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Finasteride (5 alpha-reductase inhibitor) 💊
Always check the BNF here for up-to-date prescribing advice.
- Check BNF or equivalent for current prescribing information.
- Used in benign prostatic hypertrophy (BPH) and male pattern hair loss.
⚙️ Mode of Action
- Finasteride is a 5-alpha-reductase inhibitor.
- Blocks conversion of testosterone to dihydrotestosterone (DHT).
- Reduces prostate size ➝ improves urinary flow and symptoms of obstruction.
- Takes several months for full clinical effect.
📋 Indications / Dose
- Benign prostatic hypertrophy (BPH): 5 mg OD PO.
- Male pattern baldness: 1 mg OD PO.
🔄 Interactions
- See BNF for full interaction list.
- Generally few significant interactions, but monitoring advised if co-prescribed with other prostate/androgen-related therapies.
⚠️ Cautions
- Exclude prostate cancer before starting treatment (check PSA).
- Use with caution in patients with urinary tract obstruction.
- Monitor symptoms and PSA during treatment.
⛔ Contraindications
- Women and children (not indicated).
- Potential teratogen to male fetuses ➝ avoid handling crushed tablets during pregnancy (drug can be secreted in semen).
⚡ Side Effects
- Sexual: reduced libido, erectile dysfunction, decreased ejaculate volume.
- Breast: gynaecomastia, breast tenderness.
- Psychiatric: depression (rare but reported).
- PSA levels decrease by ~50% ➝ must interpret results cautiously when screening for prostate cancer.
📚 References
- BNF – Finasteride
- MHRA Drug Safety Update – Finasteride and psychiatric/sexual side effects.
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