Drug Action
A specific inhibitor of the enzyme 5a- reductase, which metabolises testosterone into the more potent androgen, dihydrotestosterone.
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Individual generic drug information
Extracted information for Finasteride only.
A specific inhibitor of the enzyme 5a- reductase, which metabolises testosterone into the more potent androgen, dihydrotestosterone.
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Benign prostatic hyperplasia ▶BY MOUTH ▶Adult: 5 mg daily, review treatment at 3–6 months and then every 6–12 months (may require several months treatment before benefit is obtained) Androgenetic alopecia in men ▶BY MOUTH ▶Adult: 1 mg daily, continuous use for 3–6 months is required before benefit is seen, and effects are reversed 6–12 months after treatment is discontinued
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Obstructive uropathy
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NHS restrictions Finasteride is not prescribable in NHS primary care for the treatment of androgenetic alopecia in men.
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Extracted information for Finasteride only.
MHRA/CHM ADVICE: RARE REPORTS OF DEPRESSION AND SUICIDAL THOUGHTS (MAY 2017) The MHRA has received reports of depression and, in rare cases, suicidal thoughts in men taking finasteride (Propecia ®) for male pattern hair loss; depression is also associated with Proscar ® for benign prostatic hyperplasia. Patients should be advised to stop finasteride immediately and inform a healthcare professional if they develop depression.
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▶Common or very common Sexual dysfunction ▶Uncommon Breast abnormalities. skin reactions ▶Frequency not known Angioedema. depression. infertility male. palpitations. testicular pain
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Finasteride is excreted in semen and use of a condom is recommended if sexual partner is pregnant or likely to become pregnant. l EFFECT ON LABORATORY TESTS Decreases serum concentration of prostate cancer markers such as prostate- specific antigen; reference values may need adjustment. l HANDLING AND STORAGE Women of childbearing potential should avoid handling crushed or broken tablets of finasteride.
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Extracted information for Finasteride only.
There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, powder Tablet CAUTIONARY AND ADVISORY LABELS 25 ▶Finasteride (Non-proprietary) Finasteride 1 mg Finasteride 1mg tablets | 28 tablet P £16.72– £28.63 | 84 tablet P £88.40 Finasteride 5 mg Finasteride 5mg tablets | 28 tablet P £11.85 DT = £1.59 ▶Propecia (Merck Sharp & Dohme Ltd) Finasteride 1 mg Propecia 1mg tablets | 28 tablet P £33.68 | 84 tablet P £88.40 ▶Proscar (Merck Sharp & Dohme Ltd) Finasteride 5 mg Proscar 5mg tablets | 28 tablet P £13.94 DT = £1.59 1.3 Urolithiasis Renal and ureteric stones Description of condition Renal and ureteric stones are crystalline calculi that may form anywhere in the upper urinary tract. They are often asymptomatic but may cause pain when they move or Genito-urinary system obstruct the flow of urine. Most stones are composed of calcium salts (calcium oxalate, calcium phosphate or both). The rest are composed of struvite, uric acid, cystine and other substances. Patients are susceptible to stone formation when there is a decrease in urine volume and/or an excess of stone forming substances in the urine. The following are risk factors that have been associated with stone formation: dehydration, change in urine pH, males aged between 40–60 years, positive family history, obesity, urinary anatomical abnormalities, and excessive dietary intake of oxalate, urate, sodium, and animal protein. Certain diseases which alter urinary volume, pH, and concentrations of certain ions (such as calcium, phosphate, oxalate, sodium, and uric acid) may also increase the risk of stone formation. Certain drugs such as calcium or vitamin D supplements, protease inhibitors, or diuretics may also increase the risk of stone formation. Symptoms of acute renal or ureteric stones can include an abrupt onset of severe unilateral abdominal pain radiating to the groin (known as renal colic) that may be accompanied with nausea, vomiting, haematuria, increased urinary frequency, dysuria and fever (if concomitant urinary infection is present). Stones can pass spontaneously and will depend on a number of factors, including the size of the stone (stones greater than 6 mm have a very low chance of spontaneous passage), the location (distal ureteral stones are more likely to pass than proximal ureteral stones), and the degree of obstruction. Aims of treatment g The aim of treatment is to improve the detection, clearance and prevention of renal and ureteric stones thereby reducing pain and improving quality of life. h Non-drug treatment g Consider watchful waiting for asymptomatic renal stones if they are less than 5mm in diameter. If they are larger; the risk and benefit of this option should be discussed with the patient. Options for surgical stone removal should be discussed by the specialist hospital team depending on severity of obstruction, patient factors, size and site of stone. Options include shockwave lithotripsy, percutaneous nephrolithotomy and ureteroscopy. Consider stone analysis and measure serum calcium in patients with recurring renal or ureteric stones. Along with maintaining a healthy lifestyle, advise patients to drink 2.5–3 litres of water a day with the addition of fresh lemon juice and to avoid carbonated drinks. Maintain a normal daily calcium intake of 700–1,200mg and salt intake of no more than 6g a day. For patients with recurrent calcium stones avoid excessive intake of oxalate-rich products, such as rhubarb, spinach, cocoa, tea, nuts, soy products, strawberries, and wheat bran. For patients with recurrent uric acid stones, avoid excessive dietary intake of urate rich products, such as liver, kidney, calf thymus, poultry skin, and certain fish (herring with skin, sardines and anchovies). h Pain Management g Offer NSAIDs as first line treatment for the management of pain associated with suspected renal colic or renal and ureteric stones. If NSAIDs are contra-indicated or not sufficiently controlling the pain, consider intravenous paracetamol. Subsequently, opioids can be used if both paracetamol and NSAIDs are contra-indicated or not sufficiently controlling the pain. Do not offer antispasmodics to patients with suspected renal colic. h Medical Expulsive Therapy g Consider alpha-adrenoceptor blockers for patients with distal ureteric stones less than 10mm in diameter. Alpha- adrenoceptor blockers may also be considered as adjunctive Genito-urinary system therapy for patients having shockwave lithotripsy for ureteric stones less than 10mm. h Prevention of recurrence of stones g Alongside lifestyle advice, consider potassium citrate [unlicensed] in patients with recurrent stones composed of at least 50% calcium oxalate. Thiazides [unlicensed] may be given if patients also have hypercalciuria after restricting their sodium intake to no more than 6g a day. h 1.4 Urological pain Urological pain Treatment Lidocaine hydrochloride gel is a useful topical application in urethral pain or to relieve the discomfort of catheterisation. For information on the management of pain in renal and ureteric stones, see Renal and ureteric stones p. 831. Alkalinisation of urine Alkalinisation of urine can be undertaken with potassium citrate. The alkalinising action may relieve the discomfort of cystitis caused by lower urinary tract infections. Sodium bicarbonate p. 1099 is used as a urinary alkalinising agent in some metabolic and renal disorders. ALKALISING DRUGS › URINARY
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Extracted information for Finasteride only.
Cases of male breast cancer have been reported. Patients or their carers should be told to promptly report to their doctor any changes in breast tissue such as lumps, pain, or nipple discharge.
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Filter the extracted dose blocks for this individual drug.
First line only; read the complete Indications and dose section above.
5 mg daily, review treatment at 3–6 months and
This is a first-line fragment. Read the full Indications and Dose section above.
Candidate age grouping · source page 853
First line only; read the complete Indications and dose section above.
1 mg daily, continuous use for 3–6 months is
This is a first-line fragment. Read the full Indications and Dose section above.
Candidate age grouping · source page 853