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- do not use 4 weeks before a major surgery or prolonged immobilization.- some studies have linked useof this medicine with increased risk of cervical and breast cancer(Medscape, 2018).Contraindications:Hypersensitivity to drug, known or suspected
pregnancy, undiagnosed vaginal bleeding Antineoplastic,Progestins, Appetite Stimulants Megace, Megace ESMegestrolDerivative of Progestin having Antiestrogenic properties. This drug interferes with estrogen cycle causing lower levels of Luteinizing Hormone titer. Its antineoplastic propertiesmight stem from a direct effect on the endometrium through the anti-LH effects mediated through the pituitaryBreast Cancer, Endometrial Cancer, andCancer Related Cachexia (off label).Breast Cancer: 40mg PO q6hrEndometrial Cancer: 40-320mg/day PO in divided doses. Max 800mg/day.Cancer related Cachexia: 480-600 mg/day PO.Monitor patients concurrently using Insulin aspart and degludec (Medscape, 2018).Adverse Effects:HTN, insomnia, rash, sweating, amenorrhea, diarrhea, flatulence, nausea, vomiting, weight gain. (Serious SE) DVT, PE, Adrenal Insufficiency, Thrombophlebitis (Medscape, 2018).-Contraindicated in known or suspected pregnancy, thrombotic disorders, breast cancer, abnormal genital bleeding. Pregnancy Category D. Do not use during lactation Antiestrogenn/a in UStamoxifenCompetes with estrogenfor binding sites in breast and other tissues.Reduces synthesis of DNA and estrogen response- Female breast CA- palliative or adjunct treatment of advanced breast cancer- Metastasis (male and female)- Ductal CA in situ (Female)Initial-Adjunctive therapy- 20mg/day for 5yrsEstrogen receptorpositive 10yr treatmentMaintenance:20-80 mg/dayMost common:NauseaHot flashesOther:ConfusionDepressionBlurred visionVomitingVagina bleeding
- Breast CA risk reduction- Endometrial carcinoma, recurrent, metastatic, or high risk (unlabeled)- Induction of ovulation(unlabeled)- Ovarian CA, advanced, recurrent (unlabeled)- Paget’s disease of breast (risk reduction)HypercalcemiaLeukopeniaThrombocytopeniaStrokeAndrogenAndrodermAndrogelAndrogel PumpAveedDepo-TestosteroneFirst- TestosteroneTestopelVogelxxoAndrodermTestosteroneEndogenous androgen that facilitates the growth of the male sex organs and helps sustainsecondary sex characteristics in androgen- deficient males Breast cancer (female)Delayed puberty (males)Hypogonadism (males)Breast Cancer:IM: 200-400 mg every 2-4 weeksDelayed Puberty:IM: 50-200 mg every 2-4 weeks for a 4-6 monthsPellet SQ: 150-450 mg every 3-6 monthsHypogonadism:IM:50-400 mg every 2-4 weeksOr 75- 100 mg/week or 150-200 mg every 2 weeksIntranasal: 11 mg (2 pump or 1 per nostril) Skin blister or pruritus at sitePSA increase BPHHTNPVDEmotional lability, anosmia, headache, depression, nervousness, chills, confusion,aggressive behaviorCrusted skin, excoriation, bulla, xeroderma, alopeciaDecreased HDL cholesterol, HLD, hypokalemia, increased triglycerides, increased TSH, decreased libido, gynecomastia, hot flash, weight gainTesticular atrophy, prostatic disease, dysuria, UTI,
intranasal 3 times daily (6-8 hours apart) for a total of 33 mgOral: