Legal classification of drug
POM
Finasteride tablets can only be obtained in accordance with a prescription given by an appropriate practitioner and therefore the legal status of the medication is prescription only medication (POM).
Formulations
Finasteride is available in a tablet form with strength of 1mg and 5mg.
Class of drug
Finasteride belongs to a class of drugs called 5a-reductase inhibitor.
Indications
The 5mg tablet is indicated for the treatment of benign prostatic hyperplasia (BPH) and the 1mg tablet is indicated for male-pattern baldness. Finasteride can only be used in men.
How does it work?
The prostate gland is only found in men and is it is responsible for producing a liquid which mixes with sperm to make semen. In men who have BPH, the prostate cells enlarge causing narrowing of the tube in which urine is passed. The narrowing of the tube causes difficulty in passing urine, a frequent need to urinate, and a feeling that the bladder has not fully been emptied. The prostate cells enlarge due to circulating hormones in the body, in particular a hormone called dihydrotestosterone (DHT) which is made from testosterone by the aid of an enzyme called 5a-reducatse. Finasteride stops this conversion therefore reducing the size of the prostate gland and easing symptoms.
It is believed that DHT circulating with in the scalp area causes hair loss. Finasteride 1mg tablets stop the production of DHT preventing further hair loss. Finasteride 1mg tablets (Propecia®) is not available on the National Health Service and therefore the doctor cannot write out a prescription for propecia on a green FP10 prescription form, however a private prescription can be issued and the patient will be liable for the full cost of the medicine. Propecia® can also be obtained through patient group directions (PGD) through a pharmacy with a consultation with the pharmacist.
How is it taken?
Finasteride is taken as one to be taken daily with or after food. The benefits of the treatment may not be apparent for several months and therefore a regular review with your GP is required.
Pregnancy and Breast feeding
Finasteride is contra-indicated in both pregnancy and nursing mothers. Evidence has shown that finasteride can cause fetal abnormalities of the external genitalia of a male fetus. Finasteride is found in semen and men are advised to use a condom if the partner is likely to become pregnant. Broken or crushed tablets should not be handled by women of child bearing age.
Contra-indications
Finasteride is contra-indicated in women, children, and adolescents.
Side-effects
If any breast symptoms are experienced, you should see your doctor as soon as possible.
Author: Mr Shiraz Mughal, MPharmS Editor: Dr Shazan Chughtai, MB BS
