TRT and LUTS. Mick Jagger, 70 years. PRISM IV Sept 2014
|
|
|
- Magdalene Morton
- 5 years ago
- Views:
Transcription
1 TRT and LUTS Mick Jagger, 70 years PRISM IV Sept 2014
2 Combination of LUTS and LOH In ageing male : -LUTS increases -LOH increases So: the combination is a common clinical scenario
3 TRT and LUTS Startingpoint / first thought: Treatment of LUTS prevails treatment of LOH
4 TRT and LUTS Guidelines: TRT relative contra-indicated if IPSS 21 points (no data!) - Wang, ISA, ISSAM, ASA etc, Buvat, Dohle, EAU, 2012
5 TRT and LUTS; what do we know? Gradual increase of prostate volume, concomitant with progressive decline of T Hypogonadism affects 20% of elderly men with LUTS In men with Metabolic Syndrome : LUTS earlier in life Although there is no consistent relationship between TT and ft and LUTS/BPH: in eugonadal middle-aged men(lee, 2014) May be : T is the common link between : Advancing age LUTS MetS Francomano, Urology 83 (1), 2014 Rohrmann, Urology 69, 2007 Litman,BJU Int. 100,2007
6 TRT and LUTS; what is in the literature? Mild LUTS improve with TRT, Yassin, World J Urol, Mild LUTS was stable after 5y of TRT, Francomano, Urology, 2014, 83,1 -signifant lower incidence of prostatitis: T prevents prostatitis? Severe LUTS and TRT: no data!
7 TRT and LUTS Hypothesis: - Testosteron may act on the structures of the lower urinary tract: Some prove: Androgenreceptors on urethra and bladder epithelial cells are detected T maintains reflex activity of the pelvic autonomic nervous system Chavalmane, J Sex Med ,
8 TRT and LUTS Two Questions: -Is TRT bad for LUTS? -Is LUTS-therapy bad for LOH?
9 TRT and LUTS Is TRT bad for LUTS? - is TRT bad for bladder as the cause of LUTS? Probably not! - is TRT bad for BPH as the cause of LUTS? We don t know! no data
10 TRT and LUTS First recommendation: -No TRT in severe LUTS, but no data available -Just treat severe LUTS first
11 TRT and LUTS Two Questions: -Is TRT bad for LUTS? -Is LUTS-therapy bad for LOH?
12 TRT and LUTS Is LUTS-therapy bad for LOH: bad for sexual functions, bad for TRT? LUTS-Treatments: -alfa-blockers -5alfa-reductase-inhibitors -anti-cholinergic drugs in urge-patients -TURP and other operations
13 TRT and LUTS BPH-treatments: -alfablockers: alfuzosine dry orgasm; ED tamsulosine dry orgasm; ED silodine dry orgasm; ED -PDE-5-I tadalafil improves erections and LUTS/BPH!! -PDE-5-I plus alfablockers improves LUTS and ED -5ARI s: finasteride dutasteride -TURP: 10% improvement / 10% worsening of ED Leliefeld, BJU Int 2002, 89, Gacci, Eur Urol 2011;60: Huilei Yan, J Sex Med 2014;11:
14 CanTRT-patients with LUTS benefit from Dutasteride? Could be conflicting because: Effects of Dutasteride : Effects of TRT: -90% decrease of DHT in serum and prostate -prostate volume decreases ± 30 % -PSA decreases ±50 % after 3-6 months -Sexual side effects : ± 30 % -Testosterone increases -DHT increases Rittmaster, 2008, Roehrborn, 2011 Andriole, 2004 Toren, 2013
15 Question: Is Dutasteride therapy still effective in TRT-patiënts with LUTS? or: What is the influence of Dutasteride on : -PSA -prostate volume -sexual symptoms in patients that are on stable TRT
16 Randomised placebo-controlled study in patients stable on TRT TRT + dutasteride (n=11) TRT plus placebo(n=11) PSA change: 23,2% decrease no change Prostate volume: 6,65% decrease no change Sexual side effects: a trend (MSHQ) no change Kacker, R et al, Andrologia 2014; 20, 1-5
17 CanTRT-patients with LUTS benefit from Dutasteride? Possible Conclusions with caution : -PSA decreases less: 23,2%% versus 50% -Prostate volume decreases less: 6,65% versus 30% -Sexual side effects: a trend to still appear despite TRT DHT important for sexual function Kacker R, et al, Andrologia, 2014; 20, 1-5
18 CanTRT-patients with LUTS benefit from Dutasteride? In simple language might be stated: Dutasteride in TRT-patients brings : -less decrease of PSA More large volume studies are necessary -less prostate volume reduction -still sexual side effects - LUTS not examined: no data
19 J Sex Med 2012;9: Sex Med Rev 2014;2: 24-35
20 Time to learn more about Finasteride and Dutasteride
21 Finasteride : 5 alfa reductase-2-inhibitor : reduces DHT -Male pattern hair loss: mg -a sign of virility, due to high T/DHT -high DHT means baldness -high 5α-reductase-2-activity in skin of head -BPH: mg
22 Baldness: sign of virility
23 Persistent sexual side effects of 1mg in Propecia In 2008: Swedish Medical Products Agency: persistent ED after discontinuation In 2009: Agency in UK : difficulty having erection after discontinuation In 2011: Traisch JSM 8:872-84: Persistent ED, low libido and depression:1 case In 2011: Irwig, JSM 8: : Persistent sexual side effects: series of 71 men In 2012: Irwig, JSM 9: : Persistent sexual side effects: Permanent? - Inclusion: men with SD for 3 months despite cessation of finasteride 89 % still had sexual disfunction at mean FU of 14 months (n=54)
24 Rates of withdrawal because of sexual side effects of 5 mg in BPH Lowe,McConnel, Urology, 2003;61: ,3% Prospectstudy, CMAJ, 1996,155: long duration PlessStudy, Urology, 2003:61: % Whether the sexual side effects ever resolved, has not been published!!
