Megestrol can induce alterations of the pituitary-adrenal axis in some patients. It is important to consider a diagnosis of adrenal insufficiency in patients with symptoms of fatigue, hypotension, and asthenia who have been treated with megestrol. Patients who require more than 12 weeks of treatment should have their morning free cortisol levels checked at 12 weeks and biweekly thereafter.
Megestrol acetate in cachexia and anorexia - Int J Nanomedicine. 2006 December; 1(4): 411–416. Published online 2006 December
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