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 in men treated with finasteride. During the 7- year placebo-controlled Prostate Cancer Prevention Trial (PCPT) that enrolled 18,882 men, there was 1 case of breast cancer in men treated with finasteride, and 1 case of breast cancer in men treated with placebo. The relationship between long-term use of finasteride and male breast neoplasia is currently unknown.
Dutasteride (brand name Avodart) and finasteride (brand name Procar) are
medications prescribed for the treatment of an enlarged prostate (benign
prostatic hyperplasia, BPH). Both
dutasteride and finasteride delay the
progression of an enlarged prostate gland, which improves symptoms of BPH.
The side effects of both drugs are mostly sexual problems like breast enlargement, impotence (erectile dysfunction, ED). However, dutasteride may cause allergic reactions, and increases the risk of high-grade prostate cancer. In rare cases, finasteride has caused male breast cancer.
The recommended dose for dutasteride is mg once daily. finasteride should be used with caution if you have liver dysfunction. Neither drug should be used in females or pediatric patients.
An advantage of alpha blockers, compared to finasteride, is that they work almost immediately; they have the additional benefit of treating hypertension when it is present in BPH patients. However, whether terazosin is superior to finasteride may depend more on the size of the prostate. When the two drugs were compared in a study published in The New England journal of Medicine, terazosin appeared to produce greater improvement of BPH symptoms and urinary flow rate than finasteride. But this difference may have been due to the larger number of men in the study with small prostates, who would be more likely to have BPH symptoms from smooth muscle constriction, rather than from physical obstruction by excess glandular tissue. Doxazosin was evaluated in three different clinical studies involving 337 men with BPH. Patients took either a placebo or 4 to 12 mg of doxazosin a day. The active drug- reduced urinary symptoms by 40% more than the placebo, and increased the urinary peak flow by an average of ml/s (compared to ml/s in the placebo patients).