25 Finasteride : background Three isoforms of 5α-reductase: -Type I: in brain, liver, muscle, skin and little in the prostate -Type II: in epididymis, hair follicles, liver, prostate and seminal vesicles -Type III: in brain, heart, lung, pancreas, colon, stomach, liver, muscle, prostate and testicles Attention: Type III at higher levels than I and II ; potent inhibition by Finasteride and Dutasteride! Yamana, Horm.Mol Biol Clin Invest 2010;2:293-9
26 Finasteride : background Is a synthetic steroid that acts as an alternative substrate for the 5α-reductase enzymes Is lipophilic: can cross the blood-brain barrier Inhibition of formation of not only DHT but also of: -allopregnanolone (ALLO), a progesterone metabolite -androsterone -epiandrosterone -THDOC -and many other steroids Duskova, Prague Med Rep 2009; 110:222-30
27 Finasteride and Neurosteroids Neurosteroids: - steroids that are synthesized in the brain - or metabolized in the brain from steroids from gonads or adrenal glands - play a role in neurogenesis, neuroprotection, synaptic formation, plasticity of the brain and myelination Finasteride: - can alter the concentrations of neurosteroids like ALLO and THDOC - decreases neurogenesis and proliferation of neural precursor cells in mice Römer Pharmacopsychiatry 2010;43:174-8 Irwig Sex Med Rev 2014; 2: 24-35
28 Finasteride : background The 5α-reductase Type 2 that binds to finasteride have significant genetic variation with probably different affinities for finasteride In other words: finasteride can act different in different individuals Andersson, Proc Natl Acad Sci USA 1990;87:3640-4
29 Incomplete Recovery of Erectile Function in Rat after Discontinuation of Dual 5 Alpha Reductase Inhibitor Therapy In vivo erectile response in rats after pelvic nerve stimulation Controls 8 weeks dutasteride 6 weeks dutasteride and 2 weeks wash out The Journal of Sexual Medicine, CV Öztekin.e.a. Volume 9, Issue 7, pages , 8 MAY 2012 DOI: /j x
30 Incomplete Recovery of Erectile Function in Rat after Discontinuation of Dual 5 Alpha Reductase Inhibitor Therapy In vitro bath responses of CC smooth muscle Controls 8 weeks dutasteride 6 weeks dutasteride and 2 weeks wash out The Journal of Sexual Medicine, CV Öztekin e.a. Volume 9, Issue 7, pages , 8 MAY 2012 DOI: /j x
31 Finasteride and erectile disfunction Already in 1981 shown to be harmful for erections in male rats DHT in castrated rats improves erections So: Dutasteride has detrimental effects on EF in rats, proven by: -decreased erectile response with cavernosal stimulation -strips of smooth muscle :contraction and stimulation -increased collagen deposition in cavernous tissue -26% lower weight of corpora cavernosa than in controls Lit: Irwig 2014 Sex Med Rev 2:24-35
32 Finasteride and the persistent side effects Erectiele disfunction Low libido and decreased orgasm Depression Decrease in Alcohol consumption in young men and animal models Irwig, MS Sex Med Rev 2014; 2: Overview of the literature
33 Finasteride and depression in former users Depressive symptoms in finasteride group : 75% in control group : 10% Suicidal thoughts in finasteride group : 44% in control group : 3% Irwig J Clin Psychiatry 2012;73:1220-3
34 Finasteride and decrease in alcohol consumption Decrease of alcoholconsumption in 65% (41 of 63 subjects) Quitting drinking entirely: 18 of 63 subjects because of effects of alcohol on mental function: decreased euphoria Mechanism: modulation by ALLO in male mice and rats Janak 1998, Alcohol Clin Exp Res 22:
35 Finasteride and side effects Why so late reported in the literature? -Incidence of persistent side effects is less than 1% -general underreporting of adverse effects of medications -no validated instrument used in RCT of 5α-reductase inhibitors FDA in 2012: persistent sexual side effects on the label of finasteride FDA in 2010: depression on the label of Propecia
36 Finasteride and side effects Finasteride alters the levels of multiple hormones and neurosteroids Studying the brain of living humans will be difficult Persistent effects : intriguing and bothersome for men who suffer - 89% still sexual disfunction 14 months after stopping Genetics presumably determine the individual s risk for a side effect At now: no test available to predict if the patient will be unlucky!! At now: no pharmacological therapy available other than PDE-5-I TRT did not help Irwig 2012 J Sex Med 9:
37 Finasteride and side effects Messages / Summing up: - Literature on long term side effects comes mainly from 1mg finasteride - Literature on long term sexual side effects of finasteride /dutasteride in BPH is lacking - Literature on sexual side effects concerns mainly experiments in rats and mice - FDA warns for persistent sexual side effects and depression since 2010/ It is not possible to estimate the risk of persistent (sexual) side effects anno Finasteride can lower many neurosteroids and not only DHT
38 Finasteride and side effects Prescribers and users should be aware of the potential serious persistent risks of finasteride and dutasteride
39 Take home messages No TRT in severe LUTS-patients; but no data Treat severe LUTS before starting TRT Many LUTS-treatments can be : bad for LOH-patients Finasteride / Dutasteride can give sexual disfunctions/depressions Finasteride / Dutasteride can give persistent sexual disfunctions! Finasteride / Dutasteride only in patients with prostate volume 40 gram Discuss side effects with your patients
40 The End
41 Finasteride and Neurosteroids In the brain: -G-aminobutyric acid (GABA) : major inhibitory neurotransmitter - 2 important neurotransmitters are modulators of the GABA receptor: -ALLO and THDOC -The sensitivity of the GABA receptor can be altered by: -ALLO -chronic steroid administration -age, stress and social isolation Majewska, Science1986,;232:1004-7
42 Finasteride and Low libido and Decreased Orgasm Difficult to study ; mechanisms less clear; indirect evidence Sexual excitation : neurotransmitter: norepinepfrine and dopamine Inhibition of sexual arousal : serotonine and opioids -5α reductase is present in many of the brain regions linked to sexual desire -reduction of neurosteroids leads to loss of neuroprotection: sexual desire Römer Pharmacopsychiatry 2010; 43 :174-8
Natural Hair Transplant Medical Center, Inc Dove Street, Suite #250, Newport Beach, CA Phone
Natural Hair Transplant Medical Center, Inc. 1000 Dove Street, Suite #250, Newport Beach, CA 92660 Phone-949-622-6969 Finasteride (PROPECIA ) Acknowledgement Finasteride is an oral medication, manufactured
Clinical impact of type I and type II 5 alpha-reductase inhibition in prostatic disease: review and update 아주대학교김선일
Clinical impact of type I and type II 5 alpha-reductase inhibition in prostatic disease: review and update 아주대학교김선일 Development of 5ARI Discovery of 5AR type I and type II Pharmacodynamic and pharmacokinetic
PACKAGE LEAFLET: INFORMATION FOR THE USER. FINASTERIDE 1 MG FILM-COATED TABLETS (finasteride)
PACKAGE LEAFLET: INFORMATION FOR THE USER FINASTERIDE 1 MG FILM-COATED TABLETS (finasteride) Read all of this leaflet carefully before you start taking this medicine because it contains important information
FINASTERIDE (PROPECIA, PROSCAR) SIDE EFFECT & CONSENT FORM
750 West Broadway Street Suite 905 Vancouver, BC M5Z 1K1 FAX: (604) 648-9003 vancouveroffice@donovanmedical.com FINASTERIDE (PROPECIA, PROSCAR) SIDE EFFECT & CONSENT FORM What is finasteride? Finasteride
Elements for a public summary
VI.2 VI.2.1 Elements for a public summary Overview of disease epidemiology Prostate gland enlargement is a common condition as men get older. Also called benign prostatic hyperplasia (BPH) and prostatic
Male pattern baldness is the most common type of balding among males. It affects roughly, 50% of men by the age of 50,
Dihydrotestosterone (DHT) Male pattern baldness is the most common type of balding among males. It affects roughly, 30% of men by the age of 30, 50% of men by the age of 50, 57% of men by the age of 60.
FINCAR Tablets (Finasteride)
Published on: 10 Jul 2014 FINCAR Tablets (Finasteride) Composition FINCAR Tablets Each film-coated tablet contains: Finasteride USP - 5 mg Dosage Form Tablet Pharmacology Pharmacodynamics Mechanism of
Reproductive DHT Analyte Information
Reproductive DHT Analyte Information - 1 - DHT Introduction Dihydrotestosterone (DHT) together with other important steroid hormones such as testosterone, androstenedione (ASD) and dehydroepiandrosterone
1001 West Broadway, Vancouver, BC V6H 4B1. Topical Finasteride
1001 West Broadway, Vancouver, BC V6H 4B1 Topical Finasteride 1 Topical finasteride is a solution containing the drug finasteride typically sold under the brand names Propecia and Proscar. The Finasteride
Comparison of Clinical Efficacy of Finasteride and Dutasteride as 5-alpha Reductase Inhibitor
대한남성과학회지 : 제 30 권제 1 호 2012 년 4 월 Korean J Androl. Vol. 30, No. 1, April 2012 http://dx.doi.org/10.5534/kja.2012.30.1.45 Comparison of Clinical Efficacy of Finasteride and Dutasteride as 5-alpha Reductase
Elements for a Public Summary. Overview of disease epidemiology
VI.2 VI.2.1 Elements for a Public Summary Overview of disease epidemiology Benign prostatic hyperplasia (BPH) (an increase in size of the prostate that is not cancerous) is the most prevalent of all diseases
Issues. What is a low testosterone? Who needs testosterone therapy? Benefits/adverse effects of testosterone replacement Treatment options
Male Hypogonadism Jauch Symposium Waterloo, IA May 17, 2013 Janet A. Schlechte, M.D. Disclosure of Financial Relationships Janet A. Schlechte, M.D. has no relationships with any proprietary entity producing
Secrets of Abang Sado : Effects of testosterone therapy. Azraai Nasruddin
+ Secrets of Abang Sado : Effects of testosterone therapy Azraai Nasruddin + Testosterone Testosterone : Steroid hormone - Made primarily by the testicles in males - Small amounts produced by the adrenal
Current status of 5α-reductase inhibitors in the management of lower urinary tract symptoms and BPH
World J Urol (2010) 28:9 15 DOI 10.1007/s00345-009-0493-y TOPIC PAPER Current status of 5α-reductase inhibitors in the management of lower urinary tract symptoms and BPH Stavros Gravas Matthias Oelke Received:
Androgenes and Antiandrogenes
Androgenes and Antiandrogenes Androgens The androgens are a group of steroids that have anabolic and/or masculinizing effects in both males and females. Testosterone [tess-toss-terone], the most important
PHYSICIANS CIRCULAR FINASTERIDE PROSCAR. Tablet 5-Alpha Reductase Inhibitor
PHYSICIANS CIRCULAR FINASTERIDE PROSCAR Tablet 5-Alpha Reductase Inhibitor FINASTERIDE (PROSCAR) a synthetic 4-azasteroid compound, is a specific inhibitor of Type II 5α-reductase, an intracellular enzyme
This is an English translation of the original Chinese instruction leaflet generated by Google Translate. No amendments were made.
