Is Finasteride compatible with breastfeeding? Do we have alternatives for Finasteride?

Finasteride

October 9, 2016 (Low Risk)

Inhibitor of 5-α reductase enzyme that induces the pass of testosterone to dihydrotestosterone which has a greater androgenic effect.
Indicated for treatment of benign prostatic hypertrophy.
Not authorized for use in women although it is used for treatment of hirsutism with same or greater efficacy than Spironolactone or Flutamide (Moghetti 2000), androgenetic alopecia (Shum 2002) and Polycystic Ovary Syndrome (Lakryc 2003) .

At latest update no published data on excretion into breast milk were found.
Its high plasma protein-binding capacity makes it unlikely the excretion of significant amounts into breastmilk.

Not alterations on prolactin level have been reported.

A known and safer alternative should be preferred until more published data on this drug related to breastfeeding is available within the first 6 mo after birth, especially during the neonatal period and in case of prematurity.
Exposure through breastmilk may be minimized by waiting at least 6 hours before resuming breastfeed after the last dose of drug.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Writings

  • Φιναστερίδη (Greek)
  • فيناستيريد (Arabic)
  • Финастерид (Cyrillic)
  • 非那雄胺 (Chinese)
  • フィナステリド (Japanese)
  • C23H36N2O2 (Molecular formula)

Drug trade names

References

  1. AEMPS. Finasterida. Ficha técnica. 2015 Full text (in our servers)
  2. Paparodis R, Dunaif A. The Hirsute woman: challenges in evaluation and management. Endocr Pract. 2011Abstract
  3. FDA. Finasteride. Drug Summary. 2010 Full text (in our servers)
  4. Camacho-Martínez FM. Hair loss in women. Semin Cutan Med Surg. 2009Abstract
  5. Lakryc EM, Motta EL, Soares JM Jr, Haidar MA, de Lima GR, Baracat EC. The benefits of finasteride for hirsute women with polycystic ovary syndrome or idiopathic hirsutism. Gynecol Endocrinol. 2003Abstract
  6. Shum KW, Cullen DR, Messenger AG. Hair loss in women with hyperandrogenism: four cases responding to finasteride. J Am Acad Dermatol. 2002Abstract
  7. Moghetti P, Tosi F, Tosti A, Negri C, Misciali C, Perrone F, Caputo M, Muggeo M, Castello R. Comparison of spironolactone, flutamide, and finasteride efficacy in the treatment of hirsutism: a randomized, double blind, placebo-controlled trial. J Clin Endocrinol Metab. 2000Abstract
  8. Uygur MC, Arik AI, Altuğ U, Erol D. Effects of the 5 alpha-reductase inhibitor finasteride on serum levels of gonadal, adrenal, and hypophyseal hormones and its clinical significance: a prospective clinical study. Steroids. 1998Abstract