Eplerenone (Mineralocorticoid Receptor Antagonist) Induced Bilateral Gynecomastia

Mineralocorticoid receptor antagonist (MRA) is also known as potassium-sparing diuretics which is commonly used for the treatment of heart failure and hypertension. Spironolactone is the first generation of MRA but it may have some adverse effects, particularly gynecomastia. This adverse effect may be related to its properties of androgen suppression. In contrast to spironolactone, eplerenone is the second generation of MRA which may be less potent in blocking the activation of androgen receptors resulting in less gynecomastia. However, despite limited sexual and hormonal side effects, we should still keep cautious regarding the anti-androgen effect of eplerenone. In this report, we demonstrated one 88-year-old male patient with eplerenone induced gynecomastia.