Propecia

About Propecia

Propecia is a synthetic 4-azasteroid compound which is indicated for male pattern baldness and enlarged prostate or benign prostatic hyperplasia (BPH). Finasteride, the active ingredient in Propecia, inhibits the conversion of testosterone into 5?-dihydrotestosterone (DHT) which may help control baldness and BPH. It is manufactured by Merck Pharmaceuticals Inc. and is marketed as two brands, Propecia and Proscar.

Indication/Usage: Propecia is indicated for male pattern hair loss, also known as androgenetic alopecia. It is approved for use only in men with mild to moderate hair loss in the vertex and anterior scalp and is moderately safe for men between the ages of 18 and 41 years. Propecia is also indicated in benign prostate hyperplasia or enlarged prostate. It has shown additional benefits in prostate-associated issues like urination problems and decreased urinary flow. Discontinuation of Propecia should be closely monitored by the physician as its therapeutic benefits may be reversed if immediately discontinued.

Dose, Administration and Dosage forms: Propecia is available in film-coated tablet formulation in 1mg strength. The recommended dosage of Propecia is 1 mg orally, once per day. Best results are achieved when Propecia is taken for six months or more. It may take at least three months for patients to notice an effect in the treatment of alopecia. Propecia may be taken with or without food. It should be stored at room temperature (15°C to 30°C or 59 to 86°F).

Mechanism of action: Propecia is reportedly effective via specific inhibition of type II 5?-reductase enzyme (5AR), which is responsible for conversion of testosterone into dihydrotestosterone (DHT). Testosterone, produced in the testicles and adrenal glands, is bound to a sex hormone-binding globulin (SHBG) and transported to the bloodstream where it is released. This free testosterone is converted into dihydrotestosterone (DHT) by the enzyme 5-alpha reductase in skin, scalp, and prostate cells. DHT is more powerful than testosterone with a greater androgenic effect. Propecia inhibits 5-alpha reductase which in turn inhibits conversion of testosterone into DHT, resulting in anti-androgenic effects in males, specifically baldness control and relief from benign prostatic hyperplasia.

Side-effects and safety profile: The side-effects of Propecia are related to the inhibition of 5AR in the central nervous system. Clinical trials show that Propecia results in the suppressed biosynthesis of neurosteroids. Neurosteroids are reported to have a beneficial role in various issues like impaired memory, anxiety, stress, sleep issues, convulsions, and depression. Due to suppressed neurosteroid levels caused by Propecia, various mental and sexual side-effects may result. The major side effects associated with Propecia include impotence, persistent diminished libido, decreased ejaculation volume, gynecomastia, erectile dysfunction, abnormality in ejaculation pattern, and testicular pain.

Warnings/Contraindication:

• Propecia is not indicated in women and children
• Women who are pregnant or may become pregnant must keep away from crushed or broken Propecia tablets, as contact may cause teratogenic effects, especially in male fetuses
• Patients who are hypersensitive to finasteride must not take it
• Patients should disclose all concomitant medications to the prescribing physician in order to avoid adverse drug interactions

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