Finasteride is an anti androgen drug marketed in various brand names by different drug manufactures. The drug acts on the 5-alpha reductase, the enzyme responsible for the conversion of testosterone to dihydrotestosterone. This drug is used in small doses in the treatment of benign prostatic hyperplasia, popularly referred as BPH. The medicine is also found to be effective in high doses for prostate cancer. Further Finasteride in combination with the doxazosin is also treating the symptomatic progression in benign proststic hyperplasia.
1. Mode of action
Finasteride is the FDA approved non-brand name of propecia which is a DHT inhibitor pill that helps in inhibiting the production of DHT in the whole body. The enzyme 5-alpha-reductase helps Finasteride in the conversion of free testosterone to DHT. Finasteride is an oral drug that has reports of 29 – 68% success. However, Finasteride is effective only for as long as it is taken. On termination of the course, hair gained or maintained will be lost within 6-12 months. Studies have shown that propecia, like minoxodil, works on both the crown area and the hairline; with the crown showing better results.
2. Propecia, Proscar and other products
Finasteride first produced by the Merck & co was initially approved by the Food and drug administration in the year 1992 under the brand name Proscar. Proscar was being used for the treatment of prostate enlargement and the sponsor later on exhibited the efficacy of this medicine in small dose of 1 mg in the treatment of male pattern baldness. It was only in the year 1997 the FDA approved the Finasteride for the treatment for male pattern hair loss.
The drug normally administered at a higher dose of 5mg per day for BPH, during the Prostate cancer prevention trials showed that it reduced the chances of developing the disease by 25% when compared to others who took a placebo. However one disturbing feature observed was that in cases of prostate cancer that developed among those who took the finasteride were more likely to grow and spread, the reasons of which are still under clinical investigation.
So Propecia is similar to the oral prescription drug proscar that treats enlarged prostrates in higher doses. To save money, some patients buy proscar instead of propecia and then split the pills equally with a pill-splitter to ensure that sufficient amount of propecia is taken. Though propecia has been shown to be ineffective in treating hair loss in women, it should not at all be touched by pregnant or would-me-mothers. This is because propecia has been proven to produce severe birth defects in male fetuses
The drug marketed by Merck & co. under the trade name of propecia with a I mg content of finasteride, for male pattern baldness is also available in 5 mg. under the name Proscar by the same manufacturer that is being prescribed for the BPH. Cipla, under the trade name Fincar and Finpecia also market the above drug. The other major manufacturers are Dr. Reddy’s Lab known as Finax and Finast and by Ranbaxy with the trade name Finara. The Prosteride a prescription by the Aleppo Pharmaceuticals is another brand of the Finasteride.
3. Finasterid and gonadotropin levels
It has been found that testosterone tends to exert a negative feedback control on gonadotropin secretions. This is brought about either directly, with aromatization to estradiol or after 5-alpha reduction to dihydrotestosterone (DHT). However, there has been conflicting data on the role of DHT in this negative feedback. So to check if the suppression of endogenous DHT does alter gonadotropin secretion, the selective 5-alpha-reductase inhibitor, 5 mg of Finasteride was administered daily to 20 healthy men for 28 days. Bioactive LH, DHT, basal and GnRH-stimulated LH and testosterone levels were measured both before and after 14 and 28 days of treatment. It was found that basal DHT fell slightly on the completion of 28 days of Finasteride treatment. There was a slight rise in baseline testosterone at 14 days but not at 28 days. There were no significant changes in both basal and GnRH-stimulated gonadotropin levels on any day. With this it can be seen that the suppression of serum DHT levels with the daily use of 5mg Finasteride on healthy and young men has no discernible effect on serum gonadotropin levels.
4. Side Effects
The major recognized side effects among 4 percent of men that used the medicine were the erectile dysfunction and Gynecomasta that is the enlargement of breast glands. Finasteride is not recommended for women especially those who are pregnant. Women are strongly advised not to handle the drug during pregnancy or when they are likely to get pregnant. As per the FDA it comes under the X category under pregnancy that means it is known for birth defects in an unborn baby. The suggestion goes to the extend, not to handle the finasteride in crushed or broken form since chances are that it may absorb through the skin. However the drug is not harmful as long as it is not swallowed. No clinical studies have revealed whether the drug passes in to breast milk. However feeding mothers are advised not handle the drug in any form. The drug passes into the semen of men and as such during oral sex care need to be taken so as to avoid ingestion of semen by women who are pregnant or likely to get pregnant. Finasteride has also been banned by many professional sports due to its likely use in covering up the steroid abuse among sportspersons Article Manager module by by George! Software.