Food effect on the bioavailability of two distinct formulations of megestrol acetate oral suspension.
OBJECTIVE
Megestrol acetate oral suspension (MAOS) is an appetite stimulant indicated for cachexia in patients with AIDS. It is available in its original formulation, Megace (MAOS), and as a nanocrystal dispersion, Megace ES (MA-ES). Three studies were conducted to evaluate the pharmacokinetic properties of these formulations under fed and fasting conditions.


METHODS
An open-label, crossover trial was conducted in 24 healthy males randomized to MA-ES 625 mg/5 mL given with a high-calorie, high-fat meal, or after an overnight fast. Blood samples were drawn at multiple time points and pharmacokinetic parameters were determined. Two separate, open-label reference studies evaluated MAOS 800 mg/20 mL in 40 fed or 40 fasting healthy male volunteers.


RESULTS
In fasting MA-ES subjects, the average maximum concentration (C(max)) was 30% less than the fed C(max) value. For MAOS, fasting C(max) was 86% less than fed C(max). In fasting subjects, the area under the curve was 12,095 ng.h/mL for MA-ES, and 8,942 ng.h/mL for MAOS. In fed subjects, the absorption of the two formulations was comparable.


CONCLUSIONS
Bioavailability and absorption are greater for MA-ES than MAOS in fasting subjects. MA-ES may be a preferred formulation of megestrol acetate when managing cachectic patients whose caloric intake is reduced.
SFBC Anapharm, Montreal, Canada.
Benoit
B
Deschamps
Naomi
N
Musaji
John A
JA
Gillespie
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D019167:Appetite Stimulants / Q000008:administration & dosage / Q000493:pharmacokinetics; D004339:Drug Compounding / Q000379:methods; D004435:Eating; D005215:Fasting / Q000097:blood*; D006801:Humans; D008297:Male; D019290:Megestrol Acetate / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D008875:Middle Aged; D013535:Suspensions; D055815:Young Adult
D019167:Appetite Stimulants; D013535:Suspensions; D019290:Megestrol Acetate