A 55-year-old man with androgenic alopecia has had a satisfactory response on finasteride (Propecia) prescribed for him by another clinician six years ago. As his new clinician, I am being asked to authorize refills. How long can he safely use finasteride? Is any special monitoring required?
—Naheed Mahlik, MD, San Jose, Calif.

Patients can safely use finasteride on a long-term basis. No special monitoring is required. However, finasteride can cause a decrease in serum prostate-specific antigen (PSA) of up to 50% in normal men. Take this into account when interpreting PSA results to screen for prostate enlargement or prostate cancer.
—Jeffrey M. Weinberg, MD (116-12)

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