Most of the drugs that are listed are based on anecdotal reports and do not have high-quality evidence supporting a cause-and-effect relationship. Using evidence-based criteria, there is good evidence of a true association with estrogens, spironolactone, cimetidine, ketoconazole, growth hormone, gonadotropins, antiandrogen therapies, and 5-alpha-reductase inhibitors. Drugs with fair evidence include first-generation and atypical antipsychotics in adults, calcium channel blockers, omeprazole, HIV drugs, alkylating agents, anabolic steroids, alcohol, opioids,[1] and statins.[2]
ACE: angiotensin-converting enzyme;
HAART: highly active antiretroviral therapy.
References:
Deepinder F, Braunstein GD. Drug-induced gynecomastia: An evidence-based review. Expert Opin Drug Saf 2012; 11:779.
Skeldon SC, Carleton B, Brophy JM, et al. Statin medications and the risk of gynecomastia. Clin Endocrinol (Oxf) 2018; 89:470.