Propecia

Overview of Propecia

Propecia, with the generic name finasteride, is a medication primarily used to treat male pattern hair loss (androgenetic alopecia) in men. It is a 5-alpha-reductase inhibitor and works by preventing the conversion of testosterone to dihydrotestosterone (DHT), which is the hormone responsible for causing follicles to shrink, leading to hair loss.

Indications and Usage

Propecia is indicated for the treatment of male pattern hair loss on the vertex and the anterior mid-scalp area. It is not intended for use in women, children, or adolescents. Hair growth on other parts of the body is unaffected by finasteride.

Dosage and Administration

The recommended dose of Propecia is one tablet (1 mg) taken orally once a day, with or without meals. Consistency in the timing of the medication is recommended for optimal results. Doses higher than 1 mg have not been shown to increase efficacy.

Precautions Before Taking Propecia

Before starting Propecia, patients should disclose their entire medical history to their healthcare provider, especially liver disease, prostate cancer, infections, urinary problems, or allergies to finasteride or similar drugs. Propecia is absorbed through the skin; therefore, women who are pregnant or may become pregnant should not handle crushed or broken Propecia tablets.

Drug Interactions

There are no documented significant drug interactions with Propecia. However, patients are advised to inform their healthcare provider of all medications, supplements, and herbal products they are taking to prevent any possible interactions.

Pharmacokinetics

Following an oral dose of Propecia, peak plasma concentrations of finasteride are reached approximately two hours post-dose, with a bioavailability of approximately 65%. The drug is extensively metabolized in the liver via the cytochrome P450 3A4 enzyme subfamily and eliminated predominantly in feces with a urinary excretion of unchanged drug accounting for less than 2%.

Storage Conditions

Store Propecia at room temperature between 68°F to 77°F (20°C to 25°C). Keep the bottle tightly closed and protect from moisture. It should be stored out of reach of children.

Monitoring and Laboratory Tests

During treatment with Propecia, periodic monitoring of serum PSA levels is advisable to detect prostate cancer. A baseline PSA level should be established prior to starting therapy and periodically assessed thereafter.

Potential Side Effects

Common side effects include erectile dysfunction, decreased libido, decreased volume of ejaculate, and gynecomastia. Adverse reactions typically resolve after discontinuation of therapy. If the side effects persist, patients should consult their healthcare provider.

Handling and Disposal

Propecia tablets should not be crushed or broken, and should be disposed of according to local regulations. Handling of broken or crushed tablets by women who are or may become pregnant is contraindicated due to potential teratogenic risk.

Directions for Use

Patients should be directed to swallow Propecia tablets whole, with a glass of water. Any attempt to divide, crush, or chew the tablets should be avoided as the medication is specially formulated to release the drug slowly in the body.

Missed Dose

If a dose is missed, the patient should take the next dose as planned without taking two doses to make up for the missed one. Maintaining a regular dosing schedule is crucial for the efficacy of the medication.

Overdosage

In the event of an overdose, symptomatic and supportive care should be provided. Finasteride is not significantly removed from the plasma by dialysis. There is no specific antidote for overdose with Propecia.

Clinical Efficacy Studies

Clinical studies have demonstrated that Propecia is effective in treating male pattern hair loss. In these studies, men who took Propecia experienced improvement in hair count compared to men who took a placebo. These effects were noted as early as 3 months into therapy and sustained over 5 years.

Patient Counseling Information

Patients should be informed that the response to Propecia varies from individual to individual and that improvement in hair growth can take at least three months to become noticeable. They should also be aware that continued use is necessary to maintain hair growth and that the beneficial effects of Propecia may reverse within 12 months after discontinuation of treatment.

Regulatory Information

Propecia was approved by the FDA in December 1997 for the treatment of male pattern hair loss (androgenetic alopecia). It is categorized as a prescription medication and should be dispensed only upon the receipt of a valid prescription from a licensed healthcare provider.