Лечение доброкачественной гиперплазии предстательной железы с целью: - предупреждения урологических осложнений (снижение риска острой задержки мочи) и снижения необходимости проведения хирургических операций (в т.ч. трансуретральной резекции предстательной железы и простатэктомии); - уменьшения размеров увеличенной предстательной железы, улучшения тока ...
Ингибирует 5-альфа-редуктазу, снижает биосинтез дигидротестостерона. При постоянном приеме статистически значимый эффект регистрируется через 3 мес. (уменьшение объема предстательной железы), 4 мес. (увеличение максимальной скорости тока мочи) и 7 мес. (уменьшение общих симптомов и симптомов непроходимости мочевыводящих путей).
Показания к применению
Лечение доброкачественной гиперплазии предстательной железы с целью: - предупреждения урологических осложнений (снижение риска острой задержки мочи) и снижения необходимости проведения хирургических операций (в т.ч. трансуретральной резекции предстательной железы и простатэктомии); - уменьшения размеров увеличенной предстательной железы, улучшения тока мочи и уменьшения выраженности симптомов, связанных с доброкачественной гиперплазией предстательной железы. Терапия Проскаром показана пациентам с увеличенной предстательной железой
Противопоказания
Гиперчувствительность, детский возраст
Применение при беременности и в период грудного вскармливания
Беременные женщины должны избегать контакта с измельченными или потерявшими целостность таблетками Проскара. Женщинам, которые могут забеременеть, беременным и кормящим матерям не следует иметь половой контакт (без кондома) с партнером, принимающим Проскар (возможно нарушение развития наружных половых органов у плода мужского пола)
Способ применения и дозы
Внутрь, по 5 мг/сут в течение 6-7 мес. и более
Побочное действие
Нарушение половых функций (импотенция, снижение либидо, уменьшение объема эякулята
Передозировка
Симптомы: при приеме большей дозы, чем назначено, срочно обратитесь к врачу. Лечение: симптоматическое
Особые указания
Влияние на уровень простат-специфического антигена и диагностику рака предстательной железы До настоящего времени не показано положительного клинического эффекта Проскара у больных раком предстательной железы. У пациентов с ДГПЖ и повышенным уровнем ПСА в контролируемых клинических испытаниях (с несколькими определениями ПСА и проведением биопсии предстательной железы) терапия Проскаром не влияла на частоту выявления рака предстательной железы. Общая частота возникновения рака предстательной железы существенно не различалась в группах пациентов, получавших Проскар или плацебо. Перед началом лечения Проскаром и периодически в процессе лечения следует проводить ректальное исследование, а также исследование другими методами на предмет наличия рака предстательной железы. Определение сывороточного ПСА также используется для выявления рака предстательной железы. В целом, при исходном уровне ПСА выше 10 нг/мл требуется проведение более широкого обследования пациента, включая, при необходимости, назначение биопсии. При уровне ПСА в пределах 4-10 нг/мл рекомендуется дальнейшее обследование пациента. Наблюдается значительное совпадение уровней ПСА у больных раком предстательной железы и пациентов, не имеющих этого заболевания. Следовательно, у мужчин с ДГПЖ нормальные значения ПСА не позволяют исключить рак предстательной железы, независимо от лечения Проскаром. Исходный уровень ПСА ниже 4 нг/мл не исключает возможности наличия рака предстательной железы. Проскар вызывает уменьшение сывороточного ПСА приблизительно на 50% у пациентов с ДГПЖ даже при наличии рака предстательной железы. В связи с этим следует иметь в виду, что снижение уровня ПСА у пациентов с ДГПЖ, получающих лечение Проскаром, не исключает сопутствующего рака предстательной железы. Показано, что у пациентов, получающих Проскар в течение 6 мес. и более, значения ПСА должны быть удвоены для их сопоставления с нормальными значениями данного показателя у пациентов, не получающих лечения. Эта корректировка сохраняет чувствительность и специфичность анализа ПСА и возможность выявления рака предстательной железы. Любое продолжительное увеличение уровня ПСА у пациентов, получающих лечение финастеридом, требует тщательного обследования для выяснения причины, которая может заключаться в несоблюдении режима применения Проскара. Проскар существенно не уменьшает процент свободного ПСА (соотношение свободного ПСА к общему). Данный показатель остается постоянным даже под влиянием Проскара. Если для диагностики рака предстательной железы используется процент свободного ПСА, корректировка значений данного показателя необязательна. Влияние на лабораторные показатели Концентрация ПСА в сыворотке крови коррелирует с возрастом пациента и объемом предстательной железы, а объем простаты, в свою очередь, зависит от возраста пациента. При определении уровня ПСА следует учитывать, что данный показатель снижается у пациентов, принимающих Проскар. У большинства пациентов быстрое снижение уровня ПСА наблюдается в первые месяцы терапии, после чего происходит его стабилизация на новом уровне, который обычно составляет половину значения, измеренного до начала терапии. В связи с этим, у пациентов, принимающих Проскар в течение 6 и более мес., следует удваивать значение уровня ПСА для сопоставления его с нормальными показателями у мужчин, не принимающих Проскар.
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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