Amlodipine-Induced Gynaecomastia in a Patient with Spinal Cord Injury

Background: Gynaecomastia is a benign enlargement of male breast tissue, often linked to disturbances in hormonal balance. Amlodipine, a calcium channel blocker widely prescribed for cardiovascular conditions, is occasionally associated with gynaecomastia, though the causal relationship is not clearly established. This report explores a unique case of amlodipine-induced gynaecomastia in a patient with spinal cord injury (SCI), a demographic that presents additional challenges due to altered neuroendocrine function and chronic inflammatory states. Case Presentation: The authors describe a case involving a male patient in his 60s, previously treated with amlodipine following his spinal cord injury. Despite a comprehensive evaluation showing normal endocrine function and the absence of other systemic diseases, discontinuation of amlodipine led to a regression of breast enlargement, suggesting a drug-induced aetiology. Discussion: The interplay between amlodipine’s pharmacological effects and the patient’s SCI-related physiological changes highlights a complex pathophysiological mechanism. Amlodipine may influence the hormonal balance indirectly through vascular and metabolic effects, exacerbating the tendency towards an oestrogenic environment conducive to gynaecomastia. Furthermore, SCI-related factors such as increased adiposity and reduced physical activity may enhance the aromatisation of androgens to oestrogens, further predisposing to breast tissue proliferation. Conclusion: This case underscores the need for heightened clinical awareness when prescribing amlodipine, particularly in patients with SCI. It prompts consideration of underlying vulnerabilities and suggests a tailored approach to pharmacotherapy to mitigate the risk of adverse drug reactions, including gynaecomastia. The reversibility of symptoms upon drug withdrawal highlights the importance of monitoring and the potential for intervention in similar cases.