Approved Date: December 26, 2006 Revision Date: September 12, 2012 Modify Date: December 1, 2013 Finasteride tablets instructions Please read the instructions carefully and use under the guidance of a
M0BCore Safety Profile. Pharmaceutical form(s)/strength: 5 mg SE/H/PSUR/0002/006 Date of FAR:
M0BCore Safety Profile Active substance: Finasteride Pharmaceutical form(s)/strength: 5 mg P-RMS: SE/H/PSUR/0002/006 Date of FAR: 16.05.2014 4.3 Contraindications Finasteride is not indicated for use in
The Science of. NUTRICULA Longevity Journal
32 December, 2011 The Science of 33 NUTRICULA Longevity Journal As men age, there is often a decline in libido and sexual function. This decline frequently interferes in intimacy within romantic relationships,
Skin metabolism of steroid hormones as endogenous compounds?
Skin metabolism of steroid hormones as endogenous compounds? Van Luu-The Department of Molecular Medicine Laval University Québec, Canada This work has been supported by L Oréal Research Steroid hormones
Prostate enlargement, also known as benign prostatic hyperplasia
REPORTS Differences in Alpha Blocker Usage Among Enlarged Prostate Patients Receiving Combination Therapy with 5ARIs Michael Naslund, MD, MBA; Libby Black, PharmD; Michael Eaddy, PharmD, PhD; LaKeasha
Update on the use of dutasteride in the management of benign prostatic hypertrophy
REVIEW Update on the use of dutasteride in the management of benign prostatic hypertrophy Joe Miller Thomas Tarter Division of Urology, Southern Illinois University School of Medicine, Springfield, IL,
Effect of dutasteride 0.5 mg/d in men with androgenetic alopecia recalcitrant to finasteride
Report Effect of dutasteride 0.5 mg/d in men with androgenetic alopecia recalcitrant to finasteride Jae Yoon Jung 1, MD, Je Ho Yeon 1, MD, Jee Woong Choi 1, MD, Soon Hyo Kwon 1, MD, Beom Joon Kim 2, MD,
2. QUALITATIVE AND QUANTITATIVE COMPOSITION
AVODART SOFT CAPSULES 0.5 MG 1. NAME OF THE MEDICINAL PRODUCT AVODART 0.5 mg capsules, soft. 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each capsule contains 0.5 mg dutasteride. For excipients, see 6.1.
DUPROST Capsules (Dutasteride)
Published on: 10 Jul 2014 DUPROST Capsules (Dutasteride) Composition Each soft gelatin capsule contains: Dutasteride... 0.5 mg Dosage Form Capsule Pharmacology Pharmacodynamics Mechanism of Action Dutasteride
EUROPEAN UROLOGY 57 (2010)
EUROPEAN UROLOGY 57 (2010) 123 131 available at www.sciencedirect.com journal homepage: www.europeanurology.com Benign Prostatic Hyperplasia The Effects of Combination Therapy with Dutasteride and Tamsulosin
MALE PATTERN BALDNESS
MALE PATTERN BALDNESS Male-pattern hair loss (MPHL), also known as androgenic alopecia and male pattern baldness, is hair loss that occurs due to an underlying susceptibility of hair follicles to shrinkage
Clinical Significance of 5 -Reductase Activity
Clinical Significance of 5 -Reductase Activity By Jonathan Wright, MD and Barry Wheeler, ND 5 -Reductase (5AR) is the enzyme that catalyzes the conversion of (among others): Testosterone 5 -DHT Androstenedione
Sue Marty, Ph.D., D.A.B.T. The Dow Chemical Company TERA Endocrine Workshop April 23, 2013
Sue Marty, Ph.D., D.A.B.T. The Dow Chemical Company TERA Endocrine Workshop April 23, 2013 Agenda Value of WoE/MoA determinations in EDSP Information used to examine potential endocrine activity and/or
Maximum Hair Minimum Loss
Hi and welcome to your free hair loss information report. Written by Spex, a fellow hair- loss sufferer, UK Veteran of 10 years. I m Spex and within the next few emails you will gain access and insight
Safety and Tolerability of the Dual 5a-Reductase Inhibitor Dutasteride in thetreatment of Benign Prostatic Hyperplasia
European Urology European Urology 44 (2003) 82 88 Safety and Tolerability of the Dual 5a-Reductase Inhibitor in thetreatment of Benign Prostatic Hyperplasia Gerald L. Andriole a,*,1, Roger Kirby b a Division
2. QUALITATIVE AND QUANTITATIVE COMPOSITION
AVODART SOFT CAPSULES 0.5 MG 1. NAME OF THE MEDICINAL PRODUCT Avodart 0.5 mg capsules, soft. 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each capsule contains 0.5 mg dutasteride. For excipients, see 6.1.
