Финастерид – 4-азастероидное соединение, селективно и конкур... Инструкция
Показания к применению
Лечение доброкачественной гиперплазии предстательной железы с целью: уменьшения размеров предстательной железы; увеличения максимальной скорости оттока мочи и уменьшения симптомов, связанных с гиперплазией; снижение риска возникновения острой задержки мочи и связанной с этим вероятности хирургического вмешательства.
Противопоказания
Повышенная чувствительность к финастериду и другим компонентам Финаста; обструкция мочевыводящих путей; детский возраст.
Финастерид – 4-азастероидное соединение, селективно и конкурентно ингибирующее 5-редуктазу. Этот никотинамидадениндинуклеотид фосфат (НАДФ)-зависимый фермент превращает тестостерон в дигидротестостерон. Препарат специфически ингибирует изоэнзим 5-редуктазы 2 типа, что приводит к значительному снижению уровня дигидротестостерона в предстательной железе (>90%) и в системе кровообращения (от 60% до 80%).; Финастерид повышает уровень тестостерона предстательной железы (приблизительно на 85%) у пациентов с ДГПЖ, это не влияет на рост и морфологию предстательной железы. Препарат не имеет выраженного сродства к рецепторам андрогена. Финастерид значительно снижает уровень ПСА плазмы на 41 %- 71% у пациентов с симптомами ДГПЖ. Тем не менее, на соотношение значений несвязанного и общего уровня ПСА препарат не влияет.; Размер предстательной железы уменьшается под воздействием финастерида вследствие атрофии и апоптоза. Обусловленные действием препарата гистологические изменения наблюдались спустя 6 месяцев от начала лечения. Железистые элементы тканей предстательной железы наиболее чувствительны к финастериду. Препарат снижает тонус детрузора у пациентов с задержкой мочи, вызванной ДГПЖ.
Показания к применению
Лечение доброкачественной гиперплазии предстательной железы с целью: уменьшения размеров предстательной железы; увеличения максимальной скорости оттока мочи и уменьшения симптомов, связанных с гиперплазией; снижение риска возникновения острой задержки мочи и связанной с этим вероятности хирургического вмешательства.
Противопоказания
Повышенная чувствительность к финастериду и другим компонентам Финаста; обструкция мочевыводящих путей; детский возраст.
Применение при беременности и в период грудного вскармливания
Финастерид не показан беременным и кормящим женщинам.
Способ применения и дозы
Финаст принимают внутрь, независимо от приема пищи — по 5 мг 1 раз в сутки. Продолжительность терапии до оценки ее эффективности должна быть не менее 6 мес. Приблизительно у 50% больных исчезновение клинических симптомов происходит при лечении в течение 12 мес.
Побочное действие
Аллергические реакции, гинекомастия, импотенция, снижение либидо, уменьшение объема эякулята (частота побочных эффектов не превышает 3-4% и уменьшается в процессе лечения). В ряде случаев отмечалось повышение уровня ЛТГ, ФСГ и тестостерона приблизительно на 10% (однако эти показатели оставались в пределах нормы).
Передозировка
Сведений о случаях передозировки на сегодняшний день нет.
Особые указания
Использование у пациентов с нарушением функции печени; Действие на пациентов с нарушенной функцией печени не изучено. Использовать с осторожностью у пациентов с аномалиями функции печени, т.к. финастерид метаболизируется преимущественно печенью.; Использование у пациентов с нарушением функции почек; Нет необходимости индивидуального подбора дозы пациентам с нарушением функции почек; Влияние на управление автомобилем и другой техникой не изучено.; Прежде чем начать лечение финастеридом необходимо провести соответствующее обследование, чтобы исключить другие заболевания, сходные по клинике с ДГПЖ, например инфекции, рак предстательной железы, стриктуры, гипертонический мочевой пузырь или некоторые нейрогенные нарушения. Пациенты с большим остаточным объемом мочи и/или снижением тока мочи должны находиться под постоянным наблюдением на предмет возможной обструктивной уропатии, когда не показано назначение финастерида.; Женщины детородного возраста и беременные должны избегать контакта с измельченными или поврежденными таблетками финастерида из-за возможности накопления финастеида в организме с последующим возможным риском поражения плода.; Лабораторные анализы; Известно, что финастерид снижает уровень ПСА (простата-специфического антигена) плазмы приблизительно у 50% пациентов с ДГПЖ даже при наличии рака предстательной железы. Быстрое снижение ПСА наблюдается у большинства пациентов в течение первого месяца лечения, после чего стабилизируется на новом уровне, составляющем приблизительно половину уровня, зафиксированного до начала лечения. Поэтому при сравнении этих пациентов со здоровыми нужно удваивать показатель ПСА. Эта корректировка позволяет учесть чувствительность и специфичность анализа ПСА и диагностировать рак предстательной железы.
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