Do not use 4 weeks before a major surgery or

- do not use 4 weeks before a
major surgery or prolonged
immobilization.
- some studies have linked use
of 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 ES
Megestrol Derivative of Progestin
having Antiestrogenic
properties. This drug
interferes with estrogen
cycle causing lower
levels of Luteinizing
Hormone titer. Its
antineoplastic properties
might stem from a
direct effect on the
endometrium through
the anti-LH effects
mediated through the
pituitary
Breast Cancer,
Endometrial Cancer, and
Cancer Related
Cachexia (off label).
Breast Cancer: 40mg
PO q6hr
Endometrial 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
Antiestrogen
n/a in US tamoxifen
Competes with estrogen
for 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 5yrs
Estrogen receptor
positive 10yr treatment
Maintenance:
20-80 mg/day
Most common:
Nausea
Hot flashes
Other:
Confusion
Depression
Blurred vision
Vomiting
Vagina 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)
Hypercalcemia
Leukopenia
Thrombocytopenia
Stroke
Androgen Androderm
Androgel
Androgel
Pump
Aveed
Depo-
Testosteron
e
First-
Testosteron
e
Testopel
Vogelxxo
Androderm
Testosterone Endogenous androgen
that facilitates the
growth of the male sex
organs and helps sustain
secondary sex
characteristics in
androgen- deficient
males
Breast cancer (female)
Delayed puberty (males)
Hypogonadism (males)
Breast Cancer:
IM: 200-400 mg every
2-4 weeks
Delayed Puberty:
IM: 50-200 mg every 2-
4 weeks for a 4-6
months
Pellet SQ: 150-450 mg
every 3-6 months
Hypogonadism:
IM: 50-400 mg every 2-
4 weeks
Or 75- 100 mg/week or
150-200 mg every 2
weeks
Intranasal : 11 mg (2
pump or 1 per nostril)
Skin blister or pruritus at site
PSA increase
BPH
HTN
PVD
Emotional lability, anosmia,
headache, depression,
nervousness, chills, confusion,
aggressive behavior
Crusted skin, excoriation,
bulla, xeroderma, alopecia
Decreased HDL cholesterol,
HLD, hypokalemia, increased
triglycerides, increased TSH,
decreased libido,
gynecomastia, hot flash,
weight gain
Testicular atrophy, prostatic
disease, dysuria, UTI,

intranasal 3 times daily
(6-8 hours apart) for a
total of 33 mg
Oral: