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Proscar (Finasteride)

What is Proscar (Finasteride)?

Proscar (finasteride) is a 5-alpha-reductase inhibitor medication that is prescribed for the treatment of benign prostatic hyperplasia (an enlarged prostate) in men. It should not be prescribed to nor taken by women or children and should only be used by men to alleviate the common symptoms associated with an enlarged prostate and reduce their chances of requiring prostate surgery.

How is Proscar Used?

Proscar comes in tablet form and should be taken orally once per day. It may be taken with or without food. Take your medication as prescribed by your doctor regarding frequency as well as any other specific conditions that may apply.

This medication may be used solely by itself for treatment or may be prescribed alongside the alpha-blocker medication known as doxazosin for improved results.

The full results of taking Proscar (with or without doxazosin) may take up to six months to become fully apparent, and stopping the medication at any time will result in continued prostate growth.

Storage

Proscar should be stored at room temperature and should not exceed 86°F (30°C). Patients should ensure the medication is placed away from any exposure to light and remains well-sealed. It should not be stored in the bathroom and should not be exposed to moisture.

Keep this medication out of reach of pets and children at all times.

Pregnant women or women that may potentially be pregnant should not handle broken or crushed Proscar tablets due to the risk of absorption that may negatively impact the development of a male fetus. This medication is capable of being absorbed through the skin and should be washed away with soap and water immediately after making contact.

If your medication needs to be disposed of for some reason, please contact your local pharmacist or waste disposal company for instructions regarding safe disposal. Proscar should not be thrown in with one’s regular trash, poured down the sink, or flushed down the toilet.

Uses

Proscar is prescribed for the treatment of benign prostatic hyperplasia, the condition of having an enlarged prostate.

In lower doses, finasteride is marketed as Propecia and prescribed for the treatment of androgenetic alopecia (i.e., male pattern hair loss).

It may occasionally be prescribed off-label for use in females struggling with hair loss, but this is typically avoided due to the potential health risks for women in their child-bearing years. Generic, lower-dosage versions of this medication have occasionally been used off-label for the treatment of undesired facial hair growth in women.

How Does Proscar Work?

Proscar works to alleviate the symptoms associated with benign prostatic hyperplasia by shrinking the enlarged prostate of the patient. It does this due to the function of its active ingredient (finasteride) being a 5-alpha reductase inhibitor.

5-alpha reductase inhibitors work by suppressing (i.e., inhibiting) the enzyme known as “5-alpha reductase.” This enzyme exists within the body in the prostate, the skin, and one’s liver. Its purpose is to convert testosterone into dihydrotestosterone, or DHT. Dihydrotestosterone is a male sex hormone that is associated with acne, prostate growth, and facial hair growth as well as with male pattern baldness. It exists in both men and women, and 5-alpha reductase inhibitors are designed to decrease the production of DHT within the human body.

Dosage

Proscar is available as a 5 mg tablet that is blue in color, film-coated, apple-shaped, and comes printed with the brand name of “PROSCAR” on one side and “MSD 72” on the other.

Overdose

If a patient has managed to overdose or has taken an excessive amount of Proscar, they are advised to contact their local Poison Control Center or seek out emergency medical assistance.

Commonly, ingesting an excessive amount of Proscar will result in a higher likelihood of experiencing adverse effects. Some of these adverse reactions include:

  • an increase in breast size
  • an increase in breast tenderness
  • ejaculation disorder
  • difficulty getting an erection
  • difficulty maintaining an erection
  • decreased libido
  • rash

Side Effects

Taking a medication such as Proscar may cause certain patients to experience adverse side effects during treatment or after stopping the medication.

The most common side effects of taking Proscar are as follows:

  • decreased libido
  • erectile dysfunction
  • decreased volume of semen during ejaculation
  • difficulty achieving orgasm
  • testicular pain
  • increased hair growth

The most serious potential side effects of taking this medication include the following and should be reported to your doctor immediately:

  • blood in the patient’s ejaculate
  • breathing difficulties
  • breast enlargement
  • breast pain
  • lumps in the breast
  • muscle pain
  • muscle weakness
  • nipple discharge
  • ongoing or severe nausea
  • reduced semen quality or infertility
  • swelling of the lips, face, throat, or tongue
  • tenderness of the breast
  • testicular pain
  • other unusual breast symptoms or changes
  • symptoms of depression
    • decreased interest in hobbies or other enjoyable activities
    • impaired concentration
    • sleep difficulties or changes in sleep habits
    • suicidal ideation
    • weight gain or loss
  • symptoms of an allergic reaction
    • hives
    • itching
    • rash on the skin
    • swelling of the mouth, tongue, or lips

