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Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...
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Drug interactions occur when the pharmacological effect of one drug is altered by another substance, either enhancing or diminishing its activity. The drug whose activity is altered is known as the object drug, and the substance causing the alteration is called the agent drug or the precipitant. The net effects of these interactions are mostly undesirable, leading to decreased effectiveness or increased adverse effects. In rare cases, interactions can be beneficial, such as the enhanced...
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Drug toxicity: Idiosyncratic Reactions

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Drug-induced gynecomastia.

John D Bowman1, Hyunah Kim, Juan J Bustamante

  • 1Department of Pharmacy Practice, Rangel College of Pharmacy, Texas A&M Health Science Center, Kingsville, TX 78363-8202, USA. bowman@pharmacy.tamhsc.edu

Pharmacotherapy
|November 21, 2012
PubMed
Summary

Medications cause approximately 20% of gynecomastia cases in men. Common culprits include antiandrogens and protease inhibitors, necessitating potential treatment changes or surgical intervention.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Men's Health

Background:

  • Gynecomastia, a condition of abnormal breast enlargement in males, has multifactorial causes.
  • Drugs are implicated in approximately 20% of gynecomastia cases.
  • Altered estrogen:androgen ratios and various pathophysiologic mechanisms underlie drug-induced gynecomastia.

Purpose of the Study:

  • To review the existing literature on drug-induced gynecomastia.
  • To offer a novel perspective by analyzing data from the FDA's Adverse Event Reporting System.
  • To identify common and rare drug culprits associated with gynecomastia.

Main Methods:

  • Comprehensive literature review on drug-induced gynecomastia.
  • Analysis of the United States Food and Drug Administration's Adverse Event Reporting System (FAERS) data.

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  • Identification and categorization of drugs associated with gynecomastia.

    • Main Results:

    • Antiandrogens, protease inhibitors, and nucleoside reverse transcriptase inhibitors are primary drug causes.
    • Less common causes include first-generation antipsychotics, spironolactone, verapamil, and cimetidine.
    • Various other medications have been rarely reported as causative agents.

    Conclusions:

    • Drug-induced gynecomastia is a significant clinical concern.
    • Management may involve drug substitution, surgery, or irradiation.
    • Further epidemiologic studies are required to accurately determine the incidence of drug-induced gynecomastia.