Finasteride

Brand names of finasteride

  • Propecia
  • Proscar

Finasteride (Propecia) is used in the treatment of BPH (Benign Prostatic Hyperplasia), a condition in which the prostate gland in adult males is enlarged resulting in frequent but difficult urination and acute urinary retention - a sudden difficulty in passing urine. Finasteride relieves these symptoms and may, overtime, do away with the need of prostate surgery.

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Finasteride is also found useful in treating male pattern baldness, a condition affecting men which leads to gradual thinning of hair above the forehead resulting in receding hairline and ultimate baldness. However, it does not prevent thinning of hair around the temples which is more frequent in women and children, and so, is not used for the treatment of hair loss in them.

Finasteride belongs to a class of drugs called 5-alpha reductase inhibitors. It blocks the production of certain male hormones in the body. These hormones are responsible for causing the prostate to enlarge and stopping hair growth in the areas above forehead. Hence its use in BPH and male pattern baldness.

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Finasteride comes in the form of an oral tablet. The usual dosage is one tablet, once a day. It can be taken with or without food. For best results, it should be taken regularly at about the same time every day. The directions on the label or in doctor's prescription should be followed carefully, and any ambiguous points should be clarified with the doctor or the pharmacist, beforehand. Further, it should be taken exactly as directed. Neither the dose nor its frequency should be increased or decreased without doctor's advice.

Finasteride needs a long time to show its effects. In case of BPH, it may have to be taken for at least 6 months and in male pattern baldness for at least 3 months, before any improvement is noticed in symptoms.

Finasteride controls the condition by improving symptoms. However, it does not cure the problem. Therefore, you must continue its use even after you notice improvement in symptoms and feel well in general. Discontinuation, without your doctor's advice, may result in relapse of symptoms. In case of BPH, the difficulties in urination may return and in case of male pattern baldness, all the hair that has regrown may be lost, within 12 months after stopping treatment.

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If you have been taking finasteride for male pattern baldness and have not noticed any improvement in 12 months, continuing treatment may not be of much use. Ask your doctor about the desirability of continuing treatment, or stopping it.

Prior to taking finasteride let your health care provider know

  • About any allergies you have to any drug, including finasteride.
  • About all prescription or nonprescription medicines, vitamins, nutritional supplements or herbal products you are currently taking or have plans to take. Your doctor may have to adjust the dosage accordingly or monitor your condition for any side effects.
  • About any liver diseases you have or have had in the past.
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Finasteride is prescribed only for men; both BPH and male pattern baldness it treats, affect only men. However, even if it is being prescribed to women, care should be taken that they are not pregnant, and will not be pregnant while taking it. Pregnant women should not even touch finasteride tablets, especially if they are broken or crushed. Taking finasteride, or touching it, by pregnant women can harm the male fetus.

Usage

Finasteride mainly finds use in shrinking an enlarged prostate gland in adult men. The condition is medically known as BPH. Used alone, or in conjunction with other medicines, it reduces the symptoms of and problems caused by BPH. The results are shown in a decreased urge to pass urine especially at night time, less strain in passing urine, better urine flow, and reduced feeling of the fullness of bladder. Overtime, it may also do away with the need of prostate surgery. It achieves this effect by decreasing the production of DHT, a male hormone that causes the prostate to enlarge.

Finasteride also finds use in checking male pattern baldness, that is, loss of hair from the top of the forehead. This it does again by decreasing production of DHT that causes hair to stop growing in these areas of the scalp.

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Finasteride, being useful only in problems occurring in adult males, should not be used by women or children, unless advised by the doctor.

How to use finasteride

Before starting finasteride treatment, carefully read the Patient Information Leaflet that comes with it. If the package doesn't have this leaflet, ask your pharmacist about it. If you find anything ambiguous in the information, get it clarified by your doctor or pharmacist.

Take finasteride orally, with or without food, once a day or as advised by the doctor. For optimum benefits, take regularly at about the same time every day.

It may take 6 to 12 months of treatment before any improvement is noticed in the symptoms. Do not be impatient and discontinue abruptly. However, inform the doctor if the condition worsens, or persists even after that.

The tablets, especially when broken or crushed, should not be touched by women who are pregnant or are going to be pregnant. It may harm the male foetus.

How finasteride works

DHT or dihydrotestosterone is a male hormone that causes the prostate glands to enlarge and stops hair from growing in certain areas of the scalp. To produce DHT, the body needs a particular enzyme, called 5-alpha reductase, to be active. Finasteride works by inhibiting the action of this enzyme and thereby blocking its production which halts and, overtime, reverses the process of prostate enlargement, as well as reduces concentration of DHT on the scalp.

Side effects

Serious
Use of finasteride has not been associated with any serious side effects.
Common
No common side effects have been observed accompanying the use of finasteride.
Less common
Among less common side effects, some men may experience reduced sex drive leading to erectile dysfunction or impotence. Quantity of ejaculate may also decrease; however, it does not indicate reduced fertility.

Possible interactions

Other medicaments:
Finasteride, taken with tirilazad (Freedox), can increase its effect by up to 29%. Therefore, caution should be exercised.
Herbal medicines or minerals:
Saw palmetto also helps in prostate enlargement due to its anti-inflammatory, anti-androgenic action. However, its mechanism of action seems to be different. There have been no studies on its combination with finasteride. You may try it after talking to your doctor.
In case of male pattern baldness, autumn crocus should not be taken with finasteride.

Storage instructions

Keep the medication in the original container; do not transfer the content into any other container. The container should be tightly closed and kept away from children. Store at room temperature, avoiding excess heat or humidity (not near fireplace or in the bathroom). Any leftovers should be thrown away and not kept for future use.

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