Finasteride
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Finasteride
Proscar (5 mg, BPH), Propecia (1 mg, alopecia)
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Summary
Common uses
Benign prostatic hyperplasia0, Androgenetic alopecia (male pattern hair loss)0, Off-label: hirsutism, feminizing GAHT adjunct0
Pharmacy
Starting dose
5 mg PO daily for BPH; 1 mg PO daily for androgenetic alopecia
Preparations
1 mg, 5 mg tablets
US FDA Max
5 mg/d
Pharmacology
Routes
Oral
Onset
BPH symptom improvement at 3-6 months; prostate volume reduction over 6-12 months; hair regrowth at 6-12 months
Duration
24 hours
Half-life
~5-6 hours in young men, ~8 hours in elderly[1]
Bioavailability
~63% (oral)[1]
Pregnancy
Pregnant individuals should not handle crushed/broken tablets (skin absorption risk); can cause hypospadias in male fetus. Not used in pregnancy.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Finasteride is a selective inhibitor of type II 5α-reductase, the dominant prostatic isoform converting testosterone to dihydrotestosterone (DHT); DHT lowering ~70% shrinks androgen-dependent prostatic tissue and the dermal papilla of androgen-sensitive hair follicles.0 Dutasteride inhibits both type I and II isoforms with deeper DHT suppression but a similar clinical effect. Post-finasteride syndrome (persistent sexual and mood effects after discontinuation) is a controversial but recognized clinical concern that the FDA acknowledged in 2012 labeling[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Proscar (finasteride), Merck, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/020180s044lbl.pdf