title: Gynecomastia associated with fenofibrate.
abstract: OBJECTIVE
  To report a case of probable fenofibrate-induced gynecomastia.
  
  
  METHODS
  A 56-year-old white hypercholesterolemic man was treated with fenofibrate 160 mg/day for 1 year. During the course of treatment, he developed gynecomastia on the left side, which resolved after the drug was stopped and replaced with alpha tocopherol acetate. Sixteen months after fenofibrate discontinuation, the patient was rechallenged and subsequently developed gynecomastia symptoms on the right side. The usual etiologies of gynecomastia were excluded by careful assessment of the patient's medical history, physical examination, and results of diagnostic tests such as chest X-ray, mammography, scrotal ultrasonography, routine blood chemistry, and extensive hormonal panel. Gynecomastia again resolved after discontinuation of fenofibrate.
  
  
  CONCLUSIONS
  In this case, the resolution of gynecomastia on discontinuation of fenofibrate and recurrence after rechallenge highly suggest the role of fenofibrate. Use of the Naranjo probability scale registered causality as probable. Case reports of gynecomastia caused by different drugs have been previously published, but, to our knowledge, this is the first report linking gynecomastia to the use of fenofibrate. The pathogenesis of this adverse drug reaction remains unclear.
  
  
  CONCLUSIONS
  Although fenofibrate-induced gynecomastia appears to be uncommon, patients receiving this medication should be monitored for this adverse drug reaction.
authors.affiliation: Service de Pharmacologie Clinique, Centre Midi-Pyrénées de Pharmacovigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, Faculté de Médecine, Université Toulouse III Paul Sabatier, Toulouse, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Gardette
authors.forename: Delphine
authors.initials: D
authors.lastname: Vezzosi
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Maiza
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Montastruc
authors.forename: Pascale
authors.initials: P
authors.lastname: Olivier
mesh_terms: D011345:Fenofibrate / Q000009:adverse effects*; D006177:Gynecomastia / Q000139:chemically induced*; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged
chemical_list: D000960:Hypolipidemic Agents; D011345:Fenofibrate