How does finasteride work?
Finasteride works by inhibiting the enzyme 5-alpha reductase, which converts testosterone into dihydrotestosterone (DHT). DHT enlarges the prostate gland, causing BPH and lower urinary tract symptoms. By reducing DHT levels, finasteride helps to shrink the enlarged prostate and alleviate urinary symptoms in men with BPH.
How should I take finasteride? What is the recommended dosage?
For the treatment of BPH and LUTS, the typical dose of finasteride is 5 mg once daily. Taking the medication as prescribed and simultaneously daily is essential for optimal results.
What are the common side effects of finasteride 5mg, and what are the percentages of occurrence?
Common side effects of finasteride 5mg for BPH and LUTS may include decreased libido, erectile dysfunction, reduced ejaculatory volume, breast enlargement (gynecomastia), and tenderness in the breast area. Approximately 3% to 9% of men experience these side effects, which are usually reversible upon discontinuing the medication.
What should I do if I experience side effects?
If you experience any side effects while taking finasteride, it's crucial to consult your healthcare provider immediately. They can assess the situation and may recommend adjusting the dosage or trying alternative treatments.
When can I expect to see results from finasteride treatment?
In BPH and LUTS treatment, finasteride may take several months to achieve noticeable improvements in urinary symptoms. Being patient and consistent with the medication is essential, as the prostate takes time to shrink. Typically, results are felt in 9 to 12 months.
How much does finasteride reduce prostate size?
Finasteride has been shown to reduce prostate volume by about 20% to 30% after six months of treatment. This reduction helps alleviate symptoms related to BPH, such as difficulty urinating and frequent urination.
Can finasteride be combined with other medications?
Yes, finasteride can be combined with alpha-blockers like tamsulosin.
Tamsulosin helps by relaxing the smooth muscles in the prostate and bladder neck, allowing for better urine flow. The combination of finasteride and tamsulosin is used to treat BPH and LUTS more effectively than either medication alone.
What percentage of men can avoid surgery with finasteride treatment?
Approximately 50% to 70% of men with BPH can avoid surgery using finasteride. It is a compelling long-term treatment option for managing BPH symptoms and reducing the need for surgical intervention.
What common surgical treatments exist for an enlarged prostate?
What investigations will a urologist order before starting finasteride?
Before prescribing finasteride, a urologist will perform a comprehensive evaluation, including a medical history, physical examination, and digital rectal exam (DRE). Additionally, they may order a blood test called PSA, a flow test, an ultrasound post-void residual, and, if indicated, an ultrasound of the kidneys.
Does finasteride cause prostate cancer?
Some studies, such as the Prostate Cancer Prevention Trial (PCPT), have reported a potential increased risk of high-grade prostate cancer in men taking finasteride. However, it is essential to note that the evidence from this study was reanalyzed, and other well-designed studies have not consistently found a significant link between finasteride use and prostate cancer.
Some new studies suggest that the higher risk of high-grade prostate cancer in the PCPT might not be because of finasteride use, but because of better ways to find cancer. Some studies have even indicated a possible protective effect of finasteride against low-grade prostate cancer.
It's essential to consider the reliability of the sources and the totality of evidence when evaluating the association between finasteride and prostate cancer risk. As with any medical treatment, the decision to use finasteride should be made after discussing the potential risks and benefits with your healthcare provider, considering your health profile and risk factors. Always prioritise open communication with your healthcare provider to make informed decisions about your health.
Can Finasteride cause breast cancer?
The association between finasteride use and breast cancer risk is a subject of ongoing research and debate. Some studies have suggested a potential link between finasteride use and an increased risk of breast cancer in men. However, the evidence is inconclusive, and the risk appears low.
In clinical trials, the incidence of breast cancer in men taking finasteride for treating BPH has been reported to be similar to that of men not taking the medication. Additionally, studies investigating the relationship between finasteride and breast cancer in men have produced conflicting results.
Can Finasteride cause nipple discharge?
Nipple discharge is a less common side effect of finasteride but has been reported in some cases. If you experience nipple discharge while taking finasteride, it's essential to inform your healthcare professional.
Nipple discharge can have various causes, including hormonal imbalances and benign breast conditions. Your doctor may perform further evaluations, such as physical examination, imaging, or laboratory tests, to determine the underlying cause of the discharge.
As with any side effect, it's essential to communicate openly with your healthcare provider about any changes or concerns you have while taking finasteride. They can guide and determine the best action to address your situation.
Remember that individual responses to medications can vary. While finasteride is generally well-tolerated, it's essential to be vigilant for any unusual or concerning symptoms and seek medical advice promptly.
What should I avoid while taking finasteride tablets? Cautions with other medicines
While taking finasteride, one must be aware of certain precautions and potential drug interactions with other medications. Here are some things to consider:
- Avoid handling crushed or broken finasteride tablets: Women, especially pregnant women, should avoid taking crushed finasteride tablets, as the medication can be absorbed through the skin and may cause harm to the developing fetus.
- Potential interactions with alpha-blockers: Finasteride is sometimes prescribed with alpha-blockers like tamsulosin for BPH treatment. While this combination can be effective, it can lead to a higher risk of erectile issues/
- Liver metabolism interactions: Finasteride is primarily metabolised in the liver. Therefore, it's essential to be cautious if you take other medications metabolised through the liver, as there might be a risk of increased drug levels in the bloodstream. One should evaluate the risks and benefits before prescribing in the presence of liver disease. Have a conversation with your doctor or pharmacist. Do not drink alcohol in excessive amounts when you are on Finasteride 5mg treatment.
- Testosterone supplements: Finasteride reduces the conversion of testosterone to dihydrotestosterone (DHT). If you take testosterone supplements, discussing potential interactions with your doctor is essential.
What happens if I miss a dose?
If you miss a dose of finasteride, take it as soon as you remember. However, if it is close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for the missed one, as this can increase the risk of side effects. Remember, a one-off forgotten dose of finasteride is not a grave mistake.
Can I develop an allergic reaction to finasteride 5mg?
Taking finasteride tablets very rarely can cause allergic reactions. If you have an allergic reaction, contact your doctor immediately.
Is there an alternative to Finasteride?
Dutasteride is another 5-alpha reductase inhibitor that works similarly to finasteride. It inhibits the conversion of testosterone into dihydrotestosterone (DHT) and can help reduce prostate size and improve urinary symptoms.
Can Finasteride be used for male pattern hair loss?
Finasteride is indicated to treat hair loss. However, you have to speak to your doctor or pharmacist about it.
Reflection from a consultant urologist
By understanding how finasteride works, its potential side effects, and how to use it safely, you can make an informed decision about its suitability for your specific condition. Always prioritise open communication with your healthcare provider to ensure the best possible outcome for your health. Everyone is unique, and what works for one may not work for another.
