U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C22H30O3
Molecular Weight 342.4718
Optical Activity UNSPECIFIED
Defined Stereocenters 6 / 6
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of MEGESTROL

SMILES

[H][C@@]12CC[C@](O)(C(C)=O)[C@@]1(C)CC[C@@]3([H])[C@@]2([H])C=C(C)C4=CC(=O)CC[C@]34C

InChI

InChIKey=VXIMPSPISRVBPZ-NWUMPJBXSA-N
InChI=1S/C22H30O3/c1-13-11-16-17(20(3)8-5-15(24)12-19(13)20)6-9-21(4)18(16)7-10-22(21,25)14(2)23/h11-12,16-18,25H,5-10H2,1-4H3/t16-,17+,18+,20-,21+,22+/m1/s1

HIDE SMILES / InChI

Description
Curator's Comment: description was created based on several sources, including https://www.ncbi.nlm.nih.gov/pubmed/?term=23395103

Megestrol acetate is a progestational hormone used most commonly as the acetate ester. As the acetate, it is more potent than progesterone both as a progestagen and as an ovulation inhibitor. It has also been used in the palliative treatment of breast cancer. MEGACE Oral Suspension is indicated for the treatment of anorexia, cachexia, or an unexplained, significant weight loss in patients with a diagnosis of acquired immunodeficiency syndrome (AIDS). The precise mechanism by which megestrol acetate produces effects in anorexia and cachexia is unknown at the present time. But its progestin antitumour activity may involve suppression of luteinizing hormone by inhibition of pituitary function. Studies also suggest that the megestrol's weight gain effect is related to its appetite-stimulant or metabolic effects rather than its glucocorticoid-like effects or the production of edema. It has also been suggested that megestrol may alter metabolic pathyways via interferences with the production or action of mediators such as cachectin, a hormone that inhibits adipocyte lipogenic enzymes. The major route of drug elimination in humans is urine. When radiolabeled megestrol acetate was administered to humans in doses of 4 to 90 mg, the urinary excretion within 10 days ranged from 56.5% to 78.4% (mean 66.4%) and fecal excretion ranged from 7.7% to 30.3% (mean 19.8%). The total recovered radioactivity varied between 83.1% and 94.7% (mean 86.2%). Megestrol acetate metabolites which were identified in urine constituted 5% to 8% of the dose administered. Respiratory excretion as labeled carbon dioxide and fat storage may have accounted for at least part of the radioactivity not found in urine and feces. Plasma steady-state pharmacokinetics of megestrol acetate were evaluated in 10 adult, cachectic male patients with acquired immunodeficiency syndrome (AIDS) and an involuntary weight loss greater than 10% of baseline. Patients received single oral doses of 800 mg/day of MEGACE Oral Suspension for 21 days. Plasma concentration data obtained on day 21 were evaluated for up to 48 hours past the last dose.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Palliative
MEGACE

Approved Use

Megestrol acetate oral suspension is indicated for the treatment of anorexia, cachexia, or an unexplained, significant weight loss in patients with a diagnosis of acquired immunodeficiency syndrome (AIDS).

Launch Date

1993
Palliative
MEGACE

Approved Use

Megestrol acetate oral suspension is indicated for the treatment of anorexia, cachexia, or an unexplained, significant weight loss in patients with a diagnosis of acquired immunodeficiency syndrome (AIDS).

Launch Date

1993
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
753 ng/mL
800 mg 1 times / day steady-state, oral
dose: 800 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
490 ng/mL
750 mg 1 times / day steady-state, oral
dose: 750 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
1133 ng/mL
625 mg single, oral
dose: 625 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
1618 ng/mL
625 mg single, oral
dose: 625 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
1364 ng/mL
800 mg single, oral
dose: 800 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
187 ng/mL
800 mg single, oral
dose: 800 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
10476 ng × h/mL
800 mg 1 times / day steady-state, oral
dose: 800 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
6779 ng × h/mL
750 mg 1 times / day steady-state, oral
dose: 750 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
12095 ng × h/mL
625 mg single, oral
dose: 625 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
16268 ng × h/mL
625 mg single, oral
dose: 625 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
18625 ng × h/mL
800 mg single, oral
dose: 800 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
8942 ng × h/mL
800 mg single, oral
dose: 800 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
33.68 h
625 mg single, oral
dose: 625 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
39.75 h
625 mg single, oral
dose: 625 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
32.84 h
800 mg single, oral
dose: 800 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
31.38 h
800 mg single, oral
dose: 800 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEGESTROL ACETATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
Doses

