General information about the disease

Benign prostatic hyperplasia (BPH, prostate adenoma) is a benign neoplasm that progresses out of prostate tissue. A small nodule (or nodules) is formed in the prostatic gland. It grows and gradually squeezes the urethra. The result of this compression is stranguria.
According to a study in the United States, in which 1000 men were involved, Benign Prostate Hyperplasia (BPH) was detected in:

• 10% of men aged 30-40;
• 20% of men aged 40-50;
• 40% of men aged 50-60;
• and more than 70 % in persons older than 60.

This medical problem is more common in men suffering from heart disease, hypertension and overweight. It occurs less frequently among Asians, alcoholics and people engaged in manual labor. Also, studies have proven the inherited nature of the disease, especially in cases of severe prostate enlargement.

The growth of prostate adenoma is very individual in each patient. There are different manifestations of this disease.

Most wide-spread complaints and symptoms of benign prostate hyperplasia:

• urinary difficulty;
• weak stream of urine;
• urinary stuttering;
  micturition frequency;
• feeling of incomplete bladder emptying;
• urinating at night (the need to wake up more than once a night, regardless of the amount of liquid drunk);
• acute retention of urine;
• fervescence and chills;
• sexual dysfunction;
• general changes in health. Failure to empty the bladder leads to difficulty in the outflow of urine from the kidneys. As a result, kidney failure develops (laten, then obvious). This is accompanied by undue fatigability, lack of appetite and oedemata.

Description & Action

The method of hormonal treatment of adenoma with inhibitors of alpha-reductase has been steadily gaining momentum in recent years. This is a treatment with drugs which prevent the effect of male sex hormone (Testosterone) on prostate tissue. This leads to a decrease in its volume. It is known that Testosterone is partly responsible for enlargement of the prostate. Interestingly, prostatic hypertrophy does not develop in men, who were castrated for various reasons. It is proved that Testosterone penetrates into the prostate tissue, where under the influence of the enzyme alpha-reductase activates and stimulates the growth of the prostate.

The medicine called Generic Proscar (Finasteride) prevents the activation of testosterone. Testosterone is activated by the steroidogenesis enzyme. The activity of a medicine occurs in the tissues of the prostate gland and it is manifested as the inhibition of this enzyme.
The active substance of the medicine is Finasteride. This substance reduces expressions of symptoms, which are associated with prostatic adenoma. The substance prevents the proliferation of prostate tissue and selectively blocks an enzyme called 5-alpha-reductase.
Studies have shown that gain in health was observed in 63% of patients treated with the medicine for 1 year.

Thus, therapy with Proscar patients with uncomplicated form of benign prostatic hyperplasia is an alternative method of treatment and should be conducted for a long time.

It is necessary to pass medical testing to exclude prostate cancer before initiation of treatment. It is necessary to constantly monitor the patient’s body during the treatment with the medicine.

It was found (during the study) that hair growth resumed in 60% of persons taking the medication daily and hair loss stopped in 38% of men. So, this active substance can also be used to treat androgenic alopecia only in men. The active substance was also tested to treat hair loss in women, but no improvement was observed as a result of its application.

Historical reference

The discovery of the active substance was promoted by a peculiarity of one African tribe. Male sexual characteristics appeared in the boys of this tribe only after reaching awkward age. American researchers have studied this genetic phenomenon. During the study, it turned out that the male half of the tribe had never suffered from prostate enlargement. Scientists managed to find out that all men of the tribe had a deficiency of the enzyme responsible for converting testosterone to dihydrotestosterone.

Dihydrotestosterone affects prostate enlargement. It is necessary to block the enzyme production to prevent that. The active ingredient Finasteride was created specifically for these purposes. Clinical investigations have shown that the size of the prostate decreased and the difficulty of urination disappeared after the administration of Finasteride.

Medicine form and packaging

The medicine is available in the form of tablets for oral administration. The medicine is sold in packages. One package contains 14 tablets of 5 mg each.

Efficiency

The medicine has high performance indicators. Judging from the opinions of patients the inhibitor has helped many patients to get rid of dysuric manifestations and prevent the proliferation of prostatic adenoma. Proscar tablets are able to lower promptly the level of dihydrotestosterone in the human body.

