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Drug Information
Side Effects > Proscar

Proscar Side Effects

Generic Name: Finasteride

Please note - some side effects for Proscar may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).


For the consumer

For the professional

Side Effects of Proscar - for the consumer


Proscar

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Proscar:

Decreased sexual desire or ability.

Seek medical attention right away if any of these SEVERE side effects occur when using Proscar:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); breast enlargement, lumps, pain, or tenderness; nipple discharge; testicular pain.

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For the professional


Proscar

Proscar is generally well tolerated; adverse reactions usually have been mild and transient.

4-Year Placebo-Controlled Study

In PLESS, 1524 patients treated with Proscar and 1516 patients treated with placebo were evaluated for safety over a period of 4 years. The most frequently reported adverse reactions were related to sexual function. 3.7% (57 patients) treated with Proscar and 2.1% (32 patients) treated with placebo discontinued therapy as a result of adverse reactions related to sexual function, which are the most frequently reported adverse reactions.

Table 4 presents the only clinical adverse reactions considered possibly, probably or definitely drug related by the investigator, for which the incidence on Proscar was ≥1% and greater than placebo over the 4 years of the study. In years 2-4 of the study, there was no significant difference between treatment groups in the incidences of impotence, decreased libido and ejaculation disorder.

TABLE 4: Drug-Related Adverse Experiences
Year 1
(%)
Years 2, 3 and 4*
(%)
N = 1524 and 1516, finasteride vs placebo, respectively
*
Combined Years 2-4
Finasteride Placebo Finasteride Placebo
    Impotence 8.1 3.7 5.1 5.1
    Decreased
    Libido
6.4 3.4 2.6 2.6
    Decreased
    Volume of
    Ejaculate

3.7

0.8

1.5

0.5
    Ejaculation
    Disorder
0.8 0.1 0.2 0.1
    Breast
    Enlargement
0.5 0.1 1.8 1.1
    Breast
    Tenderness
0.4 0.1 0.7 0.3
    Rash 0.5 0.2 0.5 0.1

Phase III Studies and 5-Year Open Extensions

The adverse experience profile in the 1-year, placebo-controlled, Phase III studies, the 5-year open extensions, and PLESS were similar.

Medical Therapy of Prostatic Symptoms (MTOPS) Study

The incidence rates of drug-related adverse experiences reported by ≥2% of patients in any treatment group in the MTOPS Study are listed in Table 5.

The individual adverse effects which occurred more frequently in the combination group compared to either drug alone were: asthenia, postural hypotension, peripheral edema, dizziness, decreased libido, rhinitis, abnormal ejaculation, impotence and abnormal sexual function. Of these, the incidence of abnormal ejaculation in patients receiving combination therapy was comparable to the sum of the incidences of this adverse experience reported for the two monotherapies.

Combination therapy with finasteride and doxazosin was associated with no new clinical adverse experience.

Four patients in MTOPS reported the adverse experience breast cancer. Three of these patients were on finasteride only and one was on combination therapy.

The MTOPS Study was not specifically designed to make statistical comparisons between groups for reported adverse experiences. In addition, direct comparisons of safety data between the MTOPS study and previous studies of the single agents may not be appropriate based upon differences in patient population, dosage or dose regimen, and other procedural and study design elements.

Table 5: Incidence ≥ 2% in One or More Treatment Groups: Drug-Related Clinical Adverse Experiences in MTOPS
Adverse Experience Placebo

(N=737)
(%)
Doxazosin
4 mg or 8 mg*
(N=756)
(%)
Finasteride

(N=768)
(%)
Combination

(N=786)
(%)
*
Doxazosin dose was achieved by weekly titration (1 to 2 to 4 to 8 mg). The final tolerated dose (4 mg or 8 mg) was administered at end-Week 4. Only those patients tolerating at least 4 mg were kept on doxazosin. The majority of patients received the 8-mg dose over the duration of the study.
  Body as a whole
        Asthenia 7.1 15.7 5.3 16.8
        Headache 2.3 4.1 2.0 2.3
  Cardiovascular
        Hypotension 0.7 3.4 1.2 1.5
        Postural Hypotension 8.0 16.7 9.1 17.8
  Metabolic and Nutritional
        Peripheral Edema 0.9 2.6 1.3 3.3
  Nervous
        Dizziness 8.1 17.7 7.4 23.2
        Libido Decreased 5.7 7.0 10.0 11.6
        Somnolence 1.5 3.7 1.7 3.1
  Respiratory
        Dyspnea 0.7 2.1 0.7 1.9
        Rhinitis 0.5 1.3 1.0 2.4
  Urogenital
        Abnormal Ejaculation 2.3 4.5 7.2 14.1
        Gynecomastia 0.7 1.1 2.2 1.5
        Impotence 12.2 14.4 18.5 22.6
        Sexual Function Abnormal 0.9 2.0 2.5 3.1

Long-Term Data

There is no evidence of increased adverse experiences with increased duration of treatment with Proscar. New reports of drug-related sexual adverse experiences decreased with duration of therapy.

During the 4- to 6-year placebo- and comparator-controlled MTOPS study that enrolled 3047 men, there were 4 cases of breast cancer in men treated with finasteride but no cases in men not treated with finasteride. During the 4-year, placebo-controlled PLESS study that enrolled 3040 men, there were 2 cases of breast cancer in placebo-treated men, but no cases were reported in men treated with finasteride. The relationship between long-term use of finasteride and male breast neoplasia is currently unknown.

In a 7-year placebo-controlled trial that enrolled 18,882 healthy men, 9060 had prostate needle biopsy data available for analysis. In the Proscar group, 280 (6.4%) men had prostate cancer with Gleason scores of 7-10 detected on needle biopsy vs. 237 (5.1%) men in the placebo group. Of the total cases of prostate cancer diagnosed in this study, approximately 98% were classified as intracapsular (stage T1 or T2). The clinical significance of these findings is unknown. This information from the literature (Thompson IM, Goodman PJ, Tangen CM, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med 2003;349:213-22) is provided for consideration by physicians when Proscar is used as indicated. Proscar is not approved to reduce the risk of developing prostate cancer.

Post-Marketing Experience

The following additional adverse effects have been reported in post-marketing experience:

- hypersensitivity reactions, including pruritus, urticaria, and swelling of the lips and face

- testicular pain.

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