醋酸甲地孕酮

用途

• Suppression of estrus (in anestrus)
• Suppression of estrus (in proestrus)
• Suppression of estrus (behavioral estrus)
• Postponement of estrus (started during diestrus)
• Postponement of estrus (started during anestrus)
• Prevention of estrus
• Idiopathic feline miliary dermatitis
• Appetite stimulant
• Alternative treatment for immune-mediated skin diseases
• Adjunctive therapy of eosinophilic granulomas
• Eosinophilic ulcers
• Feline atopy ('last ditch' alternative)
• Feline plasma cell gingivitis

給藥方式

可能的副作用

• Profound adrenocortical suppression (especially in cats)
• Transient or permanent diabetes mellitus
• Cystic endometrial hyperplasia (CEH) and pyometra
• Mammary hypertrophy and neoplasia
• Increased appetite and weight gain
• Polydipsia and polyuria (PU/PD)
• Lethargy and personality changes
• Hepatotoxicity (rare)
• Acromegaly (dogs)
• Lactation (rare)

注意事項與禁忌

• Pregnancy
• Uterine disease (e.g., pyometra, endometritis)
• Diabetes mellitus
• Mammary neoplasias
• Prior to the first estrous cycle in dogs
• Anestrus therapy in dogs with abnormal cycles
• During diestrus or in the presence of uterine hemorrhage
• Treatment of pseudopregnancy in bitches (per manufacturer, though off-label protocols exist)
• > **Black Box Warning Equivalent**: Megestrol acetate can induce profound, life-threatening adrenocortical suppression and iatrogenic Addisonian crisis, particularly in cats. * **Adrenal Suppression**: Because of its glucocorticoid activity, patients may require exogenous stress-dose steroids during periods of trauma, surgery, or severe illness. * **Reproductive Risks**: High risk of inducing cystic endometrial hyperplasia (CEH) and pyometra. A thorough reproductive history, physical exam, mammary palpation, and vaginal cytology are strongly recommended before initiating therapy for reproductive control. * **Infection Risk**: May exacerbate latent viral infections (e.g., Feline Herpesvirus-1). * **Human Safety**: Pregnant women should handle this medication with extreme caution (FDA Category X in early pregnancy).

藥物相互作用

• Corticosteroids: Concurrent long-term use may exacerbate adrenocortical suppression and increase the risk of diabetes mellitus.
• Rifampin: May decrease progestin activity due to microsomal enzyme induction, resulting in increased progestin metabolism.

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