Medicine pharmacological properties:

1. About 57% of the medicine is excreted through the intestines and 39% is excreted through the kidneys.
2. Bioavailability of the drug is 80%.
3. The highest concentrations of finasteride in the blood are observed 2 hours after admission.
4. The half-life of metabolites is 6 hours.
5. Plasma protein binding is 93%.

You can reduce the chance of acute retention of urine and get rid of dysuric disorders while taking the medicine. Tissues of the prostate gland are less exposed to hyperplasia in case of application of a prolonged therapy with the medication.

The medication can be taken as a monotherapy. However, the treatment success is significantly increased with the simultaneous administration of Proscar and Alpha-1 blockers.

Finasteride dosage

According to the instruction, the optimal daily dose is 1 tablet per day. The treatment duration is determined by the attending physician. As a rule, this period is not less than 6-7 months. The medicine can be used regardless of food intake.

Dose adjustments are not required in patients with various stages of kidney failure since special studies have not demonstrated any changes in the pharmacokinetic profile of Finasteride.

Also, there is no need to adjust the dosage of the drug for:

• Elderly patients;
• Patients with nephatony;
• Patients with liver diseases.

The patients should adhere to the following medical advice for effective treatment:

• maintain a balanced diet;
• constantly check the endocrine profile;
• avoid bad habits;
• regularly visit a urologist for preventive examinations;
• monitor the level of hepatic transaminases and kidney function.

Finasteride side effects

Men should not take the medicine if they are sensitive to Finasteride. Other contraindications are prostate cancer and obstructive uropathy.

Men during therapy are advised to undergo regular rectal examination of the prostate and monitor the level of PSMA.

Proscar can cause the following side effects:

• allergic reactions (in particular hives, itching, angioedema);
• lessening of sexual drive;
• depression;
• rapid heart;
• increased activity of hepatic enzymes;
• decrease the level of PSMA;
• dysfunctions of reproductive system (Sometimes the therapy leads to erectile dysfunction, ejaculation disorder, infertility, decreased sperm quality, pain in the testicles).

The medicine is not allowed to persons under the 18.

Interaction with other medicine

The medicine does not have a significant effect on the enzyme system. There was no clinically significant interaction with other medicines.

Overdose

According to the results of the performed studies there were no signs of an overdose in patients taking large amounts of the medicine were absent. There are no special recommendations how to treat an overdose of this medicine.

Security measures

Keep the medicine out of reach of children.

Attention! The active substance can adversely affect the formation of genital organs in boys.

It is strictly prohibited:

• to take the medicine to pregnant women and women of reproductive age;
• to use with finasteride without a coat to women of reproductive age.

There is no information on excretion of active substance with breast milk.

Finasteride Reviews

The medication was well received and has good reviews from patients and doctors. There were reports of relief of characteristic symptoms and a decrease in the size of the prostate gland. Reports of adverse effects are very rare.

Dr. Jones Case from clinical practice
A 50-year-old male signed up for an appointment with me a year ago. Complaints were typical for cystadenoma. The patient was referred to complex diagnostics. It was found during the examination that the person had BPH of the 1st degree. It did not make sense to resort to surgical treatment because it is actually possible to stop the growth of adenoma of 1 degree of severity and improve the patient’s quality of life from a medical point of view. I decided to prescribe а therapy by complex of medicines Proscar + Omnic. There were noticeable improvements in urodynamics six months later. Dysuric manifestations disappeared. I prescribed multivitamin complexes to fix the result. The patient indicated during the last examination that problems with urination and potency had disappeared. Ultrasound and Transrectal US showed that BPH did not increase.

Mick: I took Proscar when I had little problems with the prostate. I started to feel a little sick when I urinated. The doctor said that the prostate was enlarged and put on a good medicine called Proscar. I took 1 tablet of medicine once a day for six months. As I said, the problem was insignificant. I completely restored the function of urination for half a year. My prostate returned to the normal size.

Martin: I underwent surgery to remove the adenoma. However, the physician prescribed treatment with Proscar to prevent re-growth of prostate tissue. I underwent ultrasound inspection every two weeks. As for the moment everything is in order. I do not feel any symptoms of prostatitis.

Klaus: The drug is effective. However, the major disadvantage is that you will have to take the pills within a year. The second major disadvantage is a significant decrease in sexual desire. It is restored only after the end of the treatment.