EFFECTS OF REVIVOGEN SCALP THERAPY ON TESTOSTERONE METABOLISM IN RECONSTRUCTED HUMAN EPIDERMIS
IN VITRO BIOLOGICAL TESTING BIOalternatives The state-of-the-art laboratory Proposal n : AD070315C-2 Study n : AD070315B EFFECTS OF REVIVOGEN SCALP THERAPY ON TESTOSTERONE METABOLISM IN RECONSTRUCTED HUMAN
Oncologia Molecular, Porto, Portugal; 3 WSS im. L. Rydygiera, Krakow, Poland;
The effects of combination therapy with dutasteride plus tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4- year post hoc analysis of European men in the CombAT study
SUMMARY OF PRODUCT CHARACTERISTICS
1. NAME OF THE MEDICINAL PRODUCT Avodart 0.5 mg soft capsules. SUMMARY OF PRODUCT CHARACTERISTICS 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each capsule contains 0.5 mg dutasteride. Excipient with known
Efficacy and Safety of Long-TermTreatment with the Dual 5a-Reductase Inhibitor Dutasteride in Men with Symptomatic Benign Prostatic Hyperplasia
European Urology European Urology 46 (2004) 488 495 Efficacy and Safety of Long-TermTreatment with the Dual 5a-Reductase Inhibitor Dutasteride in Men with Symptomatic Benign Prostatic Hyperplasia Frans
TESTOFEN. Anabolic & Androgenic Activity GENCOR PACIFIC, INC. Fenugreek Extract standardized for FENUSIDE TM. Copyright 2005 by Gencor Pacific, Inc.
GENCOR PACIFIC, INC. 920E. Orangethorpe Avenue, Suite B, Anaheim, CA. 92801 Ph: 714.870.8723 714.870.8724 efax: 732.875.0306 drjit@gencorpacific.com manu@gencorpacific.com www.gencorpacific.com TESTOFEN
Natural estrogens estradiol estrone estriol
Estrogens Natural estrogens estradiol estrone estriol Nonsteroidal synthetic Diethylstilbestrol Chlorotrianisene Methallenestril Steroidal synthetic Ethinyl estradiol Mestranol Quinestrol To decrease some
Summary. Introduction. Dow Stough, MD
Original Contribution Blackwell Publishing ORIGINAL Inc CONTRIBUTION Dutasteride improves male pattern hair loss in a randomized study in identical twins Dow Stough, MD The Dermatology Clinic, Hot Springs,
The ICL Insider. Lab Testing: Testosterone. In This Issue. The Debate
The ICL Insider February 2017 Volume 2, Issue 2 Lab Testing: Testosterone In This Issue Testosterone shashtilak@iclabs.ca Next Issue: Expected Release April 2017 The Debate Aging is accompanied by various
NEW ZEALAND DATA SHEET. 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each film coated tablet contains 1 mg of finasteride.
1. PRODUCT NAME Profal, film coated tablets, 1 mg NEW ZEALAND DATA SHEET 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each film coated tablet contains 1 mg of finasteride. Excipient of known effect: Lactose
PROPECIA finasteride 1 mg tablet
Name of Medicine PROPECIA finasteride 1 mg tablet Presentation A tan octagonal convex tablet embossed with a P logo on one side and PROPECIA on the other. Diameter: 7.14 mm. Therapeutic Class PROPECIA
DOSAGE FORMS AND STRENGTHS
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use finasteride tablets USP safely and effectively. See full prescribing information for finasteride
FULL PRESCRIBING INFORMATION
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use AVODART safely and effectively. See full prescribing information for AVODART. AVODART (dutasteride)
PROPECIA Tablets Merck Sharp & Dhome
PROPECIA Tablets Merck Sharp & Dhome 1. NAME OF THE MEDICINAL PRODUCT PROPECIA 1 mg Film-Coated Tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet of Propecia contains 1 mg of finasteride
Insight into male menopause'
Insight into male menopause' Dr Mark Vanderpump MD FRCP Consultant Endocrinologist Clinics: Tuesday PM Mark Vanderpump Consultant Physician and Endocrinologist Introduction Serum total and free testosterone
Buy The Complete Version of This Book at Booklocker.com:
Maintain youthful libido, sexual function, cardiovascular, bone, muscle, overall health. The Gentleman's Guide to the Fountain of Youth Buy The Complete Version of This Book at Booklocker.com: http://www.booklocker.com/p/books/2056.html?s=pdf
SUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE MEDICINAL PRODUCT Deratos 0.5 mg capsules, soft 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each capsule contains 0.5 mg dutasteride. For the full list
It is estimated that 24% to 90% of US men older than the age of
REPORTS Finasteride Versus Dutasteride: A Real-world Economic Evaluation Thomas C. Fenter, MD; M. Chris Runken, PharmD; Libby Black, PharmD; Michael Eaddy, PharmD, PhD It is estimated that 24% to 90% of
SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT 2 QUALITATIVE AND QUANTITATIVE COMPOSITION
SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT Dutasteride 0.5 mg Capsules, Soft 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each capsule contains 0.5 mg dutasteride. For the full list
Associate Professor Geoff Braatvedt
Associate Professor Geoff Braatvedt Endocrinologist Diabetologist and Physician Green Lane and Auckland City Hospitals Auckland 14:00-14:55 WS #145: Approach to Low Testosterone Values 15:05-16:00 WS #157:
PRODUCT INFORMATION. PROPECIA (finasteride) Tablets NAME OF THE MEDICINE
PRODUCT INFORMATION PROPECIA (finasteride) Tablets NAME OF THE MEDICINE Finasteride is described chemically as: N-(1,1-dimethylethyl)-3-oxo-4-aza-5 -androst-1-ene-17 carboxamide. The CAS No is 98319-26-7.