Additionally, even after stopping the use of Proscar, some patients may experience lingering side effects that should be discussed with their doctor. The most common of these symptoms include the following:

  • decreased libido even after stopping the medication
  • erectile dysfunction or other sexual difficulties
  • ongoing problems associated with ejaculation

Please contact your doctor for further information if you experience any additional side effects and have any concerns.

Warnings & Precautions

Patients taking Proscar should inform their prescribing physician of any allergies, current medications, or preexisting health conditions to ensure that this medication does not place them at an increased risk of developing certain side effects and serious health conditions. Individuals with preexisting liver conditions or a history of prostate cancer should consult with their doctor about the safety of using Proscar for treatment as well as weigh the risks versus the benefits of this medication.

Liver Disease

Proscar is processed in the liver, and individuals taking this medication should inform their doctor if they have any preexisting liver conditions or a family history of liver issues. Certain liver diseases may cause the medication to be processed more slowly, leading to a buildup of Proscar within the body and an increased risk of adverse effects from high levels of the medication. Consult with your doctor if you are at risk of this potentially occurring, and your doctor may recommend adjusting your dosage size and instructions.

Prostate Cancer

The use of Proscar has been associated with an increased risk of patients developing a high-grade form of prostate cancer in some cases. Additionally, patients who have had or currently have prostate cancer may experience a worsening of the condition if receiving treatment with this medication. Be sure to discuss all health risks, medications, your family health history, and any preexisting medical conditions that may be impacted by this medication with your doctor before beginning treatment with Proscar.

Prostate Cancer Screening

Proscar has been found to impact the results of the blood test used in detecting the presence of prostate cancer. Specifically, it may skew the results when trying to detect accurate readings of a patient’s PSA (prostatic-specific antigen) levels. Patients taking this medication should inform their doctor as well as any applicable laboratory personnel that they are taking this medication before testing.

Male Breast Cancer

Due to the hormonal changes caused by the function of Proscar as a 5-alpha reductase inhibitor, this may result in an increased risk of men taking this medication developing male breast cancer stemming from an imbalance in the patient’s androgen to estrogen ratio. Individuals taking Proscar should be prompt in reporting any changes in breast tissue, including issues such as nipple discharge, pain, or lumps.

Food Interactions

There are no known food interactions associated with Proscar. This medication may be taken with or without food.

Pregnancy

This medication should not be used during pregnancy and is not prescribed for use in women even when they are not pregnant or planning on becoming pregnant.

Breastfeeding

It is not known whether Proscar is passed through breast milk. However, this medication is not prescribed for use in women and should not be used by any woman that is breastfeeding. Breastfeeding mothers should also avoid touching broken or crushed Proscar tablets due to the risk of absorption and lack of study regarding Proscar in a woman’s system and how it may or may not be passed through breastmilk.

Children

This medication is not prescribed for use in children, and its efficacy and safety have not been studied in this age group.

Drug Interactions

Speak to your doctor about any medications or herbal supplements you are currently taking before beginning treatment with Proscar. Studies have not identified any significant interactions between Proscar and any other prescription or over-the-counter medications or herbal supplements. However, this does not mean no such interactions exist.

The following medications and herbal supplements may result in decreased levels of Proscar due to the increase in the breakdown of the medication within the liver:

  • carbamazepine
  • rifampin
  • John’s wort

The following medications may result in an increased amount of Proscar being present in a patient’s blood:

  • erythromycin
  • itraconazole

If you believe Proscar may be interacting with another medication or herbal supplement you are taking, please discuss any concerns you may have with your doctor or a trusted pharmacist.

Alternative Medications

For patients who are unable to take Proscar or experiencing significant adverse side effects, alternative medications may be used to treat some of the associated conditions for which this medication is commonly prescribed.

