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