Drugs causing gynaecomastia

Drugs cause gynaecomastia:
  • Anti-androgens
  1. Cyproterone acetate
  2. Flutamide
  3. Finasteride/
  4. Bicalutamide
  • Gastrointestinal drugs
  1. Cimetidine / ranitidine
  2. Omeprazole
  • Cancer chemotherapy
  1. Alkylating agents/vinca alkaloids (due to testicular damage and hypogonadism)
  2. Imatinib (tyrosine kinase inhibitor used for chronic myeloid leukemia (CML) and gastrointestinal stromal tumour (GIST).
  • Cardiovascular drugs
  1. Spironolactone (displaces oestrogen from SHBG, increasing free oestrogen: testosterone ratio)
  2. Digoxin
  3. Nifedipine
  4. Enalapril, Captopril
  5. Amiodarone
  6. Methyl-dopa
  7. Verapamil
  • Antimicrobial drugs
  1. Isoniazid
  2. Ketoconazole
  3. Metronodazole
  • Anti-viral drugs
  1. Highly active anti-retroviral (HAART) therapy (especially protease inhibitors)
  • Neurological drugs
  1. Phenothiazines
  2. Metoclopramide
  3. Tricyclic anti-depressants
  4. Opiates
  5. Diazepam
  6. Haloperidol
  • Hormones
  1. Androgens and anabolic steroids
  2. Chorionic gonadotropin
  3. Estrogensand estrogen agonists
  4. Growth hormone
  5. Environmental estrogen
  • Drugs of abuse
  1. Alcohol
  2. Amphetamines
  3. Heroin
  4. Marijuana
  • Other
  1. Highly active antiretroviral therapy (HAART)
  2. Phenytoin
  3. Penicillamine
  • Testosterone, Estradiol, Lutenizing hormone is useful while investigating a case of gynaecomastia 
Exam Question
  • Biclutamide causes gynaecomastia
  • Digitalis, Cimetidine & INH causes gynaecomastia 
  • Impotence,Galactorrhea & Gynaecomastia are the side effects of cimetidine
  • Metaclopramide is a D2-antagonist that Acts on CTZ, Increases gastric emptying & it's Long term use can cause parkinsonism, galactorrhoea and gynaecomastia
  • Spironolactone causes hirsuitism and gynaecomastia
  • Testosterone, Estradiol, Lutenizing hormone is useful while investigating a case of gynaecomastia 
  • Ketoconazole & Digoxin causes gynaecomastia
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