“Spironolactone, an aldosterone antagonist, can bind to androgen and progesterone receptors, in addition to the mineralocorticoid receptors, resulting in breast tenderness and gynecomastia. Eplerenone, another aldosterone antagonist, has greater specificity for the mineralocorticoid receptors and is therefore less likely to cause breast tenderness and gynecomastia than spironolactone. While there have been case reports of gynecomastia with ACE inhibitors and digoxin, it is noted to be rare. The side effect profile of hydralazine does not include gynecomastia.” ABFM

Reference

Drug-induced gynecomastia. Pharmacotherapy 2012;32(12):1123-1140.

Gynecomastia: When is treatment indicated? J Fam Pract 2012;61(12):719-725.

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