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Common Medication Causes of Gynecomastia*

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Category	Medication (or recreational drug)
Antiandrogen medications (inhibit androgen synthesis or activity)	Cyproterone (an antiandrogen used to treat prostate cancer or transgender females; not available in the United States) Dutasteride and finasteride (5 alpha reductase inhibitors) Goserelin, histrelin, leuprolide, and triptorelin (GnRH agonists); degarelix, relugolix (GnRH antagonists) Flutamide, bicalutamide, enzalutamide, abiraterone, darolutamide, apalutamide, and nilutamide (oral antiandrogens used to treatprostate cancer)
Antimicrobials	Efavirenz Ethionamide Isoniazid Ketoconazole Metronidazole
Antineoplastic medications	Alkylating agents Imatinib GnRH agonists and antagonists Methotrexate Vinca alkaloids
Antiulcer medications†	Cimetidine Ranitidine Omeprazole
Cardiovascular medications	ACE inhibitors (eg, captopril, enalapril) Amiodarone Calcium channel blockers (eg, nifedipine, diltiazem) Methyldopa Reserpine Spironolactone
CNS-acting medications	Diazepam Haloperidol Methadone Phenothiazines Tricyclic antidepressants
Hormones	Androgens Anabolic steroids Estrogens Human growth hormone
OTC herbals	Lavender oil Tea tree oils
Recreational drugs	Amphetamines Ethanol Heroin Marijuana
Other medications	Auranofin Diethylpropion Domperidone Metoclopramide Phenytoin Penicillamine Sulindac Theophylline
* Not all medications that have been associated with gynecomastia have been shown to cause gynecomastia through challenge-rechallenge testing.
† Medications are listed in order of frequency of association.
ACE = angiotensin-converting enzyme; CNS = central nervous system; GnRH = gonadotropin-releasing hormone; LH = luteinizing hormone; OTC = over-the-counter.