What is Proscar?

Proscar: uses Proscar is used to shrink an enlarged prostate ( benign prostatic hyperplasia or BPH ) in adult men. It may be used alone or taken in combination with other medications to reduce symptoms of BPH and may also reduce need for surgery.

Proscar may improve symptoms of BPH and provide benefits such as decreased urge to urinate, better urine flow with less straining, less of a feeling that bladder is not completely emptied, and decreased nighttime urination.

Proscar works by decreasing the amount of a natural body hormone ( DHT ) that causes growth of prostate.

Women and children should not use this medication.

Proscar: how to use Read Patient Information Leaflet provided by your pharmacist before we start taking Proscar and each time you get a refill. If you have any questions regarding information, consult your doctor or pharmacist.

Take Proscar by mouth, with or without food, usually once a day, or as directed by your doctor.

If tablet is crushed or broken, it should not be handled by a woman who is pregnant or by a woman who may become pregnant ( see also Precautions section ) .

Use Proscar regularly in order to get most benefit from it. Remember to use it at same time each day. Do not stop taking Proscar without consulting your doctor.

It may take 6-12 months to notice a benefit.

Inform your doctor if your condition persists or worsens.

Proscar: side effects Decreased sexual ability/desire may occur while use Proscar. In some men, Proscar can decrease the amount of semen released during sex. This is harmless. Proscar may also increase hair growth. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed Proscar because he or she has judged that benefit to you is greater than risk of side effects. Many people using Proscar don't have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur:

A very serious allergic reaction to Proscar is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include:

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Proscar: precautions Before taking Proscar, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.

Before using Proscar, tell your doctor or pharmacist your medical history, especially of:

Proscar shouldn't be used in children.

The drug can be absorbed through the skin. If film coating of tablet has been broken or tablet crushed, it should not be handled by a woman who is pregnant or planning to become pregnant. Exposing a developing male infant to Proscar can result in abnormalities of genitals.

Proscar isn't recommended for use in women and mustn't be used during pregnancy. If you become pregnant or think you may be pregnant, inform your doctor immediately.

Because Proscar isn't intended for use in women, it's not known if Proscar passes into breast milk. Consult your doctor before breast-feeding.

Proscar: interactions Your healthcare professionals ( e. g. , doctor or pharmacist ) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change dosage of any medicine before checking with them first.

Before using Proscar, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use.

Proscar can affect the results of blood test used to detect prostate cancer ( prostatic-specific antigen or PSA levels ) . Make sure laboratory personnel and your doctors know we use this drug.

This document doesn't contain all possible interactions. Therefore, before using Proscar, tell your doctor or pharmacist of all the products we use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Proscar: overdose If overdose of Proscar is suspected, contact your local poison control center or emergency room immediately. US residents can call US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly.

Proscar: notes Don't share Proscar with others.

Laboratory and/or medical tests ( e. g. , prostate exams, PSA levels ) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Keep all appointments with your doctor and the laboratory. We should have a complete physical examination. Follow your doctor's instructions for examining your breasts and testicles, and report any lumps immediately.

Although early improvement is often seen, at least 6 to 12 months of therapy may be necessary in some patients to assess whether or not a benefit has occurred. Therefore, it's important to keep regular doctor appointments and get blood tests as scheduled to make sure Proscar is working.

Many men are born with condition Proscar mimics ( prostate glands that are smaller than usual ) and lead normal lives with normal sex drives.

Proscar: missed dose If we miss a dose Proscar, take it as soon as we remember. If it is near time of next dose, skip missed dose and resume your usual dosing schedule. Don't double the dose of Proscar to catch up.

Proscar: storage Store US product at room temperature below 86 degrees F ( 30 degrees C ) away from light and moisture in a tightly closed container.

Store Canadian product at room temperature between 59 to 86 degrees F ( 15 to 30 degrees C ) away from light and moisture in a tightly closed container.

Don't store Proscar in bathroom. Keep all medicines away from children and pets.

Properly discard Proscar when it's expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Low costed Proscar

Gene That Prolongs Life After Heart Failure

About 40 percent of African-Americans have a genetic variant that can protect them after heart failure and prolong their lives, according to research conducted at Washington University School of Medicine in St. Louis and collaborating institutions.

The genetic variant has an effect that resembles that of beta blockers, drugs widely prescribed for heart failure. The new study offers a reason why beta blockers don't appear to benefit some African-Americans.

" For several years a controversy has existed in cardiovascular field because of conflicting reports about whether beta blockers helped African-American patients, " says senior author Gerald W. Dorn II, M. D. , professor of medicine, associate chairman for translational research and director of Center for Pharmacogenomics at Washington University.

