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Megestrol Coupon - Megestrol 40mg/ml oral suspension

megestrol oral suspension

Generic Megace ES
Used for Breast Cancer, Uterine Cancer, Weight Gain
Used for Breast Cancer, Uterine Cancer, Weight Gain

Megestrol oral suspension is an appetite enhancer used to treat low appetite, cachexia (wasting), or unexplained significant weight loss in adults with acquired immunodeficiency syndrome (AIDS). It works by boosting your appetite and helping with weight gain. The usual dose is 625 mg to 800 mg taken by mouth every day. Common side effects include diarrhea, erectile dysfunction, and rash. The brand name Megace ES has been discontinued, but the generic version is still available.

Reviewed by:
reviewer
Kristianne Hannemann, PharmD
reviewer
Daisy Chau, PharmD
Last reviewed on April 7, 2025
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsImagesReferencesPricesMedicare
basics-icon

What is Megestrol oral suspension?

What is Megestrol oral suspension used for?

How Megestrol oral suspension works

Megestrol oral suspension is a progestin, which is a man-made form of the natural hormone progesterone. It's not exactly clear how it works, but it seems to help with appetite and weight gain.

Are you looking for information on megestrol oral tablets for cancer instead?
When does Megestrol oral suspension start working?
Time passed since treatment started:
HOURS
DAYS
WEEKS
MONTHS
Initial effect
Full effect

Drug Facts

Common BrandsMegace ES (brand name no longer available)
Drug ClassProgestin
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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Avg retail price
$173.42(save 72.34%)
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$47.97
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What are the side effects of Megestrol oral suspension?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Diarrhea (6-15%)
  • Erectile dysfunction (4-14%)
  • Rash (2-12%)
  • Passing gas (up to 10%)
  • Headache (up to 10%)
  • High blood pressure (up to 8%)
  • Weakness (2-6%)
  • Fever (1-6%)
  • Trouble sleeping (up to 6%)
  • High blood sugar (up to 6%)
  • Pain (up to 6%)
  • Vomiting (up to 6%)

Other Side Effects

  • Nausea
  • Anemia (low red blood cell count)
  • Low sex drive
  • Indigestion
  • Pneumonia
  • More urination
  • Vaginal bleeding

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Blood clots: legs (pain, swelling, warm to the touch, redness), lungs (trouble breathing, chest pain, cough)

Source: DailyMed

The following side effects have also been reported

Along with their needed effects, progestins used in high doses sometimes cause some unwanted effects such as blood clots, heart attacks, and strokes, or problems of the liver and eyes. Although these effects are rare, some of them can be very serious and cause death. It is not clear if these problems are due to the progestin. They may be caused by the disease or condition for which progestins are being used.

The following side effects may be caused by blood clots. Although not all of these side effects may occur, if they do occur they need immediate medical attention.

Get emergency help immediately if any of the following side effects occur:

Rare

Symptoms of blood clotting problems, usually severe or sudden, such as:

headache or migraine

loss of or change in speech, coordination, or vision

numbness of or pain in chest, arm, or leg

unexplained shortness of breath

Check with your doctor as soon as possible if any of the following side effects occur:

More common

Changes in vaginal bleeding (increased amounts of menstrual bleeding occurring at regular monthly periods, lighter vaginal bleeding between menstrual periods, heavier vaginal bleeding between regular monthly periods, or stopping of menstrual periods)

symptoms of blood sugar problems (dry mouth, frequent urination, loss of appetite, or unusual thirst)

Less common

Mental depression

skin rash

unexpected or increased flow of breast milk

Rare

For megestrol—During chronic treatment

Backache

dizziness

filling or rounding out of the face

irritability

mental depression

nausea or vomiting

unusual decrease in sexual desire or ability in men

unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Abdominal pain or cramping

bloating or swelling of ankles or feet

blood pressure increase (mild)

dizziness

drowsiness (progesterone only)

headache (mild)

mood changes

nervousness

pain or irritation at place of injection site

swelling of face, ankles, or feet

unusual or rapid weight gain

Less common

Acne

breast pain or tenderness

brown spots on exposed skin, possibly long-lasting

hot flashes

loss or gain of body, facial, or scalp hair

loss of sexual desire

trouble in sleeping

Not all of the side effects listed above have been reported for each of these medicines, but they have been reported for at least one of them. All of the progestins are similar, so any of the above side effects may occur with any of these medicines.

