Brain Res. 2005 Mar 15;1038(1):59-68.
Progesterone's 5alpha-reduced metabolite, 3alpha,5alpha-THP, mediates lateral displacement of hamsters.
Frye CA, Rhodes ME.
Department of Psychology, The University at Albany-SUNY, Albany, NY, USA; Biological Sciences, The University at Albany-SUNY, Albany, NY, USA; The Center for Neuroscience Research, The University at Albany-SUNY, Albany, NY, USA.
5alpha-pregnan-3alpha-ol-20-one (3alpha,5alpha-THP), progesterone (P(4))'s 5alpha-reduced, 3alpha-hydroxysteroid oxidoreduced product, facilitates lordosis of rodents in part via agonist-like actions at GABA(A)/benzodiazepine receptor complexes in the ventral tegmental area (VTA). Whether 3alpha,5alpha-THP influences another reproductively-relevant behavior, lateral displacement, of hamsters was investigated. Lateral displacement is the movement that female hamsters make with their perineum towards male-like tactile stimulation. This behavior facilitates, and is essential for, successful mating. Hamsters in behavioral estrus had greater lateral displacement responses when endogenous progestin levels were elevated compared to when progestin levels were lower. Administration of P(4), a prohormone for 3alpha,5alpha-THP, dose-dependently (500 > 200 > 100, 50, or 0 mug) enhanced lateral displacement of ovariectomized hamsters that had been primed with SC estradiol benzoate (5 or 10 mug). Inhibiting P(4)'s metabolism to 3alpha,5alpha-THP by co-administering finasteride, a 5alpha-reductase inhibitor, or indomethacin, a 3alpha-hydroxysteroid oxidoreductase inhibitor, either systemically or to the VTA, significantly decreased lateral displacement and midbrain progestin levels of naturally receptive or hormone-primed hamsters compared to controls. These data suggest that lateral displacement is progestin-sensitive and requires the formation of 3alpha,5alpha-THP in the midbrain VTA.

Cancer. 2005 Feb 28.
Estimated impact of the Prostate Cancer Prevention Trial on population mortality.
Unger JM, Thompson IM Jr, Leblanc M, Crowley JJ, Goodman PJ, Ford LG, Coltman CA Jr.
Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington.
BACKGROUND: The potential public health impact of the recently completed Prostate Cancer Prevention Trial (PCPT) is debated. The results indicated that the period prevalence of prostate cancer was reduced by 24.8% due to finasteride, whereas an increase in the rate of high-grade tumors (Gleason score 8-10) among men who were diagnosed with cancer also was found (5.0% in the PCPT placebo arm vs. 11.9% in the PCPT finasteride arm). Whether the increased Gleason score was valid or was a histologic artifact is under investigation. METHODS: The authors estimated the number of person-years saved assuming a 24.8% reduction in the incidence of prostate cancer for 5 years among United States males age >/= 55 years. Scenarios for different proportions of patients with high-grade Gleason scores also were considered. RESULTS: With a 24.8% reduction in the number of men with newly diagnosed prostate cancer, the authors estimated that 316,760 person-years would be saved due to finasteride in the United States. An absolute increase of 6.9% in the proportion of men with high-grade tumors in the United States cancer population (corresponding to the difference between the rates on the placebo and finasteride arms of the PCPT) would reduce the number of person-years saved to 262,567. For each absolute increase of 5% in the proportion of patients with high-grade tumors, the number of person-years saved would be reduced by approximately 39,000. CONCLUSIONS: The results of the PCPT may have a major impact on population mortality from prostate cancer if they are applied clinically. The potential detrimental effects of an increased rate of patients who have prostate cancer with high-grade Gleason scores would be outweighed by a reduction in incidence.

Int J Impot Res. 2003 Aug;15(4):299-306.
Medical therapy for benign prostatic hyperplasia: sexual dysfunction and impact on quality of life.
Carbone DJ Jr, Hodges S.
Department of Urology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157, USA.
Therapies for benign prostatic hyperplasia (BPH) may either improve or exacerbate sexual function with an ensuing impact on quality of life. Here we review a total of 73 papers on medical therapies for BPH with a focus on the effects of different pharmacological agents on sexual function. For example, certain alpha(1)-adrenergic receptor blockers may improve erectile function; however, ejaculatory dysfunction with one of these agents, tamsulosin, occurs at a rate of 4-18%, rising to 30% with long-term use. In addition, treatment with the 5 alpha-reductase inhibitor finasteride is associated with problems of ejaculation (2.1-7.7%), erection (4.9-15.8%), and libido (3.1-5.4%). Such significant and undesirable complications in relation to sexual function produce a well-documented negative impact on quality of life. Thus, optimal treatment for men with BPH requires the use of agents that demonstrate efficacy and safety with fewer sexual side effects.

