A 55-year-old hypertensive man on long-term antihypertensive therapy presents with bilateral painless gynaecomastia. Which of his medications is the most likely cause?
- A Amlodipine
- B Spironolactone ✓
- C Atenolol
- D Furosemide
Correct answer: B. Spironolactone
Explanation
Spironolactone is a well-recognised cause of gynaecomastia through antiandrogenic action at the androgen receptor and displacement of testosterone from sex hormone binding globulin, occurring in up to 10 percent of men at higher doses. Amlodipine, atenolol and furosemide are not established causes. Other classic culprits include digoxin, cimetidine, oestrogens and finasteride.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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