The main alternative to Proscar is the medication known as dutasteride. This medication is very similar in function to Proscar but comes in a different dosage. It is also known to have adverse interactions with certain other medications. Additionally, dutasteride is commonly paired with Flomax (tamsulosin) for the treatment of an enlarged prostate, so this is another medication that will need to be taken into account if a patient needs to change their primary BPH medication to dutasteride.

Please speak to your prescribing physician if you are experiencing any significant adverse side effects or other concerns that may necessitate a change in your medication.

Frequently Asked Questions

The 5 mg tablets of Proscar contain 5 mg of finasteride itself along with several inactive ingredients: titanium dioxide, hydroxypropyl methylcellulose, talc, magnesium stearate, hydrous lactose, docusate sodium, microcrystalline cellulose, hydroxypropyl cellulose LF, pregelatinized starch, yellow ferric oxide, FD&C Blue 2 Aluminum Lake, and sodium starch glycolate.

When used for the treatment of benign prostatic hyperplasia, many patients will often be prescribed Proscar and remain taking the medication for months or even years. Patients should not stop taking this medication without first consulting their prescribing physician because the symptoms that the medication has been alleviating will only return once the use of this medication has ceased.

There is currently no available information regarding the long-term effects of taking this medication for more than ten years. If prolonged use of this medication may be necessary or desired by a patient, they should consult with their prescribing doctor regarding potential side effects or other health concerns associated with continued use.

Finasteride itself may be prescribed to women to treat hirsutism or to be used as antiandrogens as a part of hormone therapy for transgender women. In biological females, Proscar has been reported to cause mild acne, dry skin, and a decrease in libido. In higher doses, it may improve the thickness of a woman’s hair, but it comes with significant risks regarding pregnancy and birth defects due to essentially being a type of hormone blocker.

There are no current significant adverse effects associated with mixing the use of Proscar with alcohol consumption, but there have been reports that this medication may cause some patients to have less of a desire to consume alcohol due to changes in the individual’s brain chemistry while on this medication. Individuals with significant cases of alcoholism may be at an increased risk of prostate cancer due to excessive amounts of alcohol negating the effects of Proscar for the treatment of benign prostatic hyperplasia.

If you have missed a dose of your medication, take that dose as soon as you remember to do so. If so much time has passed that it is nearly time for you to take your next dose, disregard the missed dose and simply take your next dose. Do not double the amount of medication you are taking for the sake of catching up. Simply return to your normal dosing schedule afterward.

Patients who take Proscar for the treatment of benign prostatic hyperplasia may be able to determine the medication’s efficacy as they notice improved urine flow as well as a decreased sensation of needing to urinate as the prostate begins to shrink in size.

Proscar generally takes about seven days to be cleared from a patient’s system.

Side effects such as anxiety and symptoms of depression have been reported by individuals taking Proscar. If you are taking Proscar and are having symptoms of depression or anxiety, please contact your doctor as soon as possible. If you are experiencing suicidal thoughts or impulses, please contact the National Suicide Prevention Helpline at 800-273-8255 or go to your closest emergency room.

Proscar may take up to six months for patients to experience the full effects of the medication. Mild improvement may be noticed shortly after beginning the medication.

Erectile dysfunction is listed as one of the potential side effects of taking Proscar, and in clinical trials, about 8.1% of the men using this medication experienced impotence.

Due to Proscar reducing the size of an enlarged prostate, this action will alleviate symptoms such as the restricted level of urination that is commonly present in patients with benign prostatic hyperplasia. Although it may appear as though Proscar is causing a patient to urinate more than usual, this is typically just a patient’s return to a normal frequency of urination without interference from an enlarged prostate.

Proscar has been associated with an increased risk of developing male breast cancer in certain patients who take this medication. Please report any changes in breast tissue while taking Proscar to your prescribing physician.

Proscar may be taken at any time of the day. However, it is recommended that the medication be taken at the same time each day to maximize its efficacy and maintain a proper balance of the medication within a patient’s system.

The use of Proscar is most commonly associated with erectile dysfunction and ejaculatory issues, but incidences of penile atrophy as well as Peyronie’s disease have been reported.

Some patients taking Proscar have experienced long-term side effects from this medication, especially those associated with sexual dysfunction. Information from clinical trials and studies regarding Proscar have included reports of such symptoms remaining persistent for over six or more years, indicating that these side effects and conditions may potentially be permanent.

Proscar has not been shown to have any significant effects on blood pressure in patients taking this medication.