5-alpha reductase inhibitor
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Indications
- treatment of benign prostatic hypertrophy (BPH)
- may reduce prostate cancer mortality in men with prostate cancer[10]
- androgenic alopecia[3]
Contraindications
- women & children
- prevention of prostate cancer[1]
- no affect on mortality in men without prostate cancer[10]
Adverse effects
- fetal abnormalities in male fetus
- absorbed through skin
- may be passed to pregnant woman through blood transfusion
- impotence < 5% (transient)
- sexual dysfunction may persist after discontinuation[6]
- erectile dysfunction
- gynecomastia < 1%
- depression[4]
- not a risk factor for high-grade prostate cancer[6]
- delayed diagnosis & increased mortality from prostate cancer[9]
- increased risk for type 2 diabetes (RR= 1.3 vs tamsulosin)[8]
Mechanism of action
- inhibition of testosterone 5-alpha reductase
- shrinks androgen-sensitive prostate tissue
- is not an androgen receptor antagonist
More general terms
More specific terms
Additional terms
- 3-oxo-5-alpha-steroid 4 dehydrogenase; steroid 5-alpha reductase; testosterone 5-alpha reductase
- androgen receptor antagonist; androgen receptor signaling inhibitor (ARSI)
References
- ↑ 1.0 1.1 Andriole GL et al Effect of Dutasteride on the Risk of Prostate Cancer New Eng J Med 2010 362:1192-1202 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20357281
Walsh PC Chemoprevention of Prostate Cancer New Eng J Med 2010 362:1237 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20357287 - ↑ Robinson D et al Use of 5alpha-reductase inhibitors for lower urinary tract symptoms and risk of prostate cancer in Swedish men: nationwide, population based case-control study. BMJ 2013;346:f3406 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23778271 <Internet> http://www.bmj.com/content/346/bmj.f3406?etoc=
- ↑ 3.0 3.1 Deprecated Reference
- ↑ 4.0 4.1 Welk B, McArthur E, Ordon M et al Association of Suicidality and Depression With 5alpha-Reductase Inhibitors. JAMA Intern Med. Published online March 20, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28319231 <Internet> http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2610105
- ↑ 5.0 5.1 Hagberg KW, Divan HA, Persson R, Nickel JC, Jick SS. Risk of erectile dysfunction associated with use of 5-alpha reductase inhibitors for benign prostatic hyperplasia or alopecia: population based studies using the Clinical Practice Research Datalink. BMJ 2016;354:i4823 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27659058 Free Article <Internet> http://www.bmj.com/content/354/bmj.i4823
- ↑ 6.0 6.1 6.2 Unger JM, Hershman DL, Till C et al. Using Medicare claims to examine long-term prostate cancer risk of finasteride in the Prostate Cancer Prevention Trial. J Natl Cancer Inst 2018 Nov; 110:1208-1215. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29534197
Wallerstedt A, Strom P, Gronberg H, Nordstrom T, Eklund M. Risk of prostate cancer in men treated with 5alpha-reductase inhibitors - A large population-based prospective study. J Natl Cancer Inst 2018 Nov; 110:1216-1221 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29548030 - ↑ 7.0 7.1 Medical Knowledge Self Assessment Program (MKSAP) 18, 19 American College of Physicians, Philadelphia 2018, 2022
- ↑ 8.0 8.1 Wei L, Lai EC, Kao-Yang YH et al Incidence of type 2 diabetes mellitus in men receiving steroid 5alpha-reductase inhibitors: population based cohort study. BMJ 2019;365:l1204 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30971393 Free Article https://www.bmj.com/content/365/bmj.l1204
Andrew R, Wei L, Walker B, MacDonald D Reducing the risk of type 2 diabetes in men with benign prostatic hyperplasia - old steroids, new tricks. thebmjopinion. April 10, 2019 https://blogs.bmj.com/bmj/2019/04/10/reducing-the-risk-of-type-2-diabetes-in-men-with-benign-prostatic-hyperplasia-old-steroids-new-tricks/ - ↑ 9.0 9.1 Sarkar RR, Parsons JK, Bryant AK et al Association of Treatment With 5alpha-Reductase Inhibitors With Time to Diagnosis and Mortality in Prostate Cancer. JAMA Intern Med. 2019;179(6):812-819. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31058923 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2732119
- ↑ 10.0 10.1 10.2 Bjornebo L et al. Association of 5-alpha-reductase inhibitors with prostate cancer mortality. JAMA Oncol 2022 Jul; 8:1019. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35587340 PMCID: PMC9121300 (available on 2023-05-19) https://jamanetwork.com/journals/jamaoncology/fullarticle/2792528