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5α-Reductase Inhibitors

Comprehensive Guide to Finasteride and Dutasteride for Prostate Health and Hair Growth

Discover finasteride and dutasteride for prostate health and hair growth, including side effects and monitoring.
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Learn practical prescribing, administration, communication, monitoring, and cost details for finasteride and dutasteride therapy.

Firstly, 5α-reductase inhibitors shrink the prostate gland by blocking 5α-reductase, an enzyme that converts testosterone to dihydrotestosterone (DHT), a potent stimulator of prostate growth. This reduction in DHT production alleviates prostatic enlargement and improves urine flow.

Clinical benefits may take several months to manifest. Initially, α-blockers are often prescribed for faster symptom relief in men with moderate to severe symptoms. 5α-reductase inhibitors are particularly effective for larger prostates, as indicated by clinical examination or elevated PSA levels. They also promote hair growth, beneficial in treating androgenetic alopecia.

  • Prescribe dutasteride at 500 mcg or finasteride at 5 mg daily for benign prostatic enlargement.
  • Use finasteride at 1 mg daily for androgenetic alopecia; dutasteride is not licensed for this.
  • Swallow tablets whole, with or without food; Avoid contact with crushed tablets if pregnant.

Explain urinary difficulty due to prostate growth and treatment goal to reduce size. Note symptom improvement may take up to 6 months and diminishes if treatment stops. Highlight side effects like reduced libido and erectile issues, usually improving with continued use. Discuss alternatives if side effects persist. Warn about breast tissue changes and rare breast cancer risk with finasteride. Emphasize the need for pregnant women to avoid handling tablets and use condoms during sex.

Schedule follow-up in 3–6 months to assess changes and side effects. Continue check-ups every 6–12 months. Stop treatment if adverse effects outweigh benefits. Non-proprietary finasteride and dutasteride are inexpensive. Monitor PSA levels, as 5α-reductase inhibitors suppress PSA over 6 months. Obtain new PSA baseline at 6 months for accurate assessments. If unknown, double PSA value for long-term treatment effects.

RxPharm-adv

Key Points..

  1. Prescribe dutasteride (500 mcg) or finasteride (5 mg) daily for benign prostatic hyperplasia.
  2. Swallow tablets whole, with or without food; avoid if pregnant.
  3. Expect symptom improvement within 6 months; cessation may reverse benefits.
  4. Monitor for side effects like decreased libido and erectile dysfunction; discuss alternatives as needed.
  5. Schedule follow-up in 3–6 months for assessment; continue check-ups every 6–12 months.

References

  1. Salisbury BH, Leslie SW, Tadi P. 5α-Reductase Inhibitors. [Updated 2024 Jun 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555930
    2. Show more references

Keywords: Finasteride, Dutasteride, Benign prostatic hyperplasia treatment, Prostate health, Erectile dysfunction, Libido changes, PSA monitoring

Senior clinical pharmacist, "Pharmacy Practice Department, Tanta University Hospital, Egypt". Medical content writer.