Proscar (finasteride) is a prescription medication specifically formulated to address the clinical challenges of benign prostatic hyperplasia (BPH). As a 5-alpha-reductase inhibitor, it operates at the hormonal level to reduce prostate size, thereby alleviating obstructive and irritative urinary symptoms. This targeted mechanism offers a non-surgical management option for men seeking long-term control of BPH progression, supported by extensive clinical data demonstrating both symptomatic improvement and reduction in the risk of acute urinary retention and the need for surgery.

Features

• Active ingredient: Finasteride 5 mg
• Pharmacological class: 5-alpha-reductase inhibitor (Type II)
• Presentation: Film-coated, pentagonal-shaped tablets
• Standardized dosing for consistent 24-hour enzyme suppression
• Prescription-only medication requiring medical supervision

Benefits

• Significantly reduces prostate volume, directly alleviating bladder outlet obstruction.
• Improves urinary flow rate and reduces the frequency of nocturia, urgency, and hesitancy.
• Provides a long-term management strategy to halt the anatomical progression of BPH.
• Clinically proven to reduce the risk of acute urinary retention and the need for BPH-related surgery.
• Offers a non-invasive pharmacological alternative to surgical interventions.
• Sustained efficacy with continuous daily use, as demonstrated in multi-year clinical trials.

Common use

Proscar is indicated for the treatment of symptomatic benign prostatic hyperplasia (BPH) in men with an enlarged prostate. It is prescribed to manage lower urinary tract symptoms (LUTS) such as weak stream, straining, a feeling of incomplete bladder emptying, frequency, urgency, and nocturia. Treatment is intended for long-term use, as a minimum of six months of therapy is typically required to assess the full symptomatic and urodynamic response. It may be used as monotherapy or in combination with an alpha-blocker for additive symptomatic relief.

Dosage and direction

The standard dosage for BPH is one 5 mg tablet administered orally once a day, with or without food. Adherence to a consistent daily schedule is critical for maintaining enzyme suppression and achieving optimal therapeutic effect. Tablets should be swallowed whole and not crushed or broken due to the potential for absorption of the active ingredient through the skin, which is a pertinent precaution for handling. Treatment response should be evaluated at periodic intervals, typically at six months, to assess improvement in symptoms and flow rate. Therapy may be continued long-term based on ongoing urological assessment.

Precautions

Prior to initiation, a proper diagnosis should confirm BPH, as other conditions like prostate cancer can cause similar symptoms. A digital rectal exam (DRE) and, if clinically indicated, measurement of prostate-specific antigen (PSA) is recommended before starting treatment and periodically thereafter. Healthcare providers must be aware that Proscar reduces serum PSA concentrations by approximately 50%; therefore, PSA values for prostate cancer screening should be doubled for comparison to pre-treatment levels. Patients should be advised that the benefits of continued therapy may be lost upon discontinuation. Women who are or may potentially be pregnant must not handle crushed or broken tablets due to the risk of absorption and potential teratogenic effects on a male fetus.

Contraindications

Proscar is contraindicated in the following patient populations: women who are pregnant or may become pregnant due to the risk of abnormalities to the external genitalia of a male fetus; children; and patients with a known hypersensitivity to finasteride or any other component of the formulation. It is not indicated for use in pediatric patients and should not be used by women.

Possible side effects

While generally well-tolerated, a subset of patients may experience adverse reactions. The most common side effects are related to sexual function and include:

• Erectile dysfunction
• Decreased libido (sexual desire)
• Ejaculation disorder (e.g., decreased ejaculate volume) These effects occur in a small percentage of users and may persist after discontinuation of therapy in some patients. Less common side effects can include breast tenderness and enlargement. Allergic reactions, including lip swelling and skin rash, are rare. Patients should report any persistent or bothersome side effects to their healthcare provider.

Drug interaction

Formal drug interaction studies have not demonstrated clinically significant interactions with medications such as warfarin, digoxin, theophylline, or ACE inhibitors. However, due to its metabolism primarily via the CYP3A4 enzyme system, caution is advised when co-administering with potent inhibitors of this enzyme (e.g., certain antifungals like ketoconazole, macrolide antibiotics like erythromycin). While not a direct interaction, the effect of Proscar on PSA levels is a critical consideration when interpreting laboratory results for prostate cancer screening.

Missed dose

If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed one, as this does not enhance efficacy and may increase the risk of side effects.

Overdose

In the event of a suspected overdose, supportive measures should be instituted. Single doses of finasteride up to 400 mg have been administered without adverse effect in clinical studies. There is no specific antidote for finasteride overdose. Treatment should be symptomatic and supportive. Due to the extensive protein binding of finasteride, dialysis is unlikely to be of benefit.

Storage

Store Proscar tablets at room temperature, between 15°C and 30°C (59°F to 86°F). Keep the medication in its original container to protect it from light and moisture. Keep all medications out of the reach of children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard any expired or no-longer-needed medication through a medicine take-back program.

Disclaimer

This information is for educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided is based on the manufacturer’s prescribing information but may not be exhaustive.

Reviews

“After six months on Proscar, my urinary flow has improved significantly. The frequent nighttime trips to the bathroom have reduced from 3-4 times to just once, which has dramatically improved my sleep quality and daily energy levels. The initial concern about side effects was discussed thoroughly with my urologist, and I have not experienced any.” – M.B., 68

“Prescribed Proscar for progressive BPH symptoms that were beginning to affect my daily life. It took a good 4-5 months to notice the maximum benefit, but the reduction in urgency and the feeling of complete emptying has been remarkable. A reliable, evidence-based option for managing this condition.” – R.K., 72

“My PSA levels were creeping up, and my prostate was significantly enlarged. My doctor started me on Proscar. A year later, my prostate volume is down, my PSA has been cut in half (as expected), and my symptoms are vastly improved. It has effectively delayed the need for any surgical intervention.” – D.P., 65