{
  "schema_version": 1,
  "kind": "condition",
  "id": "gynaecomastia",
  "name": "Gynaecomastia (Adult)",
  "category": "chronic",
  "sources": "Endocrine Society Guideline on Gynecomastia 2012 · Tamoxifen 20 mg Tablets SmPC sections 4.1-4.4 (eMC product 12524)",
  "review_status": "reviewed",
  "verified_against": "Tamoxifen 20 mg Tablets SmPC sections 4.1-4.4 (eMC product 12524)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 860,
      "generic": "Tamoxifen",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 20.0,
      "adult_dose": "10-20 mg once daily for 3-6 months for painful, recent-onset (<6 months) glandular gynaecomastia",
      "adult_duration": "3-6 months",
      "dose_source": "Tamoxifen 20 mg Tablets SmPC sections 4.1-4.4 (eMC product 12524)",
      "rationale": "Selective oestrogen-receptor modulator that blocks oestrogen's proliferative effect on glandular breast tissue, used for painful, recent-onset gynaecomastia once secondary causes such as drug-induced, testicular, hepatic, or hypogonadal causes have been excluded.",
      "cautions": [
        "First exclude secondary causes: drug-induced (spironolactone, digoxin, finasteride), testicular tumor, hepatic failure, or hypogonadism.",
        "Pubertal gynaecomastia is physiological and usually resolves spontaneously within 1-2 years without medical therapy.",
        "Gynaecomastia is not a licensed indication. The label covers breast cancer, its prevention, and ovulation induction - nothing else. This is an off-label use with reasonable evidence behind it, but say so.",
        "Two to three times the clot risk. Stop it at least six weeks before planned surgery or any long stretch of immobility.",
        "There is an increased risk of deep vein thrombosis and thromboembolism."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Specialist pediatric/adolescent endocrinology evaluation",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "TAMOXIFEN 20 MG 20 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "TECHNOPHARMA",
          "price_egp": 68.0,
          "pack_count": 20,
          "unit_price": 3.4,
          "strength_mg": 20.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "gynaecomastia"
    }
  ]
}