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MagazineFebruary 1997 (Vol. 7 Issue 11)Megace

If at first tamoxifen doesn't succeed, try, try Megace

If at first tamoxifen doesn't succeed, try, try Megace. That seems to be the policy of many oncologists when they're treating breast cancer.

It may be fashion, it may be because the oncologists see tamoxifen as being a more effective drug, but whatever the reason, Megace seems destined to be always the bridesmaid and never the bride.

In one sense, this collective decision is unfortunate because Megace does not boast anything like the impressive array of side effects and adverse reactions that tamoxifen can muster.

Regular dosage for treating breast cancer is 160 mg a day, and no serious side effects have been detected, even at 1evels of 1600 mg a day.

But if a drug is to do good, it must also have the potential to do harm, and Megace is no exception.

Pregnant women, in particular, are warned not to take the drug because of the harm it can cause to the fetus. Similarly, breastfeeding mothers should also stop the treatment.

Adverse reactions include weight gain one of the most common side effects among patients although this seems to be attributable more to an increased appetite than fluid retention. Thrombosis is a serious concern, especially among those who may be susceptible, although it is a rare reaction.

Other reactions include nausea and vomiting, edema, bleeding, tumour flare, hyperglycemia, alopecia, hypertension, carpal tunnel syndrome and rash.

Like so many drugs, Megace seems to have a paradoxical effect when tested on animals. Female dogs developed benign and malignant tumours of the breast after being given the drug for seven years, although these results were not replicated when tests were carried out on rats and monkeys.

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