Proscar

Proscar (finasteride 5mg) is a prescription medicine used to treat benign prostatic hyperplasia (BPH), the non-cancerous enlargement of the prostate gland that affects many men over the age of 50. By reducing the size of the prostate, Proscar helps to relieve uncomfortable urinary symptoms such as difficulty starting urination, weak urine flow, and the need to urinate frequently or urgently during the night.

How Proscar Works

Proscar belongs to a class of medicines called 5-alpha reductase inhibitors. The prostate gland depends on dihydrotestosterone (DHT), a hormone derived from testosterone, to grow and maintain its size. Proscar blocks the enzyme responsible for converting testosterone into DHT, reducing DHT levels in the prostate by approximately 70 to 90 per cent. This causes the prostate to shrink gradually, improving urine flow and reducing symptoms over time.

What to Expect During Treatment

Unlike many medicines that produce effects within days, Proscar typically requires six to twelve months of continuous use before the full clinical benefit becomes apparent. Men who stop taking Proscar often find that their prostate returns to its original size and symptoms recur within several months. For this reason, treatment is usually long-term. Many men experience a meaningful improvement in urinary flow and a reduction in the risk of acute urinary retention and the need for prostate surgery.

Important Consideration Regarding PSA Testing

One clinically significant effect of Proscar is that it reduces prostate-specific antigen (PSA) levels by approximately 50 per cent after 6 to 12 months of treatment. PSA is a blood marker used in prostate cancer screening. Doctors must take this into account when interpreting PSA results in men taking finasteride; the measured PSA value should be doubled to estimate what the true value would be without treatment. Men should inform all healthcare professionals involved in their care that they are taking Proscar.

Proscar is not suitable for use in women or children. Women who are pregnant or may become pregnant must not handle crushed or broken tablets, as finasteride is absorbed through the skin and can cause abnormalities in the development of a male foetus.

How to Take Proscar

Proscar (finasteride 5 mg) is taken as one tablet once daily, with or without food. Swallow the tablet whole. Do not crush or break the tablet, particularly if it might be handled by a woman who is pregnant or trying to conceive — finasteride can be absorbed through the skin and causes harm to a developing male foetus.

Patience Is Required

Because Proscar works by gradually reducing the size of the prostate gland, improvement in urinary symptoms does not happen overnight. Continue taking it consistently for at least six months before assessing whether it is working. Full benefit often takes 12 months or more. Do not stop early — symptoms return once the medication is discontinued.

PSA Testing

Proscar reduces PSA (prostate-specific antigen) levels by approximately 50% after six to twelve months of use. Tell any doctor or specialist monitoring your PSA levels that you are taking finasteride, as they will need to apply a correction factor when interpreting your results. Stopping Proscar for two to four weeks before a PSA test is sometimes recommended to get an accurate baseline.

The standard dose of Proscar is one 5mg tablet taken by mouth once daily. The dose does not require adjustment based on the timing of meals. In men with kidney impairment, dose adjustment is generally not necessary because finasteride is primarily eliminated via the hepatic and faecal route rather than the kidneys. In men with significant liver impairment, caution is required as finasteride is hepatically metabolised, and levels may be higher than usual.

There is no indication for Proscar in women or children. Men over 70 may have a slightly prolonged half-life but this does not typically necessitate a dose change. Treatment is long-term; if a dose is missed, the next dose should be taken at the usual time and the missed dose should not be doubled. The medicine should be stored below 30 degrees Celsius in its original packaging, away from moisture.

Common Side Effects

• Decreased libido (reduced sex drive), most noticeable in the first year of treatment
• Erectile dysfunction
• Reduced volume of ejaculate
• Breast tenderness or enlargement (gynaecomastia)
• Testicular discomfort
• Skin rash or itching (uncommon)

Post-Finasteride Syndrome

A small number of men report that sexual side effects (reduced libido, erectile dysfunction, altered orgasm) persist after stopping Proscar, a collection of symptoms sometimes referred to as post-finasteride syndrome. The medical evidence on this is still evolving. If you are concerned about persistent side effects after stopping, discuss them with your doctor. Any new breast lumps or nipple discharge should be reported promptly.

Prostate Cancer and PSA Monitoring

Proscar reduces PSA levels by approximately 50 per cent, which can interfere with prostate cancer screening. Any confirmed increase in PSA while taking finasteride should be investigated thoroughly, as it may indicate prostate cancer that has been partially masked. Men should ensure that all clinicians requesting PSA tests are aware they are taking finasteride so that results are interpreted correctly. Proscar does not prevent prostate cancer and is not licensed for this purpose.

Liver Function

Finasteride is metabolised in the liver, and caution is required in men with hepatic impairment. Men with liver disease should discuss this with their prescriber before starting treatment. Elevated liver enzymes have been reported rarely and should be investigated if symptoms of liver problems such as persistent nausea, jaundice, or abdominal pain develop.

Pregnancy Exposure Risk

Women who are pregnant or of childbearing age must not handle broken or crushed Proscar tablets because finasteride is absorbed through intact skin. Exposure during pregnancy can cause abnormalities of the external genitalia of a male foetus. If a woman inadvertently comes into contact with the active ingredient, the skin should be washed thoroughly with soap and water and medical advice should be sought. Men taking finasteride who are sexually active with a pregnant partner should use a condom to prevent semen exposure.

• Women of childbearing potential and pregnant women (teratogenic risk to male foetus)
• Children and adolescents under 18 years
• Known hypersensitivity to finasteride or any excipient in the formulation
• Men with urinary obstruction requiring immediate surgical intervention
• Severe hepatic impairment (use with caution; contraindicated where liver function is critically compromised)
• Men with bladder muscle dysfunction as the underlying cause of urinary symptoms
• Concurrent use where monitoring of PSA for prostate cancer is not possible or practical