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The time to onset of spironolactone-induced gynecomastia has been found to be 27 ± 20 months at low doses and 9 ± 12 months at high doses. [133] Gynecomastia induced by spironolactone usually regresses after a few weeks following discontinuation of the medication. [110]
The onset of action of the antimineralocorticoid effects of spironolactone is relatively slow, with the peak effect sometimes occurring 48 hours or more after the first dose. [ 1 ] [ 24 ] Canrenone is an antagonist of the MR as is spironolactone, [ 25 ] but it is slightly more potent in comparison.
Spironolactone – most widespread use, inexpensive; Eplerenone – more selective so reduced side-effects but more expensive and less potent; Finerenone – non-steroidal, more selective and potent than spironolactone and eplerenone; Canrenone – very limited use
A few drugs such as alcohol are absorbed by the lining of the stomach, and therefore tend to take effect much more quickly than the vast majority of oral medications which are absorbed in the small intestine. Gastric emptying time can vary from 0 to 3 hours, [2] and therefore plays a major role in onset of action for orally administered drugs ...
Mycophenolic acid is an immunosuppressant medication used to prevent rejection following organ transplantation and to treat autoimmune conditions such as Crohn's disease and lupus.
Although warfarin is commonly prescribed, it exhibits a delayed onset of action, which takes approximately 5 to 7 days to reach its full therapeutic effect. [39] Apart from haemorrhage, jaundice (yellowing of the skin and eyes) is also a common side effect caused by this class of drug. [34]
Unlike the GnRH agonists, which cause an initial stimulation of the hypothalamic–pituitary–gonadal axis (HPG axis) that leads to a surge in testosterone or estrogen levels, GnRH antagonists have an immediate onset of action and rapidly reduce sex hormone levels without an initial surge. [1] [25
An example of this is the repurposing of the antimineralocorticoid and diuretic spironolactone, which was found to produce feminization and gynecomastia as side effects, for use as an antiandrogen in the treatment of androgen-dependent conditions like acne and hirsutism in women. [1] Metformin also causes off-target activity. [citation needed]
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