Reactions 510 - 16 Jul 1994

SDiazepam/enalapril

Gynaecomastia: case reportTwo separate episodes of painful bilateral gynaecomastia

developed in a 58-year-old man treated with enalapril forhypertension and diazepam for emotional problems.

The man initially presented, after a months’ treatment withenalapril 20 mg/day, with left-sided mastalgia and was treatedwith diclofenac. The patient was also taking salbutamol[albuterol] and mianserin at the time. The patient improvedslightly, but 6 months later, he presented again with bilateralmastalgia and gynaecomastia. Enalapril was discontinued andthe patient was switched to nifedipine; 15 days later thegynaecomastia had disappeared.

About 9 months later the man was administered diazepam5mg tid; he was still taking nifedipine, salbutamol andmianserin. Within 2 months the mastalgia and gynaecomastiahad reappeared. Diazepam was discontinued and the breastpain disappeared 48 hours later; within 2 weeks he wascompletely recovered.

Author comment: Both enalapril and diazepam havepreviously been implicated in gynaecomastia. ‘However, to ourknowledge, this is the first report of two consecutive episodes ofgynecomastia in the same patient associated with twostructurally and pharmacologically different drugs.’Llop R, et al. Gynecomastia associated with enalapril and diazepam. Annals ofPharmacotherapy 28: 671-672, May 1994 - Spain 800271531

1

Reactions 16 Jul 1994 No. 5100114-9954/10/0510-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved