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2725949 
Journal Article 
GYNECOMASTIA INDUCED IN NORMAL MALES BY SPIRONOLACTONE 
Huffman, DH; Kampmann, JP; Hignite, CE; Azarnoff, DL 
1978 
Yes 
Clinical Pharmacology & Therapeutics
ISSN: 0009-9236
EISSN: 1532-6535 
IPA/80/375102 
24 
4 
465-473 
English 
688736 
WOS:A1978FS77600011 
IPA COPYRIGHT: ASHP The short term (one week) and long term (10 month) effects of spironolactone (I) on the metabolic clearance of androgens in relationship to the development of gynecomastia were determined in 32 normal males aged 23-50 yr. There were no adverse effects or changes in plasma testosterone, luteinizing hormone, or progesterone levels during one week of treatment with I (200 mg/day) in 6 normal men. A continuous 4 hr sampling technique to provide an integrated plasma sample resulted in plasma hormone concentrations similar to the mean values for intermittent sampling. There was considerable intraindividual variability in the levels of each hormone. To evaluate the long term effects of I, 30 normal males were randomly divided into 3 groups: placebo, 100 mg I per day (low dose), and 100 mg I per day increased at 2 months to 200 mg I per day (high dose). The study was double blind and lasted 10 months. The presence of gynecomastia was determined clinically and confirmed by thermography. Two metabolic clearance studies with either H-testosterone or H-androstenedione were conducted (1) just before I treatment and (2) again with the same steroid either the last day of the 10 month treatment period or with the development of gynecomastia. Eighteen individuals received I (10 in the low dose group and 8 in the high dose group); of these, 8 developed gynecomastia. There were none in the placebo group. The incidence of gynecomastia was 30% in the low dose group and 62% in the high dose group. I induced no significant changes in the metabolic clearance of androstenedione or testosterone. Plasma concentrations of the various hormones did not change as a result of either I or the development of gynecomastia. Inhibition of testosterone synthesis or alteration in its metabolic clearance of I does not appear to be the cause of I induced gynecomastia in man.