UnitedHealthcare Pharmacy Clinical Pharmacy Programs
UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number 2017 P 2018-9 Program Prior Authorization/Medical Necessity Topical Androgens Medication Axiron*, Androderm, Androgel*, Fortesta*, Natesto*,
SUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1 1. NAME OF THE MEDICINAL PRODUCT Finasterid Actavis 5 mg film-coated tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each film-coated tablet contains 5 mg finasteride.
AUSTRALIAN PRODUCT INFORMATION PROPECIA (finasteride) Tablets QUALITATIVE AND QUANTITATIVE COMPOSITION
AUSTRALIAN PRODUCT INFORMATION PROPECIA (finasteride) Tablets NAME OF THE MEDICINE Finasteride QUALITATIVE AND QUANTITATIVE COMPOSITION Each film-coated tablet of PROPECIA contains 1 mg of finasteride.
Finasteride 1mg film-coated tablets (Pharmacare )
Name of Medicine finasteride 1 mg tablet Presentation Brown colour, round, film-coated tablet, debossed with H on one side and 36 on the other side. Therapeutic Class Finasteride is a synthetic 4-azasteroid
Product Monograph. Sandoz Dutasteride
Product Monograph Pr Sandoz Dutasteride Dutasteride Capsules of 0.5 mg Type I and II 5 Alpha-reductase Inhibitor Sandoz Canada Inc. 145 Jules-Léger Boucherville, QC, Canada J4B 7K8 Date of Preparation:
Jeremiah Murphy, MD Mercy Urology Clinic. October 21, 2017
Jeremiah Murphy, MD Mercy Urology Clinic October 21, 2017 Describe an appropriate strategy for the evaluation and diagnosis of male hypogonadism Endocrine Society Clinical Practice Guideline-2010 Review
Donald W. Morrish, MD, PhD, FRCPC Presented at Mountain Man: Men's Health Conference, May Terry s Testosterone
Focus on CME at University of Alberta ADAM: Dealing with the Decline Donald W. Morrish, MD, PhD, FRCPC Presented at Mountain Man: Men's Health Conference, May 2005 We now know there is a decline in total
DUTASTERIDE capsules, for oral use Initial U.S. Approval: 2001
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use Dutasteride capsules safely and effectively. See full prescribing information for Dutasteride capsules.
New Zealand Data Sheet
New Zealand Data Sheet 1. PRODUCT NAME TEROD 500 micrograms soft gelatin capsules. 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each capsule contains 500 micrograms of dutasteride. For the full list of
PROPECIA (Finasteride) Tablets, 1 mg
9328502 PROPECIA (Finasteride) Tablets, 1 mg DESCRIPTION PROPECIA * (finasteride), a synthetic 4-azasteroid compound, is a specific inhibitor of steroid Type II 5α-reductase, an intracellular enzyme that
Testosterone Use and Effects
Parkland College Natural Sciences Poster Sessions Student Works 2013 Testosterone Use and Effects Brandon Mills Parkland College Recommended Citation Mills, Brandon, "Testosterone Use and Effects" (2013).
SUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE MEDICINAL PRODUCT Finpros 5 mg film-coated tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each film-coated tablet contains 5 mg finasteride. Excipient
PRODUCT INFORMATION. PROPECIA (finasteride) Tablets NAME OF THE MEDICINE
WPC-MK0906-PPC-1T-022012 1 PRODUCT INFORMATION PROPECIA (finasteride) Tablets NAME OF THE MEDICINE Finasteride is described chemically as: N-(1,1-dimethylethyl)-3-oxo-4-aza-5α-androst-1-ene-17βcarboxamide.
Dutasteride Avodart Softgel Capsule
Dutasteride Avodart Softgel Capsule PRODUCT DESCRIPTION Dutasteride (Avodart ) is available as dull yellow, opaque, oblong soft gelatin capsules containing a clear, colourless to slightly yellow liquid.
The capsules are opaque, yellow, oblong soft gelatin capsules filled with an oily and yellowish liquid, without printing.
