Tag Archive | "Finasteride"

Recent Increase in Unnecessary Prostate Biopsy

With an increase in attention given to PSA (prostate specific antigen) levels in men in the United States comes an increase in referrals for prostate biopsy. Oftentimes, these biopsies are recommended even when doctors have no other indications of prostate cancer besides the PSA level. A new study, however, finds that such prostate biopsies are unnecessary if men have a normal clinical exam and their total PSA levels are not yet high.

“If a man’s PSA has risen rapidly in recent years, there is no cause for concern if his total PSA level is still low and his clinical exam is normal,” said Andrew Vickers, PhD, the lead author of the new study from Memorial Sloan-Kettering Cancer Center.

In this most recent study, 5,519 men who participated in the Prostate Cancer Prevention trial were evaluated. All the participants were 55 years or older, had no previous history of prostate cancer, and had normal digital rectal findings and PSA levels of 3.0 ng/mL or less.

The men were randomly assigned to take either finasteride (a medication used to treat BPH) or placebo for seven years. Each year, all the men were screened for PSA levels, and those who had a PSA greater than 4.0 ng/mL were advised to have a prostate biopsy. At the end of the study, men who did not have prostate cancer were asked if they would consent to a biopsy.

The researchers concluded, after reviewing the study’s results, that the main factor that predicted the risk of cancer was a man’s PSA level, not how rapidly the PSA rose. Men with a steady PSA of 5 ng/mL were more likely to have prostate cancer than those whose PSA rose from 2.5 to 3.4 ng/mL. They recommended that a rapidly rising PSA should not be included in screening guidelines for prostate cancer.

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Label Switch in Pfizer Drugs

There is a possible label switch in two of Pfizer’s drugs – an antidepressant and a drug used to shrink the prostate. This prompted Pfizer to do a subsidiary recall on both drugs.

The affected drugs are both in generic formulation – Citalopram is an antidepressant and Finasteride is used to treat benign prostatic hyperplasia (BPH).

It is said that only one lot was affected. Bottles labeled as Citalopram Lot # F10510058-A may contain Finasteride. The lot number involves Citalopram in 100-count bottles of 10-mg tables and Finasteride In 90-count bottles of 5-mg tablets.

Greenstone LLC, the Pfizer unit selling the products stressed that patients taking the wrong medications may be at risk for serious side effects. Patients who discontinue Citalopram abruptly may experience withdrawal symptoms and/or worsening depression. Women who are, or may become pregnant, should not take or handle Finasteride due to possible risk of abnormalities to the external genitalia of a developing male fetus.
Patients should check their bottles of either drug with this lot number on the label should return the products to the pharmacy.

The recall stemmed from the possibility that incorrect labels have been placed on the bottles by a third party manufacturer.

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Dutasteride and Finasteride May Contribute to Irreversible Sexual Dysfunction in Men

Dutasteride (Avodart), a drug frequently prescribed to treat enlarged prostate and Finasteride (Proscar and Propecia); a drug frequently prescribed to treat hair loss may contribute to erectile dysfunction, depression and loss of libido. Symptoms may even persist after the medication stopped.

This is according to a study led by Abdulmaged M. Traish, a professor of biochemistry and urology at Boston University School of Medicine. The team searched for available medical literature for reports of sexual side effects associated with Finasteride and Dutasteride. Of the men taking the drugs, 8% reported erectile dysfunction and 4.2% reported reduced libido while those taking the placebo only 4% of men reported erectile dysfunction and 1.8% of men reported reduced libido. The researchers also noted that reduced ejaculation, reduced semen volume and depression were also reported by some men.

The drugs (Dutasteride and Finasteride) work by blocking androgen but androgen is needed for erectile function, libido and ejaculation, and for just feeling good.

Traish said “as a physician you have a responsibility to take the time and explain to your patient that maybe not everyone will have these side effects, but you may, and in some cases they are irreversible””.

Dr. Bruce R. Kava, an associate professor of urology at the University Of Miami Miller School Of Medicine agreed that “these drugs do cause some of these problems but they haven’t convinced me yet, based on the data, because they don’t have any long term data”. He added that most urologists discuss potential side effects with their patients but usually “don’t discuss long term consequences that are irreversible, because most of us have not been aware of any long term problems from these drugs”.

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