Asked by Larry Roberts, Newport News, Virginia
I am a male, 66 years old. In March 2008, my cardiologist prescribed spironolactone (2 mg daily). About two months ago, I started having soreness in my left breast, and both breasts seem to have enlarged. Is there a possible connection with the medication?
Dr. Otis Brawley
Chief Medical Officer,
American Cancer Society
Dear Mr. Roberts,
Spironolactone is a potassium-sparing diuretic. It is a drug most frequently used to lower blood pressure and decrease fluid retention and swelling. It is especially useful in people with liver disease. Spironolactone is an oral agent that inhibits aldosterone, which is a hormone that causes the kidney to retain sodium and water. Retention of sodium and water increases blood pressure.
Like all drugs, spironolactone does have side effects. We in medicine try to find a drug with minimal side effects to the patient that we are treating and maximal benefit to the endpoint we are trying to achieve. In your case, that endpoint is most likely lower blood pressure and less swelling.
In rare individuals, this drug can cause inflammation of the veins (vasculitis) and blood clots. It can also cause confusion, dizziness, drowsiness, fever and fatigue. People taking the drug often have loss of appetite, cramps, diarrhea or upset stomach. In answer to your question, 9 percent, or one in 11 men taking it, do have swelling of the breast, and 2 percent have breast pain. These side effects can occur after months and years of no problem with the drug.
I strongly urge you to talk to your doctor about this problem, and your doctor will probably want to give you a different drug.
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