Finasteride Therapy

Introduction to Finasteride

Finasteride commonly causes sexual side effects including decreased libido, ejaculatory dysfunction, and erectile dysfunction, which are reversible upon discontinuation but may persist in some patients after stopping the medication 1

Finasteride reduces serum PSA levels by approximately 50% after 12 months of therapy, which is clinically important because PSA levels must be doubled when screening for prostate cancer in men taking finasteride 2
Finasteride reduces serum PSA levels by approximately 50% after 12 months of therapy, which is clinically important because failure to account for this reduction could mask the detection of prostate cancer 3
Most side effects are reversible upon discontinuation 1
However, post-finasteride syndrome has been reported - a controversial condition involving persistent sexual, physical, and psychological symptoms after stopping the medication 4
The FDA has added a warning about potential persistent sexual side effects to the drug label, though the evidence is based primarily on anecdotal reports rather than prospective trials 4

In geriatric patients, carefully weigh medication burden against benefits, as side effects may have greater impact on quality of life 5

Discuss potential side effects with patients before initiating therapy, including the risk of persistent sexual dysfunction, and monitor for sexual dysfunction, breast changes, and mood alterations 4