Finasteride (oral)

Finasteride is a doctor prescribed oral medication that serves as a substitute for surgical intervention in men who have benign prostatic hyperplasia or BPH, which is an enlarged prostate.

Overview

What is Finasteride?

Finasteride is a medication that inhibits the body's release of testosterone 5-alpha reductase, which effectively shrinks enlarged prostate glands in men who suffer from BPH, thereby avoiding surgery for these patients. Finasteride is also prescribed to grow hair on the scalp of men with male pattern baldness, a condition called hereditary alopecia. Finasteride must be taken continuously or hair that has grown during treatment will fall out and the prostate will return to an enlarged state.

Finasteride is also sold under the trade names Propecia and Proscar, among others, worldwide. It is also prescribed to women who have excessive hair growth, a condition known as hirsutism and is part of the hormone therapy drugs prescribed to women who are transgender.

How does Finasteride work?

Finasteride is a drug that targets two enzymes; Type II 5a-reductase and Type I. Type I happens to be found mostly in the scalp and the liver. Type II is found in the prostate but is also found in the scalp and liver as well. Finasteride targets these enzymes and blocks them from changing into testosterone by diverting them into another enzyme. This reduces the amount of testosterone found in the body which actively increases hair re-growth and slows hair loss. The lack of testosterone also has an effect on the prostate gland in that it shrinks to within normal limits.

What is BPH?

BPH stands for benign prostatic hyperplasia, which is a condition of the prostate gland in which it becomes enlarged. This is a benign condition, meaning that it is a non-cancerous condition. It is, however, a dangerous condition for the health of many men in that it impedes the flow of urine. In fact, symptoms mostly consist of the inability to urinate normally, loss of bladder control or weak urine stream. This can lead to bladder stones, chronic problems with the kidneys or urinary tract infections.

While there are no specifically clear reasons that men develop benign prostatic hyperplasia, there could be a genetic predisposition in some men that leads to this condition, including men who have type two diabetes, don't get enough exercise or who are obese or those who have erectile dysfunction are at risk for BPH.

Surgical intervention is an option, but includes many risks. Finasteride along with a healthy lifestyle, weight loss and exercise can be a better alternative to surgery.

Conditions Treated

  • Androgenetic alopecia
  • Hirsutism
  • Benign prostatic hyperplasia

Type Of Medicine

  • 5a-reductase inhibitor

Side Effects

Doing its work inside the cellular structure of the body to inhibit certain forms of enzymes that make testosterone, Finasteride may also cause unwanted effects on a patient's health. Not all of the unwanted effects listed below may be experienced by some patients, but if there is an occurrence of these symptoms, medical treatment should be sought urgently:

  • Cold sweats
  • Chills
  • Confused demeanor
  • Fainting
  • Dizzy or lightheaded when rising
  • Swollen arms, legs, feet, hands or face
  • Enlarged, tender breast area
  • Welts or hives on skin
  • Itching
  • Fast weight gain
  • Skin is red or skin rash
  • Swollen face or lips
  • Tingling feet or hands
  • Unusual weight loss
  • Nipple discharge that is bloody or clear
  • Dimples on skin of breast area
  • Nipples become inverted
  • Lumps under the arm or in the breast
  • Nipples are scaly or crusty
  • Breast area is swollen or red
  • Breast has sores that don't heal

Other side effects, though bothersome, don't require the attention of a doctor. Your physician, however, may be able to assist you with ways to ease these symptoms or avoid them completely. Notify your healthcare provider if you experience:

  • Low sex drive or interest
  • Erectile dysfunction
  • Loss of sexual performance, ability or desire
  • Congestion, sneezing or a runny nose
  • Fatigue
  • Drowsiness
  • Abdominal pain
  • Pain in back
  • Low semen amount
  • Dizzy
  • Headache
  • Diarrhea
  • Pain in the testicles

You may also have side effects that are not listed here. Any changes in your overall health or demeanor should be reported to your physician immediately in case underlying health issues are present.

Dosage

Finasteride should be taken only as your doctor prescribed. Do not take more of this drug than your doctor has specified for your dosage and do not take it more frequently than specified. You may only be on this medication for a certain period of time; if so, do not prolong the length of your drug therapy for any reason.

Read and review the patient leaflet that is full of information on this drug and all risks associated. If you have any questions on your prescription or on the drug itself, ask your doctor or pharmacist for clarity until you are comfortable with your knowledge of Finasteride and how it should work for your condition.

Patients taking Finasteride to combat male baldness may not experience any improvements in their condition for ninety days. You should be aware that Finasteride does not cure your condition; it will cause your hair to grow but, if discontinued, the new hair will be lost within twelve months.

Those with BPH, benign prostatic hyperplasia, can expect results within six months. Again, this medication is not a cure for your enlarged prostate, but it reduces its size while you are taking it, easing and improving any symptoms you may have been having. Discontinuing use of this drug will enable the prostate to go back to an enlarged state within months.

It is important that Finasteride is taken on a consistent basis to remain in your body at the same level. Your physician will advise you to make it a routine to take this medication at the same time every day.

As patients are different with different medical conditions, health histories and body types, the dosage each patient is prescribed will be different as well. Be sure to follow what your doctor has prescribed especially for you.