After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. During this period of time check with your doctor if you notice the following side effect:

Delayed return to fertility

stopping of menstrual periods

unusual menstrual bleeding (continuing)

For megestrol

Dizziness

nausea or vomiting

unusual tiredness or weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Megestrol oral suspension

thumbs-up

Pros

Comes in lemon-lime flavor

Available as two different strengths

Easier to swallow than tablets or capsules

thumbs-down

Cons

Raises the risk for blood clots

Common side effects include diarrhea, rash, and erectile dysfunction

Not safe during pregnancy

pharmacist-tips

Pharmacist tips for Megestrol oral suspension

pharmacist

  • Shake the megestrol oral suspension bottle well before measuring your dose to make sure the liquid is mixed evenly.

    • Use the measuring tool that comes with megestrol oral suspension or given to you by the pharmacy. Don't use a kitchen spoon because it might not be accurate.

      • You might need blood tests while taking megestrol oral suspension to check your hormone and blood sugar levels. These tests help your prescriber monitor for side effects and make sure the medication is working safely for you.

        • Megestrol oral suspension is related to progesterone and can cause vaginal bleeding in women. In clinical trials, all women reported breakthrough bleeding, so let your prescriber know if this happens to you.

          • If you can get pregnant, your prescriber might require a negative pregnancy test before starting megestrol oral suspension. You should also use birth control while taking it, since the medication can cause harm to an unborn baby.

            • Don't breastfeed while taking megestrol oral suspension since the medication can pass into breastmilk and might be harmful to your baby. Talk to your prescriber about safer feeding options for your baby.

              • Store megestrol oral suspension at room temperature and keep it away from heat.

                faqs

                Frequently asked questions about Megestrol oral suspension

                Why is megestrol oral suspension a high risk medication?
                Megestrol oral suspension can be considered a high risk medication in people with certain conditions, such as a history of blood clots or pregnancy. It's also used carefully in older adults, who might be more sensitive to the medication due to age-related changes in liver, kidney, or heart function. Be sure to discuss your full medical history with your prescriber so they can determine if this medication is safe for you.
                How long does megestrol oral suspension stay in your system?
                It can take about 4-10 days for megestrol oral suspension to fully leave your system. This timeframe is based on the medication's half-life, which can vary from person to person. Talk to your prescriber if you're concerned about how long this medication stays in your body.
                How long does it take for megestrol oral suspension to increase appetite?
                You might start feeling more hungry soon after starting megestrol oral suspension. But it can take 3 to 4 weeks to see weight gain. Continue taking this medication every day as directed by your prescriber.
                Can megestrol oral suspension cause blood clots?
                Megestrol oral suspension can raise the risk of blood clots, especially during the first 3 months of treatment. Talk to your prescriber about your risk of developing a blood clot and what symptoms to watch out for. A blood clot in the leg (deep vein thrombosis or DVT) might cause swelling, redness, warmth, or pain in one leg. A blood clot in the lungs (pulmonary embolism or PE) can cause chest pain, shortness of breath, fast heartbeat, or coughing up blood. Get medical help right away if you notice any of these symptoms.
                Does megestrol oral suspension help you gain weight?
                Yes, megestrol oral suspension can help you gain weight by making you feel more hungry. In studies, people that took the medication for 12 weeks were much more likely to gain at least 5 pounds compared to those who took the placebo. Speak to your prescriber if you have questions about weight gain while taking this medication.
                Can you take megestrol oral suspension with mirtazapine?
                Ask your prescriber about whether it's ok to take mirtazapine (Remeron) with megestrol oral suspension. These medications are not known to interact with each other, but your prescriber can review your full medical history and make sure it’s safe for you to take them together.
                What's the difference between megestrol oral suspension and Marinol?
                Both megestrol oral suspension and dronabinol (Marinol) are prescription medications used to treat low appetite and weight loss in adults with AIDs, but they work differently. Dronabinol (Marinol) is a cannabinoid, while megestrol oral suspension is a progestin. Dronabinol (Marinol) is also used to treat nausea and vomiting from cancer treatments, and it's a controlled substance. Talk to your prescriber to learn more about the differences between these two medications.
                What happens when you stop taking megestrol oral suspension?
                Don't stop taking megestrol oral suspension suddenly without talking to your prescriber first. This medication can cause hormone changes, and your body might need time to adjust. Stopping too quickly might lead to withdrawal symptoms like loss of appetite, stomach pain, and muscle weakness. If you've been taking this medication for a long time, your prescriber might recommend slowly lowering your dose before stopping it completely.
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                What are the risks and warnings for Megestrol oral suspension?

