Tab%2520finasteride

# Tab%2520finasteride ## Overview Finasteride is a 5-alpha-reductase inhibitor that blocks conversion of testosterone to dihydrotestosterone (DHT). Available as 1 mg (Propecia) and 5 mg (Proscar) tablets. ## Primary Indications - Benign prostatic hyperplasia (BPH) — 5 mg dose - Male pattern baldness (androgenetic alopecia) — 1 mg dose - Adjunctive therapy for symptomatic BPH in combination with alpha-blockers ## Adult Dosing - **BPH**: 5 mg once daily. May require 6–12 months for maximal symptom improvement. - **Androgenetic alopecia**: 1 mg once daily. Continuous use required; cessation leads to reversal within 6–12 months. ## Pediatric Dosing - Not approved for use in children or adolescents. Safety and efficacy not established. - Used off-label in some centers for gender-diverse minors (under specialist endocrinology guidance) — typical starting doses of 1–2.5 mg daily, titrated, exact dosing per local protocol. ## Dose Adjustments - No dose adjustment needed for renal impairment. - No dose adjustment for hepatic impairment (avoid in severe hepatic disease). - No adjustment for age (elderly may require monitoring for response). ## Contraindications - Women who are pregnant or may become pregnant (risk of hypospadias in male fetus; avoid handling crushed/broken tablets) - Children - Hypersensitivity to finasteride or any component - Severe hepatic impairment ## Adverse Effects - Decreased libido, erectile dysfunction, ejaculation disorders (typically reversible with discontinuation) - Gynecomastia (breast tenderness/enlargement) - Depression, anxiety (rare) - PSA reduction (by ~50% — interpret PSA values with caution) - Rare: high-grade prostate cancer (association debated) ## Key Drug Interactions - No significant CYP450 interactions. - Avoid concurrent use with other 5-alpha-reductase inhibitors (e.g., dutasteride). - Potentially reduced efficacy with potent CYP3A4 inducers (rifampin, carbamazepine) — clinical significance unclear. ## Monitoring - **BPH**: Baseline PSA, DRE; repeat PSA 6–12 months after initiation, then per risk; monitor IPSS symptoms - **Alopecia**: Photographs, patient-reported hair count - **Adverse effects**: Sexual function, mood changes, breast changes ## Clinical Pearls - Do not handle crushed/broken tablets if pregnant or may become pregnant. - Counsel male patients that effects on hair loss require ≥6 months continuous use; benefit lost after discontinuation. - PSA decreases by ~50% within 6 months — double PSA value for prostate cancer screening interpretation. - Finasteride is less effective than dutasteride for reducing DHT (~70% vs. >90%). - Sexual side effects may persist in rare cases after discontinuation (post-finasteride syndrome). **Educational Disclaimer:** This information is provided for educational reference and must be verified against current, region-specific prescribing information, local protocols, and the latest product monograph before making clinical decisions. Doses and indications may vary by jurisdiction.