Patients taking Finasteride for BPH will most likely be prescribed 5 milligrams to be taken once daily. Use of this medication in children is not recommended for any reason.

Patients with patterned male hair loss will be given a prescription of 1 milligram once daily as a general rule. Children will not be prescribed this medication for this or any reason.

Missing a dose of Finasteride should not cause you to double up on the medication; if it is not close to your next dosage time, go ahead and take your dose and resume your dose schedule as soon as possible. If it is close to your next tablet, skip the missing dose and resume your scheduled dosage routine as soon as you are able.

Interactions

All drug therapies come with risk factors that will be explained to you by your healthcare provider. You will also be given a patient leaflet that you should read completely. Ask questions about any information contained in this leaflet that you don't understand.

Hypersensitivity to other medications, certain foods, animals, artificial additives, and dyes should be communicated to your health care provider to avoid any unwanted reactions to Finasteride. Inform your healthcare provider if you are taking any other medications including those that are available over the counter, vitamin and herbal therapies or holistic remedies.

Some medications are able to be used together without harm or reduced effectiveness of either drug. Combination therapies are a way to combat symptoms and make the patient more able to live a normal life. However, there are some drugs that should not be combined. The following drug should never be used with Finasteride, which include:

  • St. John's Wort

Consult with your physician on whether to take Finasteride with food or whether certain foods should be eliminated from your diet altogether. You should also inform your doctor if you are a regular user of tobacco products or alcoholic beverages, as these could affect the way Finasteride works for you.

Your full medical history should be communicated to your physician in case you have diseases that would be dangerously affected by the use of a statin drug such as Finasteride. Specifically, the following health conditions have been known to become worse or limit the effectiveness of this medication:

  • Liver conditions and diseases

Patients with diseases involving the liver may not remove the metabolized drug from their systems at the preferred rate and require lower dosage or may not be candidates for treatment with Finasteride.

Warnings

Children, pregnant women, women who may become pregnant and women who are breastfeeding should never be prescribed treatment with Finasteride for any reason. Finasteride tablets that are broken or crushed should not even be handled by women who are pregnant as their male children may experience birth defects from exposure to the drug.

Geriatric patients should be able to take Finasteride with the same rate of success and level of risk as adult patients. The exceptions are patients who have diseases involving the liver which can cause the drug to remain in their systems for a longer period of time. These patients should have an adjustment to their dosage of Finasteride.

Your physician will want to see you for progress checks on a regular basis while you are taking Finasteride. This will ensure that the drug is working for your condition without causing you adverse health effects. Your office visit may involve blood sample testing.

Finasteride may change breast tissue, causing tenderness, lumps, enlarged breasts or pain. Notify your physician if you experience any change or symptoms in your breasts while taking this medication.

Finasteride has an effect on health tests involving the prostate such as the PSA, prostate-specific antigen test. This test is used to detect cancer of the prostate; if you will be having this test performed, make sure your physician is aware that you are taking this medication.

You may notice a decrease in the amount you ejaculate during sex; this does not affect your sperm count or your fertility in any way.

Finasteride is generally safe to take with other drugs and, in fact, may be prescribed in conjunction with other drugs to more effectively treat your condition. It is advised, however, that you disclose your full medical history along with any prescription, over-the-counter, vitamin or supplement drugs you are taking to your physician prior to taking a course of Finasteride.

Storage

Retain the original packaging that your Finasteride arrived in and use it to store this medication properly. Keep this medicine at room temperature, away from exposure to excessive light, heat or moisture. Do not allow Finasteride to freeze and do not use it if it has become frozen. This medication, as well as others, should be kept out of sight and reach of children and pets.

It is not advised that you keep any Finasteride dosages that are expired or unneeded. These doses should be disposed of properly according to your physician's instructions for safety. If this is not provided to you by your physician, consult with your pharmacist on safe disposal practices.

Summary

Finasteride is an enzyme inhibitor that slows down the production of testosterone in the body. Male patients who have a condition of enlargement of the prostate known as BPH benefit from treatment with Finasteride as it eases their urinary symptoms and avoids the necessity of surgical intervention. Male baldness is also improved with treatment by this medication. Women and children are not advised to take this drug as their safety can be compromised. However, Finasteride is used in some women to control unwanted facial hair growth as well as provide hormone therapy in transgender women.

Finasteride is generally safe to take, with minor adverse health effects occurring to sex drive, occasional nasal congestion, and stomach pain. Any problems that involve breast tissue, however, should be reported to your physician immediately as they could have underlying health risks associated with them. Those who experience tenderness, change in appearance, swelling, redness or discharge from their nipples are urged to contact their doctor right away.

Geriatric patients should be generally safe taking Finasteride with the exception of those that have diseases involving the liver, as their bodies may not metabolize this drug as quickly as expected. Adult patients with liver disease should use caution when taking Finasteride as well. Report your full medical history including prescriptions, vitamins, over-the-counter remedies and other therapies to your physician prior to being prescribed this medication for your own safety.

Finasteride can be safely stored at room temperature out of sight and reach of children and pets. Do not allow pregnant women to come in contact with Finasteride tablets, especially if crushed or broken, as they can inadvertently pass the drug onto their male offspring, causing birth defects.

If your symptoms do not improve or if your side effects are severe with taking Finasteride, discuss further treatment with your healthcare provider.