                Megestrol oral suspension can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                risk-warning

                Blood clots

                While taking megestrol oral suspension, there have been reports of blood clots, including deep vein thrombosis (DVT), which is a clot in the leg, and pulmonary embolism (PE), which is a clot in the lungs. Call your prescriber right away if you notice symptoms like leg swelling, chest pain, or trouble breathing.

                risk-warning

                Harm to unborn baby

                Animal studies show megestrol oral suspension can cause harm to an unborn baby, including low birth weight, fewer live births, and changes in male fetal development. While there isn’t enough information to know how it affects human pregnancies, it's best not to take megestrol oral suspension if you’re pregnant or planning to become pregnant.

                If you can become pregnant, your prescriber will likely do a pregnancy test before starting treatment. It's also recommended that you use birth control while taking this medication. Tell your prescriber right away if you become pregnant while using megestrol oral suspension.

                risk-warning

                Lower adrenal gland function

                • Risk factors: Taking megestrol oral suspension long term | Stress such as trauma, injury, or infection

                  Taking megestrol oral suspension for a long time can affect your adrenal glands, which help your body handle stress. Some people have developed Cushing's syndrome (too much steroid hormone) or adrenal insufficiency (not enough steroid hormone). This can happen while you're taking the medication or even after stopping. Watch for signs like low blood pressure, nausea, vomiting, dizziness, or weakness, especially if you're sick or having surgery. Tell your prescriber right away if you have any of these symptoms — they might need to do tests or give you another medication to help.

                  risk-warning

                  Diabetes

                  • Risk factors: Taking megestrol oral suspension long term

                    Taking megestrol oral suspension for a long time can raise your blood sugar levels, which can lead to diabetes or make existing diabetes worse. Let your prescriber know if you have a history of high blood sugar or notice symptoms like frequent thirst, frequent urination, excessive hunger, or weakness.

                    dosage

                    Megestrol oral suspension dosage forms

                    The average cost for 300 ml of 40mg/ml of Megestrol oral suspension is $47.97 with a free GoodRx coupon. This is 72.34% off the average retail price of $173.42.
                    ml of oral suspension
                    Ml of oral suspension
                    DosageQuantityPrice as low asPrice per unit
                    40mg/ml300 ml$47.97$0.16
                    625mg/5ml150 ml$100.40$0.67

                    Typical dosing for Megestrol oral suspension

                    The dose depends on the strength of the medication that's prescribed for you. These two strengths aren't interchangeable with each other.

                    interactions

                    Interactions between Megestrol oral suspension and other drugs

                    Megestrol oral suspension may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Megestrol oral suspension. Please note that only the generic name of each medication is listed below.

                    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

                    Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

                    Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                    drug-cost

                    How much does Megestrol oral suspension cost?

                    To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
                    Megace ES (brand)
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                    contraindications-icon

                    Megestrol oral suspension contraindications

                    Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Megestrol oral suspension will not be safe for you to take.

                    • Pregnancy

                    alternatives

                    What are alternatives to Megestrol oral suspension?

                    There are a number of medications that your doctor can prescribe in place of Megestrol oral suspension. Compare a few possible alternatives below.
                    Megestrol oral suspension
                    Used for:
                    $47.97 Lowest GoodRx priceView Prices
                    Dronabinol (Marinol)
                    Used for:
                    $82.98 Lowest GoodRx priceView Prices
                    Syndros (dronabinol)
                    Used for:
                    $4809.21 Lowest GoodRx priceView Prices
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                    Megestrol oral suspension images

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                    References

                    Best studies we found

                    ANI Pharmaceuticals, Inc. (2024). Megestrol acetate suspension [package insert]. DailyMed.

                    Baker Rogers, J., et al. (2023). Cachexia. StatPearls.

                    Centers for Disease Control and Prevention. (n.d.). PROTECT your child: Use the right tool to give the right dose.

                    View All References (5)

                    Koller, E., et al. (1999). Thrombotic events associated with megestrol acetate in patients with AIDS cachexia. Nutrition.

                    Leinung, M. C., et al. (1995). Induction of adrenal suppression by megestrol acetate in patients with AIDS. Annals of Internal Medicine.

                    Manikkuttiyil, C., et al. (2023). Megestrol. StatPearls.

                    National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Symptoms & causes of adrenal insufficiency & Addison's disease.

                    Upsher-Smith Laboratories, LLC. (2023). Megestrol acetate- megestrol acetate suspension [package insert]. DailyMed.

                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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