Finasteride is one among the more popular categories of medication, with dual use. Men suffering from benign prostatic hyperplasia and male pattern hair loss rely on Finasteride for treatment. Available as oral only medication, Finasteride is known to be highly effective in treating both the conditions. A large number of individuals are apprehensive of the side effects of the drug, especially considering the fact that it is often used as a long term medication. Patients who are on short-term medication are relatively less apprehensive or wary of the side effects of drugs. In this context, here is an in-depth detailing of Finasteride as a drug for treatment of both the conditions. The possible side effects, the documented results of studies of side effects and the best manner of using the medication is extensively explained below.
Brief look at overall side effects of Finasteride
Before we actually look at all the side effects, uses and safety of Finasteride, here is a brief look at the overall side effects of the drug. Individuals who are allergic to medications, or who are generally allergic to certain categories of food and preservatives need to share the entire history of allergies with the specialist handling the treatment. The drug is specifically meant for use by adult males only, and is not to be used by children. The drug does not have any known problems with the elderly, and its administration/prescription is generally assessed on a case-by-case basis. As clearly mentioned above, Finasteride is not intended for use by women or children. Pregnant women and women who are breastfeeding are specially cautioned not to handle or crush the tablets.
While there are no known serious drug interactions of Finasteride with other medications, it is important to discuss the same with the specialist. This will help to manage the dose and ensure that interactions or adverse effects are avoided. Individuals with organ related serious disorders need to share complete medical history with the specialist. For instance, individuals with any form of liver disease are likely to experience a slower rate of elimination of the medication from the body.
What exactly is Finasteride?
Finasteride is an inhibitor that converts testosterone into DHT. Classified as a synthetic compound, it is an oral drug prescribed for BPH (benign prostatic hyperplasia). The drug is used to help bring down urinary retention and dispense with the need for complex surgical procedures. Among other uses of the drug, is its approved used for treating male pattern hair loss. Both the conditions – benign prostatic hyperplasia and male pattern hair loss are attributed to androgen related disorders. While other medications have different mechanisms of action, medications that belong to the category of Finasteride work by targeting the root cause of the condition. This helps to eliminate side effects while effectively treating the symptoms associated with the conditions.
Mechanism of action of Finasteride
Finasteride works by inhibiting serum and DHT production. This is achieved by suppressing the enzyme that facilitates biosynthesis of DHT. On administration of Finasteride rapid decrease in DHT levels are achieved. One dose of 5 mg can work for as long as four years, with a recorded reduction of around 70%. Individuals diagnosed with benign prostatic hyperplasia experience as much as 80% reduction in DHT concentration levels when treated with Finasteride. The drug helps individuals with enlarged prostate who are at risk of a progressive decline in health receive significant relief from the condition.
Finasteride has also been extensively studied in treating male pattern hair loss. The drug has delivered promising results in the arrest of hair loss by as much as around 70%. Popularly known as a specific inhibitor, Finasteride targets the type II 5 alpha reductase. This is an enzyme in the prostate that converts testosterone into DHT. Regarded as the main contributor to the enlargement of the prostate gland, DHT is the hormonal mediator. Additionally DHT is also responsible for modulating genes involved in the proliferation of cells. There are two types of 5 alpha reductase in the prostate – type I and type II, that are responsible for DHT production. Despite the fact that Finasteride is a targeted inhibitor of type II 5 alpha reductase, continued administration of the drug is known to have an impact on type I also. This is primarily present in the skin’s sebaceous glands, apart from the liver and scalp.
Prostatic growth is attributed to DHT, as the main androgen. By virtue of being a targeted inhibitor, Finasteride helps to significantly reduce the DHT concentrations. This in turn results in reduction of prostatic growth. This could be as much as one fourth in a period of 2 years when the recipient undergoes sustained therapy. Studies have revealed that unregulated increase in the levels of DHT can result in growth of cancer cells in the prostate. Similarly Finasteride has been known to have an effect on the DHT concentration levels in the scalp. This in turn helps to turn back the effects of hair loss. In addition to a reduction in hair loss, Finasteride is known to stimulate regrowth of hair.
Finasteride is administered orally and is known to slowly accumulate during multiple dosages. Consequently bioavailability increases with the dosing, and could be anywhere between 26% to 170%. Interestingly, the bioavailability of Finasteride is not impacted in anyway by dietary intake.
How to take Finasteride for hair loss?
It is necessary to understand that medications need to be taken with caution, regardless of the presence or absence of side effects. The same conditions apply for Finasteride, it is essential to discuss various issues with the prescribing specialist. For instance, if you experience any kind of allergies when taking medication, the same needs to be informed. Similarly, you need to inform the specialist about other medications that you are presently taking for other conditions. This could be prescription medications, or over the counter medications for relatively minor conditions. It is also important to understand that use of herbal formulations also need to be informed. This will help prevent contraindications and adverse reactions between various categories of medication or mechanism of action.