Doses

DosePopulationAdverse events​
400 mg 2 times / day multiple, oral
Dose: 400 mg, 2 times / day
Route: oral
Route: multiple
Dose: 400 mg, 2 times / day
Sources:
unhealthy, 54-68 years
n = 2
Health Status: unhealthy
Age Group: 54-68 years
Sex: F
Population Size: 2
Sources:
Disc. AE: Osteoporosis...
AEs leading to
discontinuation/dose reduction:
Osteoporosis (2 patients)
Sources:
625 mg 1 times / day multiple, oral
Recommended
Dose: 625 mg, 1 times / day
Route: oral
Route: multiple
Dose: 625 mg, 1 times / day
Sources:
unhealthy, 65 years
n = 1
Health Status: unhealthy
Age Group: 65 years
Sex: M
Population Size: 1
Sources:
Disc. AE: Adrenal insufficiency...
AEs leading to
discontinuation/dose reduction:
Adrenal insufficiency (1 patient)
Sources:
40 mg 2 times / day multiple, oral
Dose: 40 mg, 2 times / day
Route: oral
Route: multiple
Dose: 40 mg, 2 times / day
Sources:
unhealthy, 85 years
n = 1
Health Status: unhealthy
Condition: Alzheimer's disease
Age Group: 85 years
Sex: F
Population Size: 1
Sources:
Disc. AE: Deep vein thrombosis...
AEs leading to
discontinuation/dose reduction:
Deep vein thrombosis (1 patient)
Sources:
400 mg 2 times / day multiple, oral
Dose: 400 mg, 2 times / day
Route: oral
Route: multiple
Dose: 400 mg, 2 times / day
Sources:
unhealthy, 86 years
n = 1
Health Status: unhealthy
Condition: Alzheimer's disease
Age Group: 86 years
Sex: F
Population Size: 1
Sources:
Disc. AE: Deep vein thrombosis...
AEs leading to
discontinuation/dose reduction:
Deep vein thrombosis (1 patient)
Sources:
1600 mg 1 times / day multiple, oral
Highest studied dose
Dose: 1600 mg, 1 times / day
Route: oral
Route: multiple
Dose: 1600 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Condition: advanced breast cancer
Sex: F
Sources:
AEs

AEs

AESignificanceDosePopulation
Osteoporosis 2 patients
Disc. AE
400 mg 2 times / day multiple, oral
Dose: 400 mg, 2 times / day
Route: oral
Route: multiple
Dose: 400 mg, 2 times / day
Sources:
unhealthy, 54-68 years
n = 2
Health Status: unhealthy
Age Group: 54-68 years
Sex: F
Population Size: 2
Sources:
Adrenal insufficiency 1 patient
Disc. AE
625 mg 1 times / day multiple, oral
Recommended
Dose: 625 mg, 1 times / day
Route: oral
Route: multiple
Dose: 625 mg, 1 times / day
Sources:
unhealthy, 65 years
n = 1
Health Status: unhealthy
Age Group: 65 years
Sex: M
Population Size: 1
Sources:
Deep vein thrombosis 1 patient
Disc. AE
40 mg 2 times / day multiple, oral
Dose: 40 mg, 2 times / day
Route: oral
Route: multiple
Dose: 40 mg, 2 times / day
Sources:
unhealthy, 85 years
n = 1
Health Status: unhealthy
Condition: Alzheimer's disease
Age Group: 85 years
Sex: F
Population Size: 1
Sources:
Deep vein thrombosis 1 patient
Disc. AE
400 mg 2 times / day multiple, oral
Dose: 400 mg, 2 times / day
Route: oral
Route: multiple
Dose: 400 mg, 2 times / day
Sources:
unhealthy, 86 years
n = 1
Health Status: unhealthy
Condition: Alzheimer's disease
Age Group: 86 years
Sex: F
Population Size: 1
Sources:
OverviewDrug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
mild [Inhibition 50 uM]
mild [Inhibition 50 uM]
moderate [Inhibition 50 uM]
moderate [Inhibition 50 uM]
no
no
no
yes [Activation 50 uM]
yes [Activation 50 uM]
yes [Inhibition 50 uM]
Drug as victim
PubMed

