These medications treat the loss of appetite and weight loss but do not treat the cachexia itself.
- Stimulate appetite, but effect lasts only for 4-8 weeks, and does not lead to weight gain.
- Dronabinol (Marinol)
- Stimulates appetite but does not clearly lead to weight gain
- Megestrol (Megace)
- Most potent
- Anabolic steroids: nandrolone, fluoxymesterone, oxandrolone (increases lean tissue mass)
- Boost, Ensure, etc.
- ProSure - Website
- eicosapentaenoic acid (an omega-3 fatty acid) + protein + calories.
- Provides 300 Cals (17 g protein) per can.
- Use 2 cans per day.
- Does not require prescription.
- Juven - Website
- HMB (beta-hydroxy-beta-methylbutyrate), arginine and glutamine.
- Use: 2 servings per day (one packet per serving). Provides 150 Cal/day (75 Cal/pkg).
- Does not require prescription
- Weight training
Corticosteroids vs Megesterol
- Mayo, 1999 (1992-96) - PMID 10506633 — "Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia." Loprinzi CL et al. J Clin Oncol. 1999 Oct;17(10):3299-306.
- 475 pts. Similar efficacy for decadron (0.75 mg qid) and megace (800 mg qd = 5x160), but differing toxicities.