Gynecomastia (off-label use): Oral: 20 mg once daily for up to 12 months (Boccardo 2005; Fradet 2007). The majority of published experiences have been in adult males with prostate cancer receiving bicalutamide. Use has also been reported in patients with idiopathic gynecomastia.
Adolescent boys가 아닌 성인에서 (adolescent boys의 경우는 성인과 약간 다릅니다)
For adults in whom no cause can be identified and the gynecomastia is tender and persists more than three months, we suggest a brief trial (three to six months) of tamoxifen for relief of symptoms. Although clinical trial data are limited, tamoxifen and raloxfen appear to decrease breast volume in adults with gynecomastia. However, complete breast regression may not be achieved with this approach, and these drugs are not approved for the treatment of gynecomastia.
Tamoxifen therapy for up to three months has been reported to result in pain relief (for those with gynecomastia associated with pain and tenderness) and at least partial regression of glandular tissue in approximately 80 percent of men.
In a retrospective series, tamoxifen appeared to be more effective than danazol therapy. Adverse events in men taking tamoxifen are rare but include epigastric distress and one report of a posttraumatic deep venous thrombosis.
In summary, although SERMs may not result in complete regression of breast tissue, they may be effective for patients with painful gynecomastia. We suggest a three-month trial of tamoxifen for adolescents with severe breast enlargement that is confirmed to be glandular tissue and is causing substantial tenderness and/or embarrassment. We suggest a similar approach for men prior to considering surgery. We typically choose tamoxifen over other SERMs, such as raloxifen, since it is the best studied of the SERMs and is reasonably well tolerated. We evaluate patients after three months to determine if the therapy is effective.
