Nursing Teaching on Contraindications for Using Megestrol

Nurse educated the patient and caregiver on contraindications for using Megestrol as follows:

1. Do not take megestrol, if you ever manifested any allergic response to intake of megestrol. In the event of an allergic response with this medication, report to your physician or other health care personnel, regarding your safety with continuing on intake of megestrol.
2. Megestrol use in expectant mothers could harm the unborn baby and result in birth defects. So, megestrol use should be avoided during pregnancy and in women planning to get pregnant. Women in active reproductive age group, taking megestrol on a regular basis must employ effective contraceptive measures in order to avoid getting pregnant.
3. Megestrol use carries the risk for clot formation, resulting in deep venous thrombosis and pulmonary embolism. Individuals can present with symptoms such as, pain and swelling of extremities – especially swelling of the lower extremities with pain in the calf muscle, episode of sudden cough and shortness of breath, episode of chest pain, and any sudden vision changes. So, megestrol could be avoided or used with extreme caution in individuals with history of thrombus formation.
4. Megestrol intake can result in elevated blood sugars. Diabetic individuals, especially with history of poorly controlled blood sugars can be at increased risk for episodes of severe hyperglycemia, secondary to megestrol intake. Individuals can present with symptoms of hyperglycemia such as, episodes of confusion, dry mouth, frequent urination, increased thirst and hunger, dry skin, and blurred vision. Megestrol could be avoided or used with extreme caution in diabetic individuals with history of poor blood sugar control.
5. Megestrol, secondary to the steroid activity it has, can result in retention of fluid. This can lead to elevated blood pressure, headache, dizziness, edema with swelling of hands and feet, and weight gain. This can be a serious issue, especially in individuals with history of poorly controlled hypertension.  Acutely elevated blood pressure in these individuals can significantly increase the risk for development of stroke. Megestrol could be avoided or used with extreme caution in individuals with history of stroke and poorly controlled blood pressure.
6. Megestrol is mainly metabolized in the liver. If liver function is deficient, the metabolism of megestrol can be compromised. This can lead to increased blood levels of the medication and metabolites for longer periods of time, resulting in increased risk for side-effects and consequent toxicity. So, megestrol could be avoided in individuals with hepatic dysfunction and an alternative medication considered or used with caution, with periodical monitoring for liver functions and development of any toxic symptoms.
7. Megestrol is mainly excreted by the kidneys. Individuals with renal disease cannot excrete megestrol metabolites normally. The medication metabolites can stay in blood circulation for longer time, resulting in increased risk for side-effects and consequent toxicity. So, megestrol could be avoided in individuals with renal dysfunction and an alternative medication considered or used with caution, with periodical monitoring for renal function and development of any toxic symptoms.