. 2004 Apr;27(4):360-9. doi: 10.1016/j.jpainsymman.2003.09.007.
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