PubMed

TitleDatePubMed
Managing cancer-related anorexia/cachexia.
2001
Hormonal therapy with megestrol in inoperable hepatocellular carcinoma characterized by variant oestrogen receptors.
2001 Apr 6
Treatment. Court decision to allow marketing of generic form of weight-loss drug.
2001 Aug 3
Megestrol and tamoxifen in patients with advanced endometrial cancer: an Eastern Cooperative Oncology Group Study (E4882).
2001 Feb
Cost-effectiveness analysis of exemestane compared with megestrol in patients with advanced breast carcinoma.
2001 Feb 1
Carbohydrate metabolism in sickle cell patients using a subdermal implant containing nomegestrol acetate (Uniplant).
2001 May
Megestrol treatment in patients with hepatocellular carcinoma.
2001 Nov 16
Management of common symptoms in terminally ill patients: Part I. Fatigue, anorexia, cachexia, nausea and vomiting.
2001 Sep 1
Prevention of menstruation with leuprorelin (GnRH agonist) in women undergoing myelosuppressive chemotherapy or radiochemotherapy for hematological malignancies: a pilot study.
2001 Sep-Oct
Efficacy and economics of hormonal therapies for advanced breast cancer.
2002
The impact of hormonal treatments on quality of life of patients with metastatic breast cancer.
2002
Estrogen as therapy for breast cancer.
2002
Tamoxifen resistant and refractory breast cancer: the value of aromatase inhibitors.
2002
Effects of megestrol acetate on weight gain, body composition, and pulmonary function in patients with cystic fibrosis.
2002 Apr
Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study.
2002 Jan 15
Effects of transdermal hormone replacement therapy on levels of soluble P- and E-selectin in postmenopausal healthy women.
2002 Mar
[Low-grade sarcoma of the endometrial stroma: late recurrence with ureteral and bladder involvement].
2002 Oct
Should aromatase inhibitors replace tamoxifen?
2003 Aug
[Antigonadotropic effects of a 19-nor-progesterone derivative: the example of nomegestrol acetate].
2003 Jan
Megestrol complications.
2003 Jan
Postmenopausal femur bone loss: effects of a low dose hormone replacement therapy.
2003 Jul 25
Bone turnover markers and insulin-like growth factor components in metastatic breast cancer: results from a randomised trial of exemestane vs megestrol acetate.
2003 Jul-Aug
An overview of nomegestrol acetate selective receptor binding and lack of estrogenic action on hormone-dependent cancer cells.
2003 Nov
Cancer cachexia.
2003 Nov 5
Incidence of deep-venous thrombosis in nursing home residents using megestrol acetate.
2003 Sep-Oct
Advances in estrogen receptor biology: prospects for improvements in targeted breast cancer therapy.
2004
The role of MRI in the conservative management of endometrial cancer.
2004 Apr
A comparison of the central effects of different progestins used in hormone replacement therapy.
2004 Aug 20
[Nome gesrol (lutenyl) induced severe acute hepatitis].
2004 Jan
Serum leptin levels and body composition in postmenopausal women: effects of hormone therapy.
2004 Jul-Aug
Effects of the combined treatment with thalidomide, megestrol and interleukine-2 in cirrhotic patients with advanced hepatocellular carcinoma. A pilot study.
2005 Apr
Treatment with inhibitors of angiogenesis in advanced hepatocellular carcinoma: a new tool in our hands or simply a hope?
2005 Apr
Bone loss and the aromatase inhibitors.
2005 Aug
[Actions of a 19-norprogesterone derivative on mammary gland: nomegestrol acetate].
2005 Feb
Effect of nomegestrol acetate on estrogen biosynthesis and transformation in MCF-7 and T47-D breast cancer cells.
2005 Jan
Control of sulfatase activity by nomegestrol acetate in normal and cancerous human breast tissues.
2005 Jul-Aug
Pregnancy following intracytoplasmic sperm injection and preimplantation genetic diagnosis after the conservative management of endometrial cancer.
2005 Jun
Antigenotoxic effects of ascorbic acid against megestrol acetate-induced genotoxicity in mice.
2005 Mar
Hormonal treatment of a recurrent granulosa cell tumor of the ovary: case report and review of the literature.
2005 Mar
Benign metastasizing leiomyoma responsive to megestrol: case report and review of the literature.
2005 Nov-Dec
Bleeding patterns during continuous estradiol with different sequential progestogens therapy.
2005 Sep-Oct
Progestogens: effects on clinical and biochemical parameters in postmenopausal women.
2005 Sep-Oct
Letrozole: a pharmacoeconomic review of its use in postmenopausal women with breast cancer.
2006
Megestrol attenuates the hormonal response to CCK-4-induced panic attacks.
2006
Effects of a single Silastic contraceptive implant containing nomegestrol acetate (Uniplant) on endometrial morphology and ovarian function for 1 year.
2006 Dec
A successful live birth through in vitro fertilization program after conservative treatment of FIGO grade I endometrial cancer.
2006 Jun
[Pharmacological therapy of cancer anorexia-cachexia].
2006 May
Activation of nitric oxide synthesis in human endothelial cells using nomegestrol acetate.
2006 Oct
Testosterone supplementation of megestrol therapy does not enhance lean tissue accrual in men with human immunodeficiency virus-associated weight loss: a randomized, double-blind, placebo-controlled, multicenter trial.
2007 Feb
Longitudinal evaluation of serum leptin and bone mineral density in early postmenopausal women.
2007 May-Jun
Patents