" By mimicking the effect of beta blockers, genetic variant makes it appear as if beta blockers are not effective in these patients, " he explains. " But although beta blockers have no additional benefit in heart failure patients with variant, they're equally effective in Caucasian and African-American patients without variant. "

Co-author Stephen B. Liggett, M. D. , professor of medicine and physiology at University of Maryland School of Medicine and director of its cardiopulmonary genomics program says the discovery adds to accumulating evidence that genetic differences contribute to the way people respond to medications and should encourage the use of genetic testing in clinical trials to identify people who can benefit from therapy tailored to their genetic makeup.

About 5 million people in United States have heart failure, and it results in about 300, 000 deaths each year. Beta blockers slow heart rate and lower blood pressure to decrease heart's workload and prevent lethal cardiac arrhythmias.

While Caucasians with heart failure participating in clinical studies of beta blockers have shown clear benefit from drugs, the evidence for benefit in African-Americans has been ambiguous. The current study, reported online April 20, 2008, in Nature Medicine, identified one particular race-specific gene variant that seems to account mechanistically and biologically for these indeterminate results.

The gene codes for an enzyme called GRK5, which depresses response to adrenaline and similar hormonal substances that increase how hard heart works. Adrenaline is a hormone released from the adrenal glands that prompts the " fight-or-flight " response - it increases cardiac output to give a sudden burst of energy.

In heart failure, decreased blood flow from struggling heart ramps up the body's secretion of adrenaline to compensate for a lower blood flow. Overproduction of the hormone makes weakened heart pump harder, but eventually worsens heart failure.

Beta blockers alleviate this problem by blocking adrenaline at its receptor in the heart and blood vessels. GRK enzymes mimic this effect by serving as " speed governors " that work like the governor in an engine to prevent adrenaline from over-revving heart, says Dorn.

The researchers - including three equally contributing co-authors: Liggett, Sharon Cresci, M. D. , assistant professor of medicine in the Cardiovascular Division at Washington University and a cardiologist at Barnes-Jewish Hospital, and Reagan J. Kelly, Ph. D. , at the University of Michigan - found that 41 percent of African-Americans have a variant GRK5 gene that more effectively suppresses the action of adrenaline than more common version of gene. People with variant gene could be said to have a natural beta blocker, Dorn says. The variant is extremely rare in Caucasians, accounting for its predominant effects in African-Americans.

The researchers showed that African-American heart failure patients with this genetic variant have about same survival rate even if they don't take beta blockers as Caucasian and African-American heart failure patients who do take beta blockers.

" That does not mean African-Americans with heart failure need to be tested for the genetic variant to decide whether to take beta blockers, " Dorn says. " Under supervision of a cardiologist, beta blockers have very low risk but huge benefits, and I am comfortable prescribing them to any heart failure patients who do not have a specific contraindication to the drug. "

" This is a step toward individualized therapy, " Cresci says. " Medical research is working to identify many genetic variants that someday can ensure that patients receive medications that are most appropriate for them. Right now, we know one variant that influences beta blocker efficacy, and we are continuing our research into this and other relevant genetic variants. "

The human heart has two forms of GRK: GRK2 and GRK5. The researchers meticulously searched DNA sequence of these genes in 96 people of European-American, African-American or Chinese descent to look for differences. They found most people, no matter their race, had exactly same DNA sequence in GRK2 or GRK5. But there was one common variation in the DNA sequence, a variation called GRK5-Leu41, variant that more than 40 percent of African-Americans have.

To determine effect of the GRK5-Leu41 variant, team studied the course of progression of heart failure in 375 African-American patients. They looked for survival time or time to heart transplant, comparing people with variant to those without. Some of these patients were taking beta blockers and some were not.

In patients who didn't take beta blockers, researchers found that those with variant lived almost twice as long as those with more common version of the GRK5 gene. Beta blockers prolonged life to the same degree as protective GRK5 variant, but didn't further increase already improved survival of those with variant.

" These results offer an explanation for confusion that has occurred in this area since clinical trials of beta blockers began, " Dorn says. " Our study demonstrates a mechanism that should lay to rest question about whether beta blockers are effective in African-Americans - they absolutely are in those who do not have this genetic variant. "

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Other institutions collaborating in the study are the University of Cincinnati, Thomas Jefferson University and University of Missouri, Kansas City.

Liggett SB, Cresci S, Kelly RJ, Syed FM, Matkovich SJ, Hahn HS, Diwan A, Martini JS, Sparks L, Parekh RR Spertus JA, Koch WJ, Kardia SLR, Dorn II GW. A GRK5 polymorphism that inhibits beta-adrenergic receptor signaling is protective in heart failure. Nature Medicine April 20, 2008 ( advance online publishing ) .

Funding from National Heart, Lung, and Blood Institute supported this research.

Washington University School of Medicine's 2, 100 employed and volunteer faculty physicians also are medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of leading medical research, teaching and patient care institutions in nation, currently ranked third in nation by U. S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, School of Medicine is linked to BJC HealthCare.

Source: Gwen Ericson Washington University School of Medicine

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