Finasteride
Status
FDA-approved. FDA-approved labeling exists as Propecia for androgenetic alopecia in men and as Proscar for symptomatic benign prostatic hyperplasia. Labeling documents effects on PSA, the high-grade prostate cancer finding, sexual adverse effects including reports of persistence after discontinuation, and depression. It is contraindicated in women who are or may become pregnant, and crushed or broken tablets should not be handled by them because of the risk to a male foetus.
What it is
An approved medicine that lowers DHT, used for hair and prostate.
What published research measured
A type 2 5-alpha-reductase inhibitor with large randomized trials supporting both approved uses — hair retention in androgenetic alopecia and symptom reduction with decreased need for surgery in benign prostatic hyperplasia. Two areas deserve careful reading. On prostate cancer, the Prostate Cancer Prevention Trial found fewer cancers overall but more high-grade tumours in the finasteride arm; later analyses attributed much of that to detection effects from a smaller gland, but the labeling retains the finding. On persistent adverse effects, reports of sexual dysfunction, mood disturbance and cognitive symptoms continuing after discontinuation have driven labeling changes in several countries and the addition of depression and suicidal ideation warnings; whether a persistent syndrome exists as a distinct entity remains disputed in the literature rather than settled either way. It also roughly halves serum PSA, which must be accounted for when interpreting a result.
Source
Prostate Cancer Prevention Trial (PCPT) · FDA labeling for Propecia and Proscar
Sources
No linked primary source is on file for this entry yet.
Educational use only, never medical advice. No doses.