Megace and Megace ES

Megace has long been shown to help weight gain in cancer and AIDS. More recently, Megace ES came on the market. The advantage is in the concentrated dose that Megace ES offers. It is indicated for the treatment of anorexia, cachexia, or an unexplained, significant weight loss in patients with a diagnosis of acquired immunodeficiency syndrome (AIDS).

The recommended adult initial dosage of Megace ES (megestrol acetate) oral suspension is 625 mg/day (5 mL/day or one teaspoon daily). The equivalent Megace dose it 800 mg and requires 20 ml. These drugs are are bioequivalent in a fed state.
However,  in unfed patients Megace ES achieved 5 times greater peak plasma levels than Megace suspension. Additionally, the study demonstrated that a lower volume of Megace ES achieved maximum blood concentration more rapidly than the currently available oral suspension products.

However, the two products were not directly compared in regard to clinical effectiveness and it is not known if this pharmacokinetic advantages translate into any clinical advantage.

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