Finpecia (Finasteride)
Also sold as: Finpecia, Propecia (1mg), Proscar (5mg), Finast, Finara
Pregnancy
Cat X
Lactation
Unknown
Schedule
H
Forms
Tablet 1mg (androgenetic alopecia) +1
Indications
- Benign prostatic hyperplasia (BPH) — reduces prostate volume; usually with tamsulosin (combination therapy)
- Male-pattern hair loss (androgenetic alopecia) — 1 mg
Adult Dosing
BPH
5 mg PO once daily
Minimum 6 months before assessing response; lifelong
Male-pattern alopecia
1 mg PO once daily
Minimum 3-6 months; lifelong for maintained benefit
Pediatric Dosing
Contraindicated in children
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| Any CrCl | No adjustment — hepatically metabolised |
Hepatic Adjustment
Use cautiously in significant hepatic impairment
Pregnancy & Lactation
Pregnancy: Category X
CONTRAINDICATED in women, especially pregnant women — inhibits DHT, causing feminisation of male fetus (hypospadias). Pregnant women must NOT handle crushed/broken tablets. Female partners of men on finasteride: avoid contact with semen (condoms recommended). Men should stop 1 month before attempting conception.
Lactation: Unknown
Male medication. Not applicable.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| No significant drug interactions (limited CYP metabolism) | Generally well-tolerated from interaction standpoint | Minor |
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Side Effects
Common
- Decreased libido (1-2%)
- Erectile dysfunction (1%)
- Reduced ejaculate volume
- Gynecomastia (rare)
- Breast tenderness
Serious / Discontinue If
- Post-finasteride syndrome (controversial — persistent sexual dysfunction, depression after stopping; contested in literature)
- High-grade prostate cancer risk (unclear — lowers overall cancer rate but may increase high-grade; FDA note)
- Depression and suicidal ideation (rare, case reports — FDA label update 2012)
Contraindications
- Women (especially pregnant women)
- Children
- Hypersensitivity to finasteride
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Finpecia 1mg | Cipla | 30 tab ₹175 |
| Finast 5mg | Sun Pharma | 30 tab ₹225 |
| Finara 5mg | Alembic | 30 tab ₹195 |
| Propecia 1mg | MSD | 30 tab ₹985 |
Monitoring Required
- PSA at baseline and annually (finasteride lowers PSA by ~50% — double observed value to get true PSA equivalent)
- Prostate size / IPSS (BPH)
- Sexual function (libido, erectile function)
- Mental health (depression — rare but monitor)
Patient Counseling Points
- Takes 3-6 months for hair growth; 6 months for prostate shrinkage — patience required
- Lifelong therapy — benefit reverses 6-12 months after stopping
- Pregnant women must NOT handle broken tablets — feminisation of male fetus
- PSA test: tell your urologist/doctor you are on finasteride — it reduces PSA by 50%
- Sexual side effects affect ~2% — usually reversible on stopping; discuss if concerned
- Semen may have small amounts of drug — use condoms if partner is/might be pregnant
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Clinically reviewed by: Dr. Rajiv Nair, MCh (Urology), Consultant Urologist
Last reviewed: 2026-04-01
References
- BNF — Finasteride
- EAU BPH Guidelines 2023
- EAU Male LUTS Guidelines
- FDA Finasteride Prescribing Information