A 58-year-old hypertensive man being evaluated for resistant hypertension is noted to have bilateral non-tender gynaecomastia. Which of his medications is the most likely cause?
- A Metoprolol
- B Spironolactone ✓
- C Amlodipine
- D Furosemide
Correct answer: B. Spironolactone
Explanation
Spironolactone is a classic cause of drug induced gynaecomastia because it blocks androgen receptors and raises oestradiol relative to testosterone, especially at doses above 100 mg daily. Metoprolol, amlodipine and furosemide have no meaningful antiandrogenic or oestrogenic action. Recognising this matters because switching to an alternative agent such as eplerenone usually reverses the gynaecomastia.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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