Trazodone and Gynecomastia

Medications Known to Cause Gynecomastia

• Spironolactone has a greater risk of gynecomastia compared to eplerenone when used as aldosterone antagonists, as stated by the American College of Cardiology 1, 2, 3

Clinical Implications

Differential Diagnosis for Gynecomastia

• When evaluating gynecomastia, clinicians should consider medications with established associations, particularly spironolactone, which is documented to cause this side effect, according to the American Heart Association 1, 2, 5
• Male breast enlargement may also represent pseudogynecomastia (fatty tissue deposition without glandular proliferation), especially in patients with elevated BMI, as noted by the American College of Radiology 6

Monitoring and Management

• For patients requiring medication for conditions like heart failure or hypertension who develop gynecomastia on spironolactone, switching to eplerenone may be beneficial as it has a lower risk of this side effect, as recommended by the American College of Cardiology 1, 2, 5