Endace

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What Is Endace?

Endace is an oral tablet from Cipla containing megestrol acetate (40 mg and 160 mg). Megestrol is a synthetic progestin with potent appetite-stimulant effects. The dominant modern use is as supportive care for cancer cachexia — the involuntary weight loss that affects most patients with advanced cancer and significantly worsens quality of life and treatment tolerance. It also retains a niche role in palliative endocrine therapy for advanced hormone-receptor-positive breast and endometrial cancer.

Käyttö ja indikaatiot

• Cancer cachexia — appetite stimulation and weight gain
• HIV-related anorexia and weight loss (less commonly used in 2026 with modern ART)
• Palliative endocrine therapy in advanced HR+ breast cancer — later-line after AI and tamoxifen
• Advanced endometrial cancer palliation
• Off-label: hot flushes in patients who cannot use HRT

Annostelu ja käyttöohje

• Cancer cachexia / HIV anorexia: 400–800 mg/day (often 800 mg/day) of suspension or tablet equivalent
• Breast cancer palliation: 160 mg/day in divided doses
• Endometrial cancer palliation: 80–320 mg/day in divided doses

1. Take with food to improve absorption and reduce nausea.
2. Once daily or in divided doses depending on indication.
3. Pakollinen seuranta: baseline weight, blood glucose (megestrol commonly raises glucose); BP; signs of DVT; symptoms of adrenal suppression. Periodic FBC.
4. For cachexia, expect appetite improvement at 1–2 weeks and weight gain at 4–6 weeks. Most weight gain is fat (not muscle), and adding nutritional support and resistance exercise where possible amplifies benefit.
5. Älä lopeta äkillisesti after prolonged use — risk of adrenal crisis from progestin-mediated adrenal suppression. Taper under specialist guidance.

Haittavaikutukset

Yleisiä: weight gain (the desired effect in cachexia), increased appetite, fluid retention, hyperglycaemia, breakthrough vaginal bleeding, mood changes, insomnia, sweating, hot flushes (paradoxically, in some patients).

Tärkeää:

• Venous thromboembolism (DVT, PE) — consider prophylactic anticoagulation in immobilised cancer patients
• Adrenal suppression with prolonged high-dose use
• New-onset diabetes or worsening glycaemic control
• Hypertensio
• Cushingoid features at high doses
• Menstrual irregularities

Varoitukset

• Raskaus: contraindicated. Reliable contraception throughout treatment.
• Imetyksen aikana: vältä.
• Active VTE or recent thrombosis: avoid; alternatives include corticosteroids for cachexia (short-term) or omega-3.
• Diabetes: monitor glucose carefully; insulin or hypoglycaemic dose adjustment likely.
• Adrenal insufficiency: taper, do not stop abruptly after prolonged use.
• Cardiovascular risk factors: caution — fluid retention, hypertension.

Lääkeaineenvaihdunta

Säilytys

• Huoneenlämpötilassa, 15–25°C, alkuperäisessä blisterissä.
• Out of reach of children and pets.

Aiheeseen liittyvät vaihtoehdot MedsBasessa

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• Endoxan (syklofosfamidi 50 mg)
• Celkeran (chlorambucil 2 / 5 mg)
• Temotero (temozolomiili 20/100 mg)
• Temozol (temozolomiili 20 mg)
• Lomoother (lomustini 40 mg)

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Usein Kysytyt Kysymykset

When will I notice the appetite-stimulant effect?

Improved appetite typically starts at 1–2 viikkoa. Measurable weight gain (mostly fat, with smaller fluid component) at 4–6 viikkoa. Most weight gain is fat — megestrol does not significantly increase lean muscle mass. Adding nutritional support and gentle resistance exercise where possible amplifies the benefit.

Why is venous thromboembolism a risk?

Megestrol is a progestin and shares the VTE risk of all hormonal contraceptives + progestins, particularly in cancer patients (who already carry a 5–10× increased baseline VTE risk). Be alert for unilateral leg swelling, sudden chest pain or breathlessness; seek same-day care if these occur. Consider prophylactic anticoagulation in immobilised cancer patients on megestrol.

Will Endace raise my blood sugar?

Yes — commonly. Megestrol mimics some of the metabolic effects of corticosteroids (impairs insulin action, raises hepatic glucose output). Diabetic patients usually need their hypoglycaemic medication adjusted upward; new-onset diabetes can occur in non-diabetic patients on long-term high-dose megestrol. Monitor capillary glucose weekly initially.

Why must I taper rather than stop Endace?

Long-term high-dose megestrol suppresses the adrenal axis (mineralocorticoid effect on the hypothalamic-pituitary-adrenal axis). Abrupt discontinuation after > 4–6 weeks of high-dose use risks adrenal crisis — nausea, vomiting, hypotension, hypoglycaemia. Taper down over 2–4 weeks under specialist supervision.

Are there alternatives to Endace for cancer cachexia?

Limited options with strong evidence. Kortikosteroidit (dexamethasone 4 mg/day) provide short-term appetite stimulation but have severe long-term toxicity. Cannabinoids (dronabinol where legal) have modest evidence. Anamorelin (ghrelin agonist) is approved in Japan and some other markets. Olanzapine low-dose has emerging supportive evidence. Nutritional and exercise interventions remain first-line. Discuss with the palliative care team.

Can Endace treat my breast cancer?

Megestrol has a niche role in palliative endocrine therapy for HR+ advanced breast cancer — usually later-line after aromatase inhibitor and tamoxifen failure. It is no longer a first or second-line endocrine choice in most modern practice; CDK4/6 inhibitors + AI / fulvestrant have largely replaced it. Specialist oncology decision.

Is Endace safe in pregnancy?

No — contraindicated. Megestrol is a progestin and may cause fetal masculinisation and other developmental effects. Reliable contraception throughout treatment.

Can I drink alcohol on Endace?

Occasional small amounts are tolerable but heavy drinking compounds the metabolic side effects (hyperglycaemia, hypertension, fluid retention). Discuss with the supportive care team in the context of overall cancer care.

Miksi tilata MedsBasesta

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Aiheeseen liittyvät syöpälääkkeet

Muut tämän tuotteen rinnalla varastossa olevat syöpälääkkeet:

• Cytomid (flutamide 250 mg)
• Bicalumutidi (bikalutamidi 50 mg)
• Bdenza (enzalutamidi 40 mg)
• Tamilong (tamoxifen 10/20 mg)
• Xtane (exemestane 25 mg)

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