Comparative Pharmacology
Head-to-head clinical analysis: HYDROXYPROGESTERONE CAPROATE versus MEGACE ES.
Peer-Reviewed Evidence
Head-to-head clinical analysis: HYDROXYPROGESTERONE CAPROATE versus MEGACE ES.
HYDROXYPROGESTERONE CAPROATE vs MEGACE ES
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Hydroxyprogesterone caproate is a synthetic progestin that acts as an agonist of the progesterone receptor. Its mechanism in preventing preterm birth is not fully understood but may involve suppression of uterine contractility, maintenance of cervical integrity, and modulation of the inflammatory response.
Megestrol acetate is a synthetic progestin that inhibits pituitary gonadotropin secretion, leading to suppression of ovarian and testicular hormone production. It also has antineoplastic effects possibly through local action on hormone-sensitive tissues and stimulates appetite via modulation of neuropeptide Y and other appetite-regulating factors.
250-500 mg intramuscularly once weekly. For recurrent preterm birth prevention: 250 mg intramuscularly weekly starting at 16-20 weeks gestation until 36 weeks.
625 mg orally once daily (MEGACE ES suspension contains 625 mg/5 mL; shake well before use). For appetite stimulation in cachexia.
None Documented
None Documented
Clinical Note
moderateHydroxyprogesterone caproate + Digoxin
"Hydroxyprogesterone caproate may decrease the cardiotoxic activities of Digoxin."
Clinical Note
moderateHydroxyprogesterone caproate + Digitoxin
"Hydroxyprogesterone caproate may decrease the cardiotoxic activities of Digitoxin."
Clinical Note
moderateHydroxyprogesterone caproate + Deslanoside
"Hydroxyprogesterone caproate may decrease the cardiotoxic activities of Deslanoside."
Clinical Note
moderateHydroxyprogesterone caproate + Acetyldigitoxin
Terminal elimination half-life is approximately 7-8 days (range 5-14 days) due to slow release from the intramuscular depot, supporting weekly or biweekly dosing.
Approximately 34 hours in plasma; steady-state achieved after 2-3 weeks of daily dosing.
Primarily renal as metabolites; approximately 50-60% of a dose is excreted in urine within 96 hours, with less than 5% as unchanged drug. Biliary/fecal excretion accounts for approximately 30-40%.
Primarily renal (≤1% unchanged) and biliary; extensive metabolism to inactive glucuronide conjugates excreted in feces.
Category D/X
Category C
Progestin
Progestin
"Hydroxyprogesterone caproate may decrease the cardiotoxic activities of Acetyldigitoxin."