Information available on the label/printed leaflet along with the medication is important. Most individuals tend to ignore this, and proceed with assumptions. This is incorrect and unhealthy. Information leaflets provide additional information that can be very useful in nature. Actual consumption of medication needs to be timed in such a manner that the gap between doses is maintained. The medication can be consumed with food or without food, and is not to be powdered or crushed. Another important medication related instruction is the need to avoid taking double doses to make up for missed doses of medication. This is not going to help or makeup in anyway, and can in fact have adverse side effects. It is therefore necessary to leave the missed dose and continue with the treatment regimen. Simple precautions are necessary when you are on long-term medication. Ensure that the brand and dose of medication is the same when you go in for fresh medical supplies. When you change the brand of medication, there is always the possibility of ending up with a changed dosage. While this is not always the case, it is a possibility. For instance, certain manufactures, may produce Finasteride medication for treating a particular condition with a specific dosage. Other manufacturers may produce Finasteride medication for a different category of intended users. Consequently, the brand and dosage combination may differ. This is precisely why it is always important to ensure that you read the brand and dosage combination, especially when reordering medical supplies.
How long should one take Finasteride for hair loss?
Male pattern hair loss cannot be treated overnight through medications. It requires to be taken over a particular period of time for the effects of the medication to be visible. Finasteride is known to arrest hair loss, in addition to triggering the regrowth of hair. Both of these conditions take time, and it is therefore necessary to take the medication for at least a period of 3 months. The time taken for hair to actually grow should also be considered when measuring the results of the medication. The specialist treating you will determine the dosage and the duration, depending on your condition. Since Finasteride is relatively safe, it can be continued for a lengthy period as prescribed by the doctor. As mentioned in various sections here, the side effects of Finasteride are either reversible or diminishing in nature, and can be hence safely used over short-term or long-term as required.
Side effects of Finasteride on sexual health of recipients
In addition to the side effects of Finasteride that have been widely discussed, here is a look at the impact of Finasteride on the sexual health of recipients. Various studies have assessed the side effects and conclusively reveal that Finasteride can impact sexual health of 4% of individuals. Among various issues that are typically experienced, erectile dysfunction is the predominant side effect followed by ejaculation related disorders and reduced libido. Most of the effects that were observed were known to impact the individual in the early stages of therapy, with effects being mainly temporary. In other words the side effects subsided with recipients regaining normal sexual abilities on discontinuation of the medication. Studies that were relied upon to arrive at these conclusions include indepth assessment of medical therapies using Finasteride for BPH. While it is true that the psychological impact of the medication contributed to the impaired sexual ability, the pharmacological action also had an impact on sexual health. Commonly known as the nocebo effect, this was taken into consideration by researchers during the studies. One of the major findings of the study was the reversible nature of the side effects on discontinuation of Finasteride. In some of the cases this was experienced within a period of 5 days of discontinuation of Finasteride.
There have been other studies conducted, which revealed that the side effects of Finasteride are also known to gradually stop when the patient continues Finasteride. In other words, patients who are on long-term therapeutic use of Finasteride will gradually cease to experience side effects. As mentioned earlier, the side effects were primarily experienced during the initial stages of therapy. Side effects, such as reduced libido, ejaculation related disorders and erectile dysfunction subsided when one of two conditions were met. The first was the discontinuation of Finasteride, while the second was long term use of Finasteride. The diminishing impact of the medication has been a subject of various studies, that also took into consideration the dosage levels. The side effects of low doses of Finasteride have also been documented. This includes changes in DNA in sperm, motility and actual sperm count. The findings also concluded that the side effects resolved when the drug was discontinued. Final findings of all studies have consensus that Finasteride does not have any persistent impact on patients. The studies have concluded that there is no evidence to suggest a link between in the medication and long-term effects. In support of the findings, researchers pointed to the fact that the side effects disappear when the patient either stops the medication or the medication. Patients are without exception, likely to belong to one of these two categories. This effectively means that either the patient will discontinue the medication and be freed from the side effects, or continue the medication with a gradual subsiding of the side effects. Reports of persistent side effects as a result of Finasteride are only rare and do not indicate/prove a clear and conclusive link between the medication and the side effects.
The following points need to be considered when evaluating Finasteride for use as part of treatment regimen.
Finasteride is regarded as one of the best medications for treatment of hair loss, with proven results. As on date, there are very few alternatives available that can take the place of Finasteride. Its safety has been assessed for long term use. Smaller doses are unlikely to trigger side effects, while heavier doses may initially cause side effects which are reversible in nature.
· Patients who are planning to have a family, should avoid the drug due to the temporary impact of Finasteride on sexual health. This is especially true in the case of individuals with oligospermia.
