5-alpha reductase inhibitors

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Information about 5-alpha reductase inhibitors[edit source]

The 5-alpha reductase inhibitors are a family of agents used to treat benign prostatic hypertrophy. They act by inhibiting the steroid 5-alpha reductase which catalyzes the conversion of testosterone to dihydrotestosterone. Dihydrotestosterone is an important prostatic growth factor and its inhibition causes gradual shrinkage of prostate.

Liver toxicity of 5-alpha reductase inhibitors[edit source]

Both of the available agents lower serum concentrations of dihydrotestosterone without affecting serum testosterone and usually with minimal antiandrogenic effects.

History of 5-alpha reductase inhibitors[edit source]

The 5-alpha reductase inhibitors in clinical use in the United States include two agents of similar chemical structure (azasteroids) and activity: finasteride (Proscar: 1992) and dutasteride (Avodart: 2001). Both agents cause a reduction in the size of the prostate, improve urinary flow and suppress prostate-specific antigen (PSA) levels. Both finasteride and dutasteride are associated with a low rate (<1%) of serum enzyme elevations during chronic therapy, which are usually mild-to-moderate in severity, self-limited in course, and rarely require dose modification or discontinuation. Neither of the 5-alpha reductase inhibitors in current use has been linked to clinically apparent acute liver injury.

The 5-alpha reductase inhibitors used for benign prostatic hypertrophy are discussed individually, with references on their hepatotoxicity given together at the end of this introductory section.

Drug class for 5-alpha reductase inhibitors[edit source]

Drug Class: benign prostatic hypertrophy Agents, 5-Alpha Reductase Inhibitors

Alpha-blockers used to treat benign prostatic hypertrophy (BPH):

5-Alpha Reductase Inhibitors

5-alpha reductase inhibitors Resources
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Contributors: Prab R. Tumpati, MD