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- Proscar: Finasteride for treatment of an enlarged prostate is taken once a day as a 5-mg tablet. The pill may be crushed or broken if the patient finds it hard to swallow.
- Propecia: Finasteride for hair regrowth is taken once a day as a 1-mg tablet. The drug may be taken with or without meals, as the patient prefers.
Pharmacologic class: Androgen inhibitor
Therapeutic class: Sex hormone, hair regrowth stimulant
Pregnancy risk category X
Suppresses dihydrotestosterone levels by inhibiting the hepatic enzyme 5-alpha reductase, which converts testosterone to dihydrotestosterone in prostate, liver, and skin
Tablets: 1 mg (Propecia), 5 mg (Proscar)
Indications and dosages
➣ Symptomatic benign prostatic hypertrophy (BPH)
Adults: 5 mg P.O. daily
➣ To reduce risk of progression of BPH symptoms
Adults: 5 mg P.O. daily (Proscar) given with doxazosin
➣ Male-pattern baldness
Adults: 1 mg P.O. daily
• Acne in women
• Hypersensitivity to drug or its components
• Pregnant patients, women who may potentially be pregnant
Use cautiously in:
• hepatic impairment, obstructive uropathy, increased risk of high-grade prostate cancer, decrease in serum prostate-specific antigen (PSA) level
• women (not indicated)
• children (not indicated).
• Give with or without food.
• Know that female patients who are or may be pregnant shouldn't handle crushed or broken tablets. (Tablets are coated, so handling of intact tablets doesn't pose a problem.)
CNS: dizziness, headache, asthenia
EENT: lip swelling
GU: erectile dysfunction, decreased ejaculate volume, decreased libido, testicular pain, gynecomastia
Musculoskeletal: back pain
Drug-drug. Theophylline: increased theophylline clearance
Drug-diagnostic tests. PSA: 50% decrease
• Carefully evaluate sustained PSA increases during therapy.
• Monitor fluid intake and output closely.
• Tell patient he may take drug with or without food.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Inform patient that he may experience erectile dysfunction and decreased ejaculate. Advise him to discuss these issues with prescriber.
• Caution female caregiver or companion who is or may be pregnant not to handle crushed or broken tablets.
• Tell patient he may need at least 6 months of therapy for BPH treatment and at least 3 months to see improvement in male-pattern baldness.
• Inform patient with BPH that he'll undergo periodic digital rectal exams.
• Instruct patient not to donate blood for at least 1 month after last dose.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and tests mentioned above.
finasteride/fi·nas·te·ride/ (fĭ-nas´ter-īd) an inhibitor of 5, used in the treatment of benign prostatic hyperplasia and as a hair growth stimulant in the treatment of androgenetic alopecia.
finasterideProscar®, Propecia™ Hair A competitive inhibitor of 5α-reductase, the enzyme responsible for converting testosterone to DHT or dihydrotestosterone; it is used to ↓ BPH Sx–↓ obstructive Sx, ↓ prostate volume, ↑ urinary flow–reportedly less effective than Hytrin; it binds with 5α-reductase type 2, inhibiting production of DHT; its uses include reversal of male-pattern baldness, hirsutism, acne Adverse effects ↓ Libido, impotence, ejaculatory defects. See Androgen ablation therapy.
finasterideAn anti-androgen drug used to reduce prostate enlargement in benign prostatic hypertrophy by inhibiting the enzyme 5-alpha reductase which is concerned in the conversion of TESTOSTERONE to dihydrotestosterone, the main prostate androgen. Like all testosterone antagonists this drug can cause reduced sexual interest, impotence, ejaculation problems, breast tenderness and breast enlargement (gynecomastia). In a trial involving nearly 19,000 men the drug was found to reduce the incidence of prostate cancer by a quarter. It may, however, increase the risk of high-grade cancers. A brand name is Proscar.
drug class: synthetic steroid;
action: competitive inhibitor of 5-α-reductase, which converts testosterone to 5-α-dihydrotestosterone;
use: symptomatic benign prostatic hyperplasia.