· It is necessary to take Finasteride for as long as at least 3 months for visible results in hair regrowth and hair loss control.
· Medication needs to be consumed on a daily basis, as per the description of the specialist.
· Major hair regrowth is experienced in the first 24 months of taking Finasteride regularly.
· Discontinuation of Finasteride is linked to a reversal of hair regrowth after a period of time. This makes it necessary to review effects of the medication and the impact of discontinuation.
· Medication is not intended for use by women for children, and is only for use by adult males.
· Individuals whose prostate specific antigen levels are being monitored through blood tests, need to inform the specialist.
· One dose of Finasteride is sufficient to significantly reduce serum DHT levels. Reduction of DHT levels is maintained for as long as one full day with sustained doses. The maximum effect in terms of reduction of DHT levels is observed within a period of 8 hours from the time of taking the medication.
· Patients on long term medication of Finasteride experienced significant reduction in DHT concentration levels. The reduction achieved is as much as 70%, when 5mg dosage is consumed.
Contraindications/reactions of medications
Some of the known interactions of other drugs with Finasteride are listed below. Medications are known to have an adverse impact on other medications, either by diluting the effect, or triggering side effects. While it is not necessary to actually stop one of the two conflicting medications, it could be necessary to alter the dosage or the time of taking the medication. Effectively drug interactions mandate the need for a proper management of all medications. While, there are no recorded instances of serious drug interactions with Finasteride, possible interactions with moderate or less than moderate impact include the following medications.
#3. Antiretroviral HIV medications
#5. Certain categories of antifungal medications and fluvoxamine.
More information about possible interactions of Finasteride with other medications are typically listed in the leaflet along with the medication. Careful reading of the leaflet is necessary, even if you have informed your specialist about other medications. It is possible that you may have missed out certain over the counter medications or herbal formulations.
Indications of side effects
There are clear indications of side effects through certain telltale symptoms. Some may require medical attention, while others may not require any kind of medical attention. Here is a list of some of the common symptoms that could be possibly experienced by individuals on Finasteride.
· Breaking into a cold sweat, either accompanied or not accompanied by chills.
· A feeling of confusion or dizziness, especially when rising up from a seated or lying down position.
· Rashes on the skin, accompanied by inflamed skin.
· Abnormal weight gain, or sudden loss of weight
· A tingling sensation in the limb extremities such as the hands and feet
· Discharge from the area and possible dimpling of the skin around the area
· Lack of interest in performing sexual activities
· Erectile dysfunction/inability to maintain an erection
· Clear loss of libido, and inability to perform sexual activities despite efforts
· Reduced volume of semen discharge during sexual intercourse
· Possible pain in the testicles
· Abnormal fatigue and feelings of tiredness
· Running nose, constant sneezing and blocked nose
· Unusual pain in the abdomen, unrelated to any other condition
· Pain in the lower back, not associated with trauma or other conditions
· Possible incidents of diarrhea
Side effects that require medical intervention
While most of the side effect that have been recorded and documented are not serious in nature there is always the possibility of certain adverse reactions. This is likely in most medications. In the event of experiencing any indications of a serious side effect, it is necessary to instantly seek medical attention. Here are some of the side effects that could possibly indicate serious side effects or possible future side effects. If you experience any kind of abnormal swelling in the region above your neck, it is necessary to inform the specialist. For instance if you experience swelling in your lips, your face, your throat or tongue, get in touch with the specialist. If you experience any kind of discharge from your areola, it is necessary to get in touch with the specialist. There is also the possibility of experiencing depression while on this medication. While this is not serious in nature, it is best to take professional advice and prevent it from manifesting into a serious case of depression. This is important because of the long-term nature of the medication.
Round up on side effects of Finasteride
Finasteride has been generally accepted to have side effects that are either reversible or diminishing in nature. In other words, discontinuation of the medication can reverse the side effects that are experienced. Similarly, when the drug is taken over a long period of time, the side effects gradually diminish to a level where it does not seriously affect the health of the individual. This is precisely why it is prescribed both as a short-term and long-term medication for both of the conditions. The dosages are prescribed by specialists on a case-by-case basis, taking into account various criteria such as age of the patient, nature and intensity of the condition.
It is therefore relatively safe to take the medication both for long term and short term use. Patients are advised to monitor and report any symptoms of side effects, especially symptoms that are indicative of serious side effects. Finasteride is to be taken only under medical supervision and should never be a self prescription for either benign prostatic hyperplasia or male pattern baldness. Patients who are suffering from BPH are unlikely to use the medication without proper diagnosis and medical supervision. However, patients with male pattern baldness are more likely to try the medication without a prescription for consultation. This is mainly because of the documented results of Finasteride in treating hair loss. This practice needs to be avoided to ensure that you receive the best results without any adverse effects.