Appetite Stimulants Drug Class

Appetite stimulants are medications prescribed to increase appetite and improve the nutritional status of patients experiencing severe weight loss associated with certain chronic illnesses. The FDA-approved appetite stimulant is megestrol acetate, a progestin, which is a synthetic derivative of progesterone, the natural female sex hormone.

Megestrol acetate was originally developed as a contraceptive, but the side effect of weight gain led to its use as an appetite stimulant. Megestrol acetate prevents ovulation and the release of estrogen from the ovaries and is also used in palliative care for advanced stages of endometrial and breast cancers.

It is not clear how exactly megestrol increases appetite. Studies suggest that progesterone plays a major role in reducing inflammation and improving nutritional status in the late stages of pregnancy. It is believed that megestrol’s anti-inflammatory activity may be a reason for an increase in appetite, resultant weight gain, and improvement in quality of life.

Megestrol is thought to reduce inflammation by inhibiting the production of pro-inflammatory proteins (cytokines) such as tumor necrosis factor-a, interleukin-1, and interleukin-6. Megestrol may also stimulate the synthesis, release, and transport of neuropeptide Y, a peptide in the brain that stimulates appetite.

Appetite stimulants are oral tablets and suspensions used to stimulate appetite in the following conditions:

FDA-Approved

• The FDA has approved megestrol acetate, oxandrolone, and dronabinol as appetite stimulants
• Acquired immune deficiency syndrome (AIDS)-related anorexia (loss of appetite) and cachexia (a wasting syndrome that causes significant weight loss, resulting in extreme weakness)
• Palliative treatment of advanced disease in:
  • Breast cancer
  • Endometrial cancer

Off-label uses:

• Cancer-related cachexia

Side effects of appetite stimulants may include the following:

• Hypertension (high blood pressure)
• Insomnia
• Mood swings
• Rash
• Sweating, hot sweats

Menstrual disorders such as:

• Amenorrhea (absence of menstruation)
• Breakthrough bleeding
• Change in menstrual flow
• Spotting
• Impotence

Gastrointestinal issues such as:

• Diarrhea
• Flatulence
• Indigestion
• Nausea
• Vomiting
• Weight gain

Blood coagulation disorders such as:

• Deep vein thrombosis (blood clot formation in deep veins)
• Pulmonary embolism (blood clot in lungs)
• Thrombophlebitis (inflammation of veins with blood clots)
• Anemia (low red blood cell count)
• Adrenal insufficiency (a condition in which the adrenal gland doesn’t produce enough hormones)
• Asthenia (abnormal weakness)
• Overdose may cause:
• Shortness of breath
• Cough
• Unsteady gait
• Listlessness
• Chest pain

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of appetite stimulant drugs include:

• Megace ES
• megestrol
• oxandrolone (Oxandrin)
• dronabinol (Marinol)
• mirtazapine (Remeron)
• cyproheptadine (Periactin)