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Finasteride

    Brands

    DEA Class; Rx

    Common Brand Names; Propecia, Proscar

    • 5-Alpha-Reductase Inhibitors

    5-alpha reductase inhibitor
    Used for symptomatic treatment of BPH and male pattern baldness (i.e., androgenetic alopecia)
    May decrease risk of low-grade prostate cancer; but, may increase risk of more serious high-grade prostate cancer

    Indicated

    For the treatment of symptomatic benign prostatic hyperplasia (BPH) in men with an enlarged prostate to improve symptoms, to reduce the risk of acute urinary retention, and to reduce the risk of the need for surgery including transurethral resection of the prostate (TURP) and prostatectomy.
    For the treatment of male pattern hair loss (i.e., androgenetic alopecia), in patients with mild to moderate hair loss of the vertex and anterior mid-scalp area.
    For the second-line treatment of hirsutism.
    For prostate cancer prophylaxis.

    Hypersensitivity

    Women of childbearing potential

    • Erectile dysfunction (1.3-8.1%)
    • Decrease libido (1.8-6.4%)
    • Breast enlargement (0.5-1.8%)
    • Ejaculation disorder (0.8-1.2%)
    • Breast tenderness (0.4-0.7%)
    • Rash (0.5%)

    Use with caution with obstructive uropathy; carefully monitor patients with large residual urinary volume or severely diminished urinary flow

    Use caution in liver disease

    May cause decreased serum PSA in presence of prostate cancer; increases in PSA levels from nadir while on finasteride may signal the presence of prostate cancer and should be carefully evaluated (even if PSA value within normal range)

    Pregnant and potentially pregnant women should not handle crushed or broken tablets or semen of male partner; may have negative impact in fetal development

    Rare reports of male breast cancer observed with use; any breast tenderness, enlargement, pain, lumps, nipple discharge or any other type of breast changes should be reported immediately to healthcare provider

    Therapy is contraindicated in pregnant females and not indicated for use in females; based on animal studies and mechanism of action, drug may cause abnormal development of external genitalia in a male fetus if administered to pregnant female

    Drug is not indicated for use in females

    Adults

    Males: 5 mg/day PO for benign prostatic hyperplasia (BPH); the manufacturer literature states that patients have received up to 80 mg/day PO for three months without adverse effects; however, it is not clear if the dose was used therapeutically or provided additional benefit over the usual dose range. Maximum dose-response is 1 mg/day PO for alopecia.

    Elderly

    Males: 5 mg/day PO for benign prostatic hyperplasia (BPH); the manufacturer literature states that patients have received up to 80 mg/day PO for three months without adverse effects; however, it is not clear if the dose was used therapeutically or provided additional benefit over the usual dose range. Maximum dose-response is 1 mg/day PO for alopecia.

    Adolescents

    Not indicated.

    Children

    Not indicated.

    Finasteride

    tablet

    • 1mg (Propecia)
    • 5mg (Proscar)