Megace Linked To Adrenal Insufficiency?

Researchers at Albany Medical College in the USA have reported a case of adrenal insufficiency in an AIDS patient that appeared to be causally related to treatment with Bristol-Myers Squibb's Megace (megestrol acetate), according to an article in AIDS Clinical Care.

After taking the drug for four years, the patient abruptly discontinued its use. Two weeks later, he experienced dramatic weight loss, vomiting, extreme fatigue, and orthostatic hypotension. Levels of basal cortisol and adrenocorticotrophic hormone were found to be abnormally low, but replacement hydrocortisone significantly eased his symptoms. Subsequently, four other patients with cachexia were studied. After one month's treatment, they had impressive weight gains, but cortisol and ACTH levels had decreased dramatically.

Similarly, a letter to the editor published in the Annals of Internal Medicine also reports a case of adrenal insufficiency which developed after six weeks of Megace therapy. These reports suggest that patients taking the appetite and weight increasing drug may need monitoring for adrenal-pituitary suppression, as well as close supervision when ending long-term treatment.