Finasteride and persistent side effects
Finasteride and persistent side effects
Finasteride inhibits the enzyme 5 α-reductase, which acts as a catalyst in the conversion of testosterone into the more effective androgen dihydrotestosterone (DHT). Finasteride is authorised for the treatment of benign symptomatic prostatic hyperplasia in a dosage of 5 mg daily and, in a lower dosage (1 mg daily) for treating men with mild to moderately severe androgenetic alopecia.
In some cases, finasteride may produce long-lasting side effects that persist even after treatment is discontinued. These include sexual dysfunctions such as erectile dysfunction and loss of libido. The underlying pathophysiology has not yet been fully explained. Patients should be informed about possible side effects before commencing treatment with finasteride.
Finasteride, erectile dysfunction, impaired concentration, loss of drive, per-sistent disorders, alopecia, androgenetic alopecia,
Incident data |
Description |
Case: 2020 Age: adult Sex: male Medicinal product: Finasterid-Mepha Procapil® Active substance(s): finasteride Indication: alopecia UDR: persistent sexual dysfunction, psychological and cognitive problems Outcome: not recovered |
After discontinuation of a 1-month course of finasteride treatment, the patient experienced persistent disorders of sexual function as well as psychological and cognitive problems. These complaints had already persisted for 3.5 years at the time of the report. The patient was known to have suffered concomitantly from hypercholesterolemia. |
Summary and recommendation
In the medicinal product information on finasteride, sexual dysfunction (frequency: unknown) and erectile dysfunction (frequency: uncommon) are listed as adverse drug reactions. Depression and anxiety (frequency: unknown) are also mentioned. Cognitive problems are not explicitly mentioned in the Swiss drug information [1].
It should be noted that in some cases finasteride can cause long-lasting side effects that persist even after discontinuation. These adverse reactions include sexual dysfunctions such as erectile dysfunction and loss of libido. The exact pathophysiology of these persistent side effects has not yet been fully elucidated, though hormonal imbalance, epigenetic changes and neurosteroid dysfunction have been discussed as possible mechanisms [2].
Patients should be informed of the possible adverse drug reactions before starting treatment with finasteride[3].
Statutory duty of healthcare professionals to report adverse drug reactions (ADRs)
In Switzerland, healthcare professionals who are authorised to dispense or administer medicinal products are obligated to report severe and/or previously unknown side effects. Reports to Swissmedic can be entered and sent in the Electronic Vigilance Reporting Portal “ElViS” (ElViS login).
