Such a disease as adenoma of the prostate, today is a fairly common urological pathology. Another name for this disease is considered – benign prostatic hyperplasia. The causes of this pathology are unknown to the end, but its development is associated with hormonal imbalance in the male body. The enlargement of the gland occurs under the influence of a high concentration of male sex hormones. Therefore, one of the methods of conservative treatment of adenoma of the prostate is the use of finasteride.
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The main data on the medical remedy
A single Finasteride tablet usually contains 5 mg of the active or active ingredient. The pharmaceutical form of Finasteride is a tablet, which has a capsule shape with a blue shell. On one of the surfaces of the tablet there is an engraving FNT-5. The drug belongs to the group of 5-alpha reductase enzyme inhibitors.
A bit of theory
5-alpha reductase – this is an enzyme that is found in the cells of the prostate. Under its influence the basic male sex hormone testosterone is transformed into dihydrotestosterone. Excessive amounts of dihydrotestosterone, in turn, leads to binding to receptors in prostate cells and the release of various growth factors into the blood. These substances enter the epithelium of the gland and stimulate cell growth and differentiation. Thus, the prostate gland grows.
How finasteride works?
Once in the bloodstream, the drug blocks the effect of 5-alpha reductase, thereby reducing the concentration of dihydrotestosterone. This leads, over a period of time, to a reduction in the size of the cells and the glandular tissue itself, as well as a reduction in the severity of symptoms. A feature of this drug is the lack of effect on androgen receptors in the body, while not causing many side effects compared to other drugs. In addition, it does not affect the metabolism of lipids, the level of cortisol, prolactin, thyroid hormones, thus not affecting the main metabolic processes in the male body.
For the release of finasteride as a treatment, a huge number of scientific studies were conducted. The study included patients with adenoma of the prostate, and they were treated with finasteride at a dose of 5 mg per day, and the drug was used for about 3 years. The results of the study revealed a decrease in the concentration of dihydrotestosterone, due to which the volume of the gland has decreased by approximately 27%.
In addition, prostate-specific antigen levels also decreased by more than 50%. This indicates a decrease in the growth rate of prostate cells. Considering that dihydrotestosterone was not synthesized from testosterone, the concentration of the latter increased by 10-20%. In addition, due to continuous and long-term intake of the drug (about 4 years), the risk of complications and the frequency of surgical treatment (removal of part of the prostate, emergency catheterization for urinary retention and other necessary measures) decreased by 50%.
Peculiarities of pharmacokinetics of the drug
Finasteride is completely excreted from the stomach into the bloodstream after 6 hours. Food intake does not affect absorption processes. The maximum level of finasteride is determined as early as 2 hours after administration. If the drug is used for a long time and continuously, it accumulates in doses necessary for a positive effect. At a standard dose of the drug, its plasma level is usually kept at 8-10 ng/ml. Finasteride enters the cerebrospinal fluid through the blood-brain barrier, however, in therapeutic dosage does not exceed permissible values and has no effect on the CNS.
Usually the drug is excreted from the body with urine and feces in the form of safe substances. Given that the age of patients with adenoma of the prostate is quite high, this patient population has any concomitant pathology. In the elderly, finasteride is excreted slightly longer, but this usually does not require a reduction in the dosage of the drug.
In addition, patients with renal or cardiovascular disease also do not require dose adjustments. In a study in patients with renal insufficiency, finasteride was found to be excreted more in the feces with decreased metabolites in the urine.
So, the main indication for the prescription of finasteride is the conservative treatment of enlarged prostate or adenoma of the prostate. In this case, the main objectives of taking the drug are to reduce the volume of the gland and the prevention of complications such as acute urinary retention, due to the blockage of the urethra by the gland's tissues. It should be remembered that adenoma of the prostate does not exclude the development of prostate cancer. And taking into account that finasteride reduces the level of prostatic antigen, it can distort the results of tests for cancer.
The list of contraindications for use is quite small. It includes individual intolerance to the drug, as well as its components, it is not recommended to take the drug to pregnant women and persons under 18 years of age. When it is absorbed into the blood of a pregnant woman, it can cause irreparable damage to the fetus, mainly male, causing disruption of genital organ formation, as well as other disorders.
How to use the drug?
The drug is usually taken orally with fluids. Urologists recommend taking 5 mg daily. The minimum duration of treatment is about six months, after which a second adjustment of the dosage is necessary.
Are there any side effects?
Unfortunately, as with many other drugs, finasteride causes various side effects. Rarely, drowsiness, pain in the testicles, mammary glands, itching, urticaria. Often there may be impotence, impaired libido. However, the side effects are usually transient.
No data have been obtained on the development of adverse effects caused by overdose.
In addition, the drug can be used with other drugs.
Finasteride has proven to be a good drug in the treatment of benign prostatic hyperplasia.