Proscar (finasteride) is a prescription medication specifically formulated to address two distinct yet common medical conditions in men: benign prostatic hyperplasia (BPH) and male pattern hair loss (androgenetic alopecia). As a 5-alpha-reductase inhibitor, it represents a cornerstone of long-term, non-surgical management strategies. Its mechanism of action targets the hormonal pathway responsible for the progression of these conditions, offering a scientifically validated approach to treatment. This medication requires a prescription and ongoing medical supervision to ensure its appropriate and safe use.

Features

• Active Ingredient: Finasteride 5 mg (for BPH) / 1 mg (for hair loss, marketed as Propecia®).
• Drug Class: 5-alpha-reductase inhibitor, Type II specific.
• Administration: Oral tablet.
• Available by prescription only.
• Works systemically to reduce levels of dihydrotestosterone (DHT).

Benefits

• Reduces Prostate Volume: Effectively shrinks an enlarged prostate gland, alleviating the physical obstruction causing urinary symptoms.
• Improves Urinary Flow: Leads to a measurable increase in urine flow rate, reducing straining and improving bladder emptying.
• Alleviates BPH Symptoms: Provides significant relief from bothersome lower urinary tract symptoms (LUTS) such as urgency, frequency, nocturia, hesitancy, and weak stream.
• Decreases Risk of Acute Urinary Retention: Long-term use significantly reduces the risk of developing a complete inability to urinate, a serious complication of BPH.
• Lowers Surgical Intervention Risk: Reduces the probability of needing future prostate-related surgery, such as transurethral resection of the prostate (TURP).
• Promotes Hair Maintenance and Regrowth (at 1mg dose): Slows or stops the progression of hair loss and can stimulate regrowth in a significant proportion of men with androgenetic alopecia.

Common use

Proscar is primarily prescribed for the treatment of symptomatic benign prostatic hyperplasia (BPH) in men with an enlarged prostate. It is used to improve urinary flow and reduce the need for surgery related to BPH. The 1 mg formulation (Propecia®) is indicated for the treatment of male pattern hair loss (vertex and anterior mid-scalp) in men only. It is not indicated for use by women or children.

Dosage and direction

• For BPH: The recommended dosage is one 5 mg tablet administered orally once a day, with or without food.
• For Male Pattern Hair Loss: The recommended dosage is one 1 mg tablet administered orally once a day, with or without food (note: this is the dosage for Propecia®, the branded product for alopecia. Proscar 5mg tablets are not scored and should not be split for this use).
• Administration is typically long-term. A minimum of six months of treatment is usually necessary to assess whether the medication is effective for an individual patient, particularly for BPH symptom relief and hair regrowth.
• The tablet should be swallowed whole. It may be taken at any time of day but should be taken at approximately the same time each day to maintain consistent drug levels.

Precautions

• Pregnancy Warning: Finasteride is contraindicated in women who are or may become pregnant due to the risk of causing abnormalities of the external genitalia in a male fetus. Women should not handle crushed or broken tablets if they are or may become pregnant.
• Regular Monitoring: Patients taking Proscar for BPH should undergo regular digital rectal exams (DREs) and may require other monitoring (e.g., PSA tests) as directed by their physician. Interpretation of PSA values requires adjustment, as finasteride reduces serum PSA levels by approximately 50%.
• Carcinogenicity: While not commonly observed, patients and physicians should be aware of the potential, though low, risk of high-grade prostate cancer as discussed in clinical trials and outlined in the full prescribing information.
• Hepatic Impairment: Caution is advised in patients with liver function abnormalities, as the drug is extensively metabolized in the liver.
• Blood Donation: Men being treated with finasteride should not donate blood until at least one month has passed after their final dose to prevent administration to a pregnant female transfusion recipient.

Contraindications

• Hypersensitivity to finasteride or any other component of the formulation.
• Use in women, particularly those who are pregnant or of childbearing potential.
• Use in pediatric patients.

Possible side effect

As with all medications, Proscar can cause side effects, although not everybody gets them. The most commonly reported side effects are related to sexual function and are usually reversible upon discontinuation of therapy.

• Common (>1/100): Erectile dysfunction, decreased libido (sex drive), ejaculation disorder (e.g., decreased volume of ejaculate).
• Uncommon (1/100 to 1/1000): Breast enlargement (gynecomastia) and/or tenderness.
• Rare (<1/1000): Allergic reactions, including rash, itching, hives, and swelling of the lips and face; testicular pain; depression.
• Post-Marketing Reports: Persistent sexual dysfunction (e.g., erectile dysfunction, diminished libido, ejaculatory disorders) that continues after discontinuation of treatment has been reported; however, the incidence and mechanism are not well understood. Male breast cancer has also been reported.

Drug interaction

Formal drug interaction studies have not shown clinically significant interactions with many common medications. However, the following should be considered:

• The effectiveness of Proscar could be theoretically reduced by drugs that induce the cytochrome P450 3A4 enzyme system (e.g., rifampin, certain anticonvulsants like phenytoin, St. John’s Wort).
• No significant interactions have been found with antihypertensive agents, ACE inhibitors, alpha-blockers (often co-administered with finasteride for BPH), beta-blockers, diuretics, NSAIDs, oral hypoglycemic agents, or anticoagulants like warfarin.

Missed dose

If a dose is missed, it should be taken as soon as remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. Do not take a double dose to make up for a missed one.

Overdose

In reported cases of overdose with finasteride, no specific adverse events were identified. Single doses of up to 400 mg and multiple doses of up to 80 mg/day for three months have been administered without significant clinical effects. In the event of a suspected overdose, symptomatic and supportive treatment should be provided. There is no specific antidote.

Storage

• Store at room temperature between 15°C and 30°C (59°F and 86°F).
• Protect from light and moisture.
• Keep in the original container to protect from light.
• Keep out of reach and sight of children and pets.
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided may not cover all possible uses, directions, precautions, drug interactions, or adverse effects.

Reviews

• Clinical Efficacy (Urology): “Finasteride 5 mg has been a game-changer in our medical management of moderate-to-severe BPH. We see consistent, sustained improvements in symptom scores and flow rates, and it demonstrably reduces the long-term risk of AUR and surgery. It is a foundational therapy.” – Urologist, 15 years experience
• Patient Experience (BPH): “After six months on Proscar, my nightly trips to the bathroom reduced from 4-5 to 1-2. The constant feeling of urgency is gone. It gave me my sleep back.” – Male, 68
• Clinical Efficacy (Dermatology): “For the right candidate—a man with early-stage androgenetic alopecia who understands the commitment—finasteride 1mg is the most effective medical treatment we have to halt progression and stimulate regrowth. Patient education on the potential for sexual side effects is paramount.” – Dermatologist, 10 years experience
• Patient Experience (Hair Loss): “I’ve been on it for two years. My hair loss completely stopped, and I’ve had noticeable regrowth on my crown. I did experience a slight dip in libido for the first month, but it leveled out and returned to normal.” – Male, 32