Urology 2003 Feb;61(2):354-8
Long-term treatment with finasteride in men with symptomatic benign prostatic hyperplasia: 10-year follow-up.
Lam JS, Romas NA, Lowe FC
Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York, USA.
To evaluate the safety and efficacy of finasteride 5 mg during a 10-year period in men with enlarged prostates from a single center who participated in the double-blind and extension phases of the multicenter, Phase III, North American benign prostatic hyperplasia (BPH) trial. It is important that the long-term safety and efficacy of drugs intended for chronic administration in men with BPH be well understood.The Phase III North American BPH trial involved a 1-year, placebo-controlled, double-blind study, followed by a 5-year open extension with finasteride 5 mg/day. The trial enrolled men with symptomatic BPH, an enlarged prostate on digital rectal examination, and no evidence of prostate cancer. Of the 46 patients originally enrolled from our institution, 43 were randomized to receive finasteride or placebo, of whom 41 (95%) completed the double-blind study and entered the 5-year extension. Thirty (73%) of these 41 patients completed the 5-year extension. Patients continued to be followed up by their physicians for an additional 5 years, for a total follow-up of at least 10 years.Twenty-four (56%) of the original 43 patients randomized to finasteride or placebo were judged as successfully treated during the 10-year finasteride follow-up (17 patients taking finasteride alone at 10 years and 7 patients who were taking finasteride alone when they discontinued during the 10-year follow-up for reasons not related to finasteride treatment). Altogether, 22 (51%) of the original 43 randomized patients continued finasteride treatment at 10 years (17 taking finasteride alone, 4 taking finasteride plus an alpha-blocker, and 1 taking finasteride for treatment of hematuria). Finasteride was well tolerated, with no new adverse experiences occurring with increasing duration of exposure to the drug.This long-term follow-up study has demonstrated that appropriately selected patients with symptomatic BPH and enlarged prostates are likely to have a long-term response to taking finasteride 5 mg daily.

Drug information

GENERIC NAME: finasteride
BRAND NAME: Proscar

DRUG CLASS AND MECHANISM: The prostate gland is located around the tube which empties urine from the bladder (urethra). As the prostate gland enlarges, usually after 50 years of age, it can obstruct or partially block the urine flow. This leads to symptoms which include dribbling of urine, narrow stream, problems starting urine flow, interruption while urinating, and a feeling of incomplete emptying. Other symptoms include wetting and staining of clothes, urinary burning, and urgency.

Prostate gland enlargement (Benign Prostatic Hyperplasia or BPH), is directly dependent on DHT (a hormone converted from the male hormone testosterone). Finasteride inhibits the enzyme necessary for the conversion of testosterone to DHT in the prostate. Therefore, administration of finasteride lowers blood and tissue DHT levels and helps reduce the size of the prostate gland.

Although reductions in the size of the prostate gland can occur in virtually all the patients who take finasteride, only 50% will experience improvement in the symptoms of BPH. Patients generally respond to finasteride in several weeks, but it often takes 6 months for the patient to receive the full effect of the drug.

PREPARATIONS: Tablet (5mg).

STORAGE: Finasteride should be stored at room temperature in a tight light resistant container.

PRESCRIBED FOR: Finasteride is used to treat symptoms of BPH. Finasteride is approved for use with the alpha-blocker, doxazosin, to reduce the progression of symptoms of BPH.

DOSING: Finasteride is metabolized mainly by the liver, and caution should be used in patients with liver dysfunction. Finasteride may be taken with or without food.

DRUG INTERACTIONS: Drug interactions are generally not a problem.

PREGNANCY: Finasteride causes abnormal development of the sexual organs of the male fetus. Therefore, women who are pregnant or are likely to be pregnant should not handle crushed or broken finasteride tablets in order to prevent absorption through the skin.

NURSING MOTHERS: Finasteride is not prescribed for women.

SIDE EFFECTS: Side effects are rare but can include impotence and decreased sex drive. Finasteride should not be used by women, children, or male partners of women trying to become pregnant. Finasteride should not be used until a thorough prostate examination has been done to exclude cancer, stricture, or infection in the gland.

Caution! Before starting to take this medicine, it is vital that you should consult your doctor! Do not use it on your own initiative, without medical advice.
Also, you should read carefully important health information about this drug given here:

www.nlm.nih.gov

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PROSCAR
Substance: Finasteride
Manufacturer: Merck Sharp & Dohme Idea Inc.

Health information and news

Dosage	Packing	Price	Pay now
5 mg	28 tab	USD 72.00
5 mg	84 tab	USD 189.00

PROSCAR - GENERIC (generic - what is it?)
Substance: Finasteride

Dosage	Packing	Price	Pay now
5 mg	30 tab	USD 52.00
5 mg	60 tab	USD 78.00
5 mg	90 tab	USD 112.00