Finasteride
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| Trade names | Propecia, Proscar |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a698016 |
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| Routes of administration |
Oral |
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| Pharmacokinetic data | |
| Bioavailability | 63% |
| Metabolism | Hepatic |
| Biological half-life | Elderly: 8 hours Adults: 6 hours |
| Excretion | Feces (57%) and urine (39%) as metabolites |
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| Chemical and physical data | |
| Formula | C23H36N2O2 |
| Molar mass | 372.549 g/mol |
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Finasteride, sold under the brand names Proscar and Propecia among others, is a medication used for the treatment of benign prostatic hyperplasia (enlarged prostate) and pattern hair loss. It is a type II and type III 5α-reductase inhibitor; 5α-reductase, an enzyme, converts testosterone to dihydrotestosterone (DHT).
Physicians use finasteride for the treatment of BPH, informally known as an enlarged prostate. Finasteride may improve the symptoms associated with BPH such as difficulty urinating, getting up during the night to urinate, hesitation at the start of urination, and decreased urinary flow. It provides less symptomatic relief than alpha-1 blockers such as tamsulosin and symptomatic relief is slower in onset (six months or more of treatment with finasteride may be required to determine the therapeutic results of treatment). Symptomatic benefits are mainly seen in those with prostate volume > 40 cm3. In long-term studies finasteride but not alpha-1 inhibitors reduce the risk of acute urinary retention (−57% at 4 years) and the need for surgery (−54% at 4 years). If the drug is discontinued, any therapeutic benefits reverse within about 6–8 months.
Finasteride is used to treat pattern hair loss (androgenetic alopecia) in men only. Treatment slows further hair loss and provides about 30% improvement in hair loss after six months of treatment, with effectiveness only persisting as long as the drug is taken. Finasteride has also been tested for pattern hair loss in women; the results were no better than placebo.
Finasteride has been found to be effective in the treatment of hirsutism (excessive facial and/or body hair growth) in women. In a study of 89 women with hyperandrogenism due to persistent adrenarche syndrome, finasteride produced a 93% reduction in facial hirsutism and a 73% reduction bodily hirsutism after 2 years of treatment. Other studies using finasteride for hirsutism have also found it to be clearly effective.
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