Indications
- Male pattern androgenetic alopecia(FDA approaved).
- Female pattern hair loss.
- Hirsutism.
- Acne vulgaris.
- Hidradenitis suppurativa.
- With hair transplantation.
Dosage
- Male pattern androgenetic alopecia : 1 mg PO qd at least 3 months.
- Hirsutism : 2.5-5 mg/day.
- Hidradenitis suppurativa: 5 mg/day.
Mechanism of action
- Finasteride is inhibitor of type II 5-α-reductase, which stimulates conversion of testosterone to dihydrotestosterone.
Baseline Monitoring
- Prostate-specific antigen for men 50 years and older.
Side effects
Side effects that occur in <2% of men taking finasteride.
- Reversible decreased libido.
- Decreased ejaculate volume.
- Erectile dysfunction.
- Impotence.
- Gynecomastia.
- Myopathy.
- Hypersensitivity reaction.
- Teratogenicity (male fetus).
Contraindications
- Hypersensitivity to finasteride or any component of product.
- Use in children.
- Use in women of childbearing potential.
- Liver disease.
Interactions
- Nevirapine,rifampin, cortisone, dexamethasone, griseofulvin and carbamazepine may reduce finasteride levels and efficacy.
- Clarithromycin,erythromycin,isoniazid,cyclosporine,grapefruit, fluconazole, itraconazole and ketoconazole may increase the level or effect of finasteride.
Pregnancy &Lactation
- Pregnancy category X .
- Lactation: contraindicated.
Precautions
- Blood donation is also contraindicated for those taking fnasteride for at least 6 months after the last dose to prevent blood donation to a pregnant female transfusion recipient, which may harm the male fetus.
- Rare reports of male breast cancer observed with use; any breast tenderness, enlargement, pain, lumps, nipple discharge or any other type of breast changes should be reported immediately.
Drug Info
- Finasteride (Propecia, 1 mg) has had FDA approval for men with AGA since 1997.
- Some physicians prescribe finasteride and instruct patients to split the 5-mg tablet with a pill splitter into four equal parts.
- Approximately 20% to 30% of men do not respond.
- Finasteride is not FDA-approved for women with AGA, and at a dosage of 1 mg daily, no improvement was observed in clinical trials.
- There have been two reports of severe azoospermia leading to impaired fertility.