Patents

Sample Use Guides

Oral Suspension is 800 mg/day (20 mL/day). In clinical trials evaluating different dose schedules, daily doses of 400 and 800 mg/day.
Route of Administration: Oral
Megestrol acetate was shown to inhibit the growth of HepG2 cells in vitro in dose- and time-dependent manners with an IC (50) of 260 uM (24-h incubation)
Name Type Language
MEGESTROL
HSDB   INN   VANDF   WHO-DD  
INN  
Official Name English
MEGESTROL ACETATE IMPURITY B [EP IMPURITY]
Common Name English
MEGESTROL [VANDF]
Common Name English
MEGESTROL [HSDB]
Common Name English
Megestrol [WHO-DD]
Common Name English
17-HYDROXY-6-METHYLPREGNA-4,6-DIENE-3,20-DIONE
Systematic Name English
CHRONOPIL
Brand Name English
megestrol [INN]
Common Name English
Classification Tree Code System Code
WHO-VATC QG03AC05
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-ATC G03AC05
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
LIVERTOX 593
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-ATC G03FB04
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
CFR 21 CFR 520.1341
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
NCI_THESAURUS C776
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-VATC QG03DB02
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-ATC G03FA08
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-ATC L02AB01
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-VATC QG03FA08
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-ATC G03AB01
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-VATC QG03AB01
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
NDF-RT N0000175602
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-ATC G03DB02
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-VATC QL02AB01
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
NDF-RT N0000011301
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-VATC QG03FB04
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-ATC G03AA04
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
WHO-VATC QG03AA04
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
Code System Code Type Description
DAILYMED
EA6LD1M70M
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
INN
1529
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
NCI_THESAURUS
C630
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
CHEBI
6722
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
RXCUI
6703
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY RxNorm
HSDB
3233
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
FDA UNII
EA6LD1M70M
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
ChEMBL
CHEMBL1201139
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
WIKIPEDIA
MEGESTROL
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
CAS
3562-63-8
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
EVMPD
SUB08712MIG
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
PUBCHEM
19090
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
EPA CompTox
DTXSID00100933
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
ECHA (EC/EINECS)
222-628-6
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
SMS_ID
100000081461
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY
MESH
D008535
Created by admin on Fri Dec 15 14:58:15 GMT 2023 , Edited by admin on Fri Dec 15 14:58:15 GMT 2023
PRIMARY