Gynecomastia associated with fenofibrate

Area of Science:

• Endocrinology
• Pharmacology

Background:

• Hypercholesterolemia is a common condition requiring pharmacologic management.
• Gynecomastia can be idiopathic or drug-induced, necessitating careful etiological investigation.

Observation:

• A 56-year-old male developed bilateral gynecomastia during fenofibrate therapy.
• Gynecomastia resolved upon fenofibrate discontinuation and recurred upon rechallenge.
• Standard gynecomastia workup excluded other causes.

Findings:

• The temporal relationship and rechallenge suggest fenofibrate as the probable cause of gynecomastia.
• The Naranjo probability scale indicated probable causality.
• This is the first reported case linking fenofibrate to gynecomastia.

Implications:

• Fenofibrate may be an underrecognized cause of drug-induced gynecomastia.
• Clinicians should consider fenofibrate when evaluating patients with new-onset gynecomastia.
• Monitoring patients on fenofibrate for gynecomastia is warranted.