Finasteride

Specific, selective inhibitor (4-azosteroid) of the enzyme steroid 5-α reductase type II and type III, which is primarily used in benign prostatic hyperplasia (BPH) and in androgen-related hair loss(androgenetic alopecia, AGA). Finasteride is subject to medical prescription in Germany, Austria and Switzerland (but is not reimbursable in Germany for the indication "androgenetic alopecia").

The active ingredient is offered in a dosage of 5 mg p.o. for benign prostatic hyperplasia and 1 mg for androgen-related hair loss.

By inhibiting the enzyme "5 alpha-reductase" is the conversion of testosterone to 5alpha-dihydrotestosterone (increases the cell division rate of prostate tissue and reduces the growth phase lowering of the plasma certain hair follicles). After taking finasteride, the plasma level of dihydrotestosterone is reduced by more than 50% within 24 hours.

Testosterone and estradiol levels rise, but remain within the normal range. Reduction of PSA in serum by about 50%.

Finasteride stabilizes the process of androgenetic alopecia in men between the ages of 18 and 41, according to registration studies. There is no evidence of efficacy in bitemporal receding of the hairline ("receding hairline") or in end-stage hair loss.

Benign prostate hyperplasia; men >18 years, with mild to moderately severe alopecia androgenetica in men ( Hamilton-Norwood II-III) off-label use ) . Alopecia androgenetica in women; postmenopausal, fibrosing, frontal alopecia (off-label use!) .

Remember! Finasteride, when taken by a pregnant woman, can cause malformations of the external genitals of male fetuses!

It is important that the active ingredient is present in the seminal plasma. For this reason, the risk of teratogenicity in male fetuses by inhibiting sexual differentiation of the male genital organs is discussed, should the pregnant woman come into contact with finasteride in sperm.

A pregnant sexual partner of a patient treated with finasteride should not come into contact with the patient's sperm.

• Important is the occurrence of the active substance in the seminal plasma. Therefore, the risk of teratogenicity in male fetuses by inhibiting sexual differentiation of the male reproductive organs is discussed, should the pregnant woman come into contact with finasteride in sperm.
• A pregnant sexual partner of a patient treated with finasteride must not come into contact with the patient's sperm.

Rarely erectile dysfunction, decreased libido, decreased ejaculate volume, ejaculation disorder or touch sensitivity. The symptoms may persist even after discontinuing the preparation!

In addition to a reduction in the volume of the prostate, the amount of ejaculate can also be reduced under Finasteride.

The influence of 5-alpha-reductase inhibition on fertility is not yet fully understood. However, there are now clear indications of a reversible restriction of spermiogenesis and sperm motility.

After prolonged use, gynaecomastia and the occurrence of breast carcinoma in men are observed.

Also: drug exanthema, pruritus, urticaria, swelling of the lips and face, testicular pain, chloasma in women.

Propecia®; Finasteride Puren® 1 mg film-coated tablet

1. Arca E et al (2004) An open, randomized, comparative study of oral finasteride and 5% topicalminoxidil
   in male androgenetic alopecia. Dermatology 209:117-125.
2. Famenini S et al (2014) Finasteride associated melasma in a Caucasian male.
3. J Drugs Dermatol 13:484-486
4. Mella J et al (2010) Efficacy and safety of finasterid therapy for androgenetic alopecia. Arch Dermatol 146: 1141-1150
5. Saraswat A et al (2003) Minoxidil vs. finasteride in the treatment of men with androgenetic alopecia. Arch Dermatol 139: 1219-1221
6. Schanz S (2015) Finasterid: A hairy problem? JDDG 13 (Suppl.1): 59
7. Shapiro J et al (2003) Use of finasteride in the treatment of men with androgenetic alopecia (male pattern hair loss). J Investig Dermatol Symp Proc 8: 20-23
8. Trueb RM (2003) New and proven in the therapy of hair diseases. dermatologist 54: 732-740
9. Whiting DA et al (2003) Efficacy and tolerability of finasteride 1 mg in men aged 41 to 60 years with male pattern hair loss. Eur J Dermatol 13: 150-160