Damn, it's like you guys don't have google and you all call yourselves knowledgeable...
Pharmacology[edit]
Pharmacodynamics[edit]
Finasteride is a
5α-reductase inhibitor.
[16][1] It is specifically a
selective inhibitor of the
type II and
III isoforms of the
enzyme.
[1][47][48] By inhibiting these two isozymes of 5α-reductase, finasteride reduces the formation of the potent androgen dihydrotestosterone (DHT) from its precursor testosterone in certain tissues in the body such as the prostate gland, skin, and hair follicles.[1][49] As such, finasteride is a type of antiandrogen, or more specifically, an androgen synthesis inhibitor.[50][51] However, some authors do not define finasteride as an "antiandrogen," a term which can refer more specifically to antagonists of the androgen receptor.[52]
Finasteride results in a decrease of circulating DHT levels by about 65 to 70% with an oral dosage of 5 mg/day and of DHT levels in the prostate gland by up to 80 to 90% with an oral dosage of 1 or 5 mg/day.
[47][53][54] In parallel, circulating levels of testosterone increase by approximately 10%, while local concentrations of testosterone in the prostate gland increase by about 7-fold and local testosterone levels in hair follicles increase by around 27 to 53%.
[55][56] An oral dosage of finasteride of only 0.2 mg/day has been found to achieve near-maximal suppression of DHT levels (68.6% for 0.2 mg/day relative to 72.2% for 5 mg/day).
[56][57] Finasteride does not completely suppress DHT production because it lacks significant inhibitory effects on the
5α-reductase type I isoenzyme, with more than 100-fold less inhibitory potency for type I as compared to type II (
IC50 = 313 nM and 11 nM, respectively).
[16][1] This is in contrast to inhibitors of all three isoenzymes of 5α-reductase like
dutasteride, which can reduce DHT levels in the entire body by more than 99%.
[47] In addition to inhibiting 5α-reductase, finasteride has also been found to competitively inhibit
5β-reductase (AKR1D1).
[58] However, its affinity for the enzyme is substantially less than for 5α-reductase (an order of magnitude less than for 5α-reductase
type I) and hence is unlikely to be of clinical significance.
[58]
As of 2012, the tissues in which the different isozymes of 5α-reductase are expressed are not fully clear.
[49] This is because different investigators have obtained varying results with different
reagents, methods, and tissues examined.
[49] However, the different isozymes of 5α-reductase appear to be widely expressed, with notable tissues including the prostate gland,
seminal vesicles,
testes,
epididymides, skin, hair follicles,
liver,
kidneys, and
brain, among others.
[49]
By inhibiting 5α-reductase and thus preventing DHT production, finasteride reduces androgen signaling in tissues like the prostate gland and the scalp. In the prostate, this reduces prostate volume, which improves BPH and reduces risk of prostate cancer. Finasteride reduces prostate volume by 20 to 30% in men with benign prostatic hyperplasia.
[59] Inhibition of 5α-reductase also reduces
epididymal weight, and decreases motility and normal morphology of spermatozoa in the epididymis.
[60]
Neurosteroids like
3α-androstanediol (derived from DHT) and
allopregnanolone (derived from
progesterone) activate the
GABAA receptor in the
brain; because finasteride prevents the formation of neurosteroids, it functions as a
neurosteroidogenesis inhibitor and may contribute to a reduction of GABAA activity. Reduction of GABAA receptor activation by these neurosteroids has been implicated in
depression,
anxiety, and
sexual dysfunction.
[61][62][63]
So by definition, by inhibiting these two isozymes of 5a-reductase, finasteride reduces the formation of the POTENT ANDROGEN DIHYDROTESTOSTERONE. So even if however some authors do not define finasteride as an "antiandrogen" is still is from it's definition. It's like saying what it does, reducing one of the most potent androgens, but it's not considered an antiandrogen because Ikarus does not think it is or does not like how it sounds because Ikarus does not consider the most potent hormone in the male body, an androgen. Damn you guys, use that brain...