Finasteride (Benign prostatic hyperplasia)

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Contents

[edit] BRAND NAMES

[edit] STRUCTURE

Finasteride.jpg

[edit] MECHANISM OF ACTION

The development and enlargement of the prostate gland is dependent on the potent androgen, dihydrotestosterone (DHT). Type II 5α-reductase is an enzyme that converts testosterone to dihydrotestosterone (DHT) in human prostate and hair follicles. DHT induces androgenic effects by binding to androgen receptors in the cell nuclei of these organs.

Finasteride is a competitive and specific inhibitor of Type II 5α-reductase with which it slowly forms a stable enzyme complex. Turnover from this complex is extremely slow (t½ ∼ 30 days). Finasteride use in BPH has resulted in sustained reductions in prostatic volume and PSA level.

[edit] INDICATIONS

  • Treatment of symptomatic benign prostatic hyperplasia (BPH), alone or in combination with an Alpha 1 antagonist (e.g. Tamsulosin), 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.

[edit] DOSAGE

  • Benign prostatic hyperplasia (BPH): One tablet (5 mg) taken once a day with or without meals

[edit] CONTRAINDICATIONS

  • Hypersensitivity to Finasteride

[edit] WARNINGS AND PRECAUTIONS

  • PSA levels: Finasteride (5mg)reduces serum prostate specific antigen (PSA) levels by approximately 50%. However, any confirmed increase in PSA while on Finasteride may signal the presence of prostate cancer and should be evaluated, even if those values are still within the normal range for men not taking a 5α-reductase inhibitor.
  • 5α-reductase inhibitors may increase the risk of development of high-grade prostate cancer.
  • Prior to initiating treatment with Finasteride for BPH, consideration should be given to other urological conditions that may cause similar symptoms (e.g. obstructive uropathy). In addition, prostate cancer and BPH may coexist.

[edit] INTERACTIONS

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category X (US). Finasteride is contraindicated for use in women who are or may become pregnant
  • Nursing Mothers: Finasteride is not indicated for use in women

[edit] SIDE EFFECTS

Possible adverse reactions include: Impotence, decreased libido, decreased volume of ejaculate, breast enlargement, breast tenderness and rash

[edit] RELATED LINKS

Benign Prostatic Hyperplasia (BPH) and Treatments (Video 1)
Benign Prostatic Hyperplasia (BPH) and Treatments (Video 2)

[edit] BIBLIOGRAPHY

[edit] REFERENCES

Benign Prostatic Hypertrophy
5α reductase inhibitors Dutasteride (Avodart)   Finasteride (Proscar)
Alpha 1 antagonists Alfuzosin (Uroxatral, Xatral)   Doxazosin (Cardura)   Prazosin   Silodosin (Silodyx, Rapaflo)   Tamsulosin (Omnic, Flomax, Secotex)   Terazosin (Hytrin)
Phytotherapy Pygeum africanum   Serenoa repens
PDE5 inhibitors Tadalafil (Cialis)
Combination products Dutasteride/Tamsulosin (Combodart, Jalyn, Duodart)
Other Mepartricin
Veterinary Osaterone (Ypozane)
Androgens
Agonists Androstanolone   Dihydrotestosterone   Fluoxymesterone   Mesterolone   Methyltestosterone   Testosterone
Antiandrogens Androgen antagonists Bicalutamide   Chlormadinone acetate   Cyproterone acetate   Dienogest   Drospirenone   Flutamide   Nilutamide   Spironolactone
5α reductase inhibitors Dutasteride (Avodart)   Finasteride (Proscar)