1. NAAM VAN HET GENEESMIDDEL Dutasteride 0,5 mg Teva, zachte capsules 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each capsule contains 0.5 mg of dutasteride. Excipient with known effect: lecithin (may
The effect of dutasteride on intraprostatic dihydrotestosterone concentrations in men with benign prostatic hyperplasia
ORIGINAL ARTICLE (27) 1, 149 154 & 27 Nature Publishing Group All rights reserved 1365-7852/7 $3. www.nature.com/pcan The effect of dutasteride on intraprostatic dihydrotestosterone concentrations in men
PRODUCT INFORMATION TESTOVIRON DEPOT. (testosterone enanthate)
PRODUCT INFORMATION TESTOVIRON DEPOT (testosterone enanthate) NAME OF THE MEDICINE Testosterone enanthate is designated chemically as 17 beta-heptanoyloxy-4-androstene-3- one. The empirical formula of
Benign prostatic hyperplasia (BPH), which leads to an
REPORTS 5-Alpha Reductase Inhibitors in Men With an Enlarged Prostate: An Evaluation of Outcomes and Therapeutic Alternatives Michael Naslund, MD, MBA; Timothy S. Regan, BPharm, RPh, CPh; Christine Ong,
TESTOFEN HUMAN CLINICAL TRIAL GENCOR PACIFIC, INC. Copyright 2006 by Gencor Pacific, Inc.
GENCOR PACIFIC, INC. 920 E. Orangethorpe Avenue, Suite B, Anaheim, CA 92801 Ph: 714.870.8723 714.870.8724 efax: 732.875.0306 drjit@gencorpacific.com gita@gencorpacific.com www.gencorpacific.com TESTOFEN
SILOFAST D Capsules (Silodosin + Dutasteride)
Published on: 26 Sep 2016 SILOFAST D Capsules ( + ) Composition SILOFAST D 4 Capsules Each combipack contains: 10 hard gelatin capsules of and 10 soft gelatin capsules of (A) hard gelatin capsules Each
CONFÉRENCE À SUCCÈS EN SCIENCES DE LA VIE : ENDOCEUTICS
CONFÉRENCE À SUCCÈS EN SCIENCES DE LA VIE : ENDOCEUTICS 13 Septembre 2018 Quebec, Canada 1 ENDOCEUTICS No. 1 Innovative pharmaceutical company in menopausal women s health in the world 2 Facilities Head
ANNEX 3 TO THE DRAFT REPORT OF THE OECD VALIDATION OF THE RAT HERSHBERGER BIOASSAY: PHASE 2
ANNEX 3 TO THE DRAFT REPORT OF THE OECD VALIDATION OF THE RAT HERSHBERGER BIOASSAY: PHASE 2 Hershberger Assay Interlaboratory Study: Statistical analysis of phase 2 data from 16 laboratories in the multi-chemical
BEST FINASTERIDE IN INDIA
Best Finasteride In India page 1/5 BEST FINASTERIDE IN INDIA Topical for sale, tab leg 5mg nutrition, 88 tablet 5mg, tablets 5mg 48, cancer prostate and grade high. 5mg enlargement surgery recovery breast,
Package leaflet: Information for the user Finasteride 5 mg Film-coated Tablets Finasteride
Package leaflet: Information for the user Finasteride Read all of this leaflet carefully before you start taking this medicine because it contains important information for you. Keep this leaflet. You
Dr Tarza Jamal Pharmacology Lecture 2
Contraceptives and androgen hormone Contraceptives: Currently, interference with ovulation is the most common pharmacologic intervention for preventing pregnancy. Major classes of contraceptives 1. Combination
STUDY OF THE EFFECT OF AN EXTRACT OF Serenoa repens on the production of the 5-α reductasa enzyme
STUDY OF THE EFFECT OF AN EXTRACT OF Serenoa repens on the production of the 5-α reductasa enzyme 1) ROLE OF 5-α-ALFA-REDUCTASA 5-α reductasas (5-α-R) are a family of enzymes involved in steroid metabolism.
PROPECIA (finasteride) Tablets, 1 mg
9328505 PROPECIA (finasteride) Tablets, 1 mg DESCRIPTION PROPECIA * (finasteride), a synthetic 4-azasteroid compound, is a specific inhibitor of steroid Type II 5α-reductase, an intracellular enzyme that
PRODUCT INFORMATION CF 3
PRODUCT INFORMATION AVODART SOFT CAPSULES NAME OF MEDICINE Dutasteride The chemical structure is: CH 3 O H N CF 3 CH 3 H O N H H H H CF 3 CAS Registry Number 164656-23-9. DESCRIPTION The chemical name
HIGHLIGHTS OF PRESCRIBING INFORMATION
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use finasteride tablets safely and effectively. See full prescribing information for finasteride tablets.
european urology 55 (2009)
european urology 55 (2009) 461 471 available at www.sciencedirect.com journal homepage: www.europeanurology.com Benign Prostatic Hyperplasia The Influence of Baseline Parameters on Changes in International
Package Leaflet: Information for the patient. Sustanon 250, 250 mg/ml, solution for injection (testosterone esters)
Package Leaflet: Information for the patient Sustanon 250, 250 mg/ml, solution for injection (testosterone esters) Read all of this leaflet carefully before you start using this medicine because it contains
ARE FINASTERIDE SIDE EFFECTS PERMANENT
ARE FINASTERIDE SIDE EFFECTS PERMANENT Are Finasteride Side Effects Permanent Finasteride side effects in pregnant women Finasteride and dutasteride at the same time Does finasteride cause dizziness 1
PRODUCT INFORMATION. Apo-Finasteride 1 (Finasteride Film-coated Tablets 1 mg)
NAME OF THE MEDICINE PRODUCT INFORMATION Apo-Finasteride 1 (Finasteride Film-coated Tablets 1 mg) Finasteride is described chemically as: N-(1,1-dimethylethyl)-3-oxo-4-aza-5 -androst-1-ene- 17 carboxamide.
Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients
Dermatologic Therapy, Vol. 28, 2015, 303 308 Printed in the United States All rights reserved VC 2015 Wiley Periodicals, Inc. DERMATOLOGIC THERAPY ISSN 1396-0296 ORIGINAL PAPERS Combined treatment with
Adverse effects of anabolic androgenic steroids abuse on gonadal function, glucose homeostasis and cardiovascular function
Adverse effects of anabolic androgenic steroids abuse on gonadal function, glucose homeostasis and cardiovascular function Associate Professor Caroline Kistorp, Ph.D Department of Internal Medicine, Herlev
URIMAX D Tablets (Tamsulosin hydrochloride + Dutasteride)
Published on: 22 Sep 2014 URIMAX D Tablets (Tamsulosin hydrochloride + ) Composition Each film-coated tablet contains: Tamsulosin Hydrochloride... 0.4 mg (as modified-release tablets)... 0.5 mg Dosage
Efficacy and tolerability of the dual 5a-reductase inhibitor, dutasteride, in the treatment of benign prostatic hyperplasia in African-American men
(2006) 9, 432 438 & 2006 Nature Publishing Group All rights reserved 1365-7852/06 $30.00 ORIGINAL ARTICLE www.nature.com/pcan Efficacy and tolerability of the dual 5a-reductase inhibitor, dutasteride,
AVODART (dutasteride) Soft Gelatin Capsules
PRESCRIBING INFORMATION AVODART (dutasteride) Soft Gelatin Capsules DESCRIPTION AVODART (dutasteride) is a synthetic 4-azasteroid compound that is a selective inhibitor of both the type 1 and type 2 isoforms
Priyam Bhaskar Rai, Pragya Khushwaha*, Nitish Jain, Swati Gupta
International Journal of Research in Dermatology Rai PB et al. Int J Res Dermatol. 2018 Aug;4(3):386-390 http://www.ijord.com Original Research Article DOI: http://dx.doi.org/10.18203/issn.2455-4529.intjresdermatol20183163
PRODUCT INFORMATION CF 3
PRODUCT INFORMATION AVODART SOFT CAPSULES NAME OF MEDICINE Dutasteride The chemical structure is: CH 3 O H N CF 3 CH 3 H O N H H H H CF 3 CAS Registry Number 164656-23-9. DESCRIPTION The chemical name
Proviron. Proviron Functions & Traits: (Mesterolone)
Proviron (Mesterolone) Proviron represents one of the oldest anabolic androgenic steroids on the market. A product of the giant pharmaceutical company Schering, it would first appear in 1934. Officially
population Completed double-blind 458 (67.7) 445 (65.0) study n (%)
Study No: ARIA3002 Year 4 Title: A Randomized, Double-Blind, Placebo-Controlled, Two Year Parallel Group Study of the Efficacy and Safety of GI198745 0.5mg in the Treatment and Prevention of Progression
Female testosterone level chart
Female testosterone level chart The Borg System is 100 % Female testosterone level chart Mar 23, 2015. Male, Female. Age: T Level (ng/dl):, Age: T Level (ng/dl):. 0-5 mo. 75-400, 0-5 mo. 20-80. 6 mos.-9
MI Androgen Deficiency Hypogonadism
MI Androgen Deficiency Hypogonadism WADA TUE Expert Group John A Lombardo, MD October 2014, Columbus, Ohio USA Hypothalamic-Pituitary-Gonadal Axis / 2 Hypogonadism/Androgen Deficiency Clinical syndrome:
Formally known as anabolic steroids or anabolic-androgenic steroids, but they are sometimes called 'roids', 'gear' or 'juice'.
Steroids What are steroids? Steroids are drugs that help the growth and repair of muscle tissue. They are synthetic hormones that imitate male sex hormones, specifically testosterone. Steroids can increase
HGH for Sale Natural Anti-Aging Human Growth Hormone
HGH for Sale Natural Anti-Aging Human Growth Hormone Human growth hormone is one of the hottest supplement trends on the market, and now you can purchase top-quality HGH to be delivered right to your home!
Gynaecomastia. Benign breast conditions information provided by Breast Cancer Care
Gynaecomastia This booklet tells you about gynaecomastia. It explains what gynaecomastia is, what causes it, how it s diagnosed and what will happen if it needs to be treated or followed up. Benign breast
PRODUCT INFORMATION PROVIRON
PRODUCT INFORMATION PROVIRON NAME OF TE MEDICINE Mesterolone is a white to yellowish crystalline powder and is practically insoluble in water. The chemical name for mesterolone is 17 beta-ydroxy-1 alpha-methyl-5