Yintoni i-finasteride kwaye isetyenziselwa ntoni?

Ulwazi lweziyobisi

Yintoni impandla yamadoda kunye neprostate eyandisiweyo efanayo? Zombini ziphathwa nge-finasteride-kwaye kulapho ukuphela kwazo ukufana. Yintoni? Esi sikhokelo sichaza iimeko ezinyangayo, iziphumo ebezingalindelekanga ezinokubakho, kunye nolunye unyango.

Yintoni ifinasteride?

I-Finasteride yi-5-alpha reductase inhibitor. Isebenza ngokuthintela ukuveliswa kwe-5-alpha reductase enzyme, etshintsha i-testosterone kwi-dihydrotestosterone (DHT), ekhuthaza ukukhula kweprostate kunye nokubangela ukulahleka kweenwele. Iziphumo ze-DHT zezasekhaya, oko kuthetha ukuba ubukho bayo entlonzeni abubonakalisi ukwandiswa kweprostate kwaye kungenjalo. Nangona kunjalo, i-finasteride, phantsi kwamagama ahlukeneyo nakwiidosi ezahlukeneyo, iyasebenza ekunyangeni zombini ezi meko. Amagama ebhrendi e-finasteride afaka iProscar (eyandisiweyo yeprostate) kunye nePropecia (yokulahleka kweenwele). Eli yeza linokunciphisa umngcipheko womhlaza webala lobudoda ophantsi.

Isetyenziselwa ntoni imali?

Ulawulo lwezoKutya kunye neDrug (i-FDA) evunyiweyo ye-finasteride kunyango lwe-benign prostatic hyperplasia (BPH) kunye ne-androgenetic alopecia, ukucheba kancinci kweenwele. Buza umboneleli wezempilo malunga nokunye ukusetyenziswa kwelebula.

I-Benign prostatic hyperplasia

Igama lebrand Iproscar inokusetyenziswa yodwa okanye ngokudibeneyo neCardura (doxazosin) ukunyanga i-BPH, ukwanda kwe-Prostate gland. Xa idlala leprostate likhula, licinezela ngokuchasene nomchamo. Iimpawu ze-BPH, ngokwe Isiseko soKhathalelo lweUrology , zibandakanya:

• Ukugcinwa kwe-Urinary-ukungakwazi ukukhupha i-bladder ngokupheleleyo
• Ndiva ukungxamiseka kokuchama
• Ukuhamba kancinci komchamo
• Ubunzima ngokuchama
• Ukufuna ubunzima bokuchama

Izifundo zibonise ukuba amadoda athatha i-finasteride kwiinyanga ze-12 aqatshelwe ukuba anciphise i-23% kuthintelo kunye ne-18% yokuncipha kwamanqaku angonakalisiyo, ukunyuka kokuhamba komchamo, kunye nokwehla kwe-19% kumthamo weprostatic, utsho UDouglas P. Jeffrey , MD, ugqirha wosapho e-Oregon kunye nomcebisi kwezonyango eMediHealth .Kubalulekile ukuthatha i-finasteride kangangeenyanga ezintandathu ukuya kwezili-12 ngaphambi kokuba ubukhulu beprostate buncitshiswe ngokwaneleyo ukuphucula iimpawu ezinxulumene ne-BPH. Iimpawu ziyakhululwa ngokude kuqhubeke iyeza iminyaka. Xa iyeza limisiwe iimpawu zokuqala ze-BPH ziya kubuya ngokubanzi. Iyeza lithathwa ngokuba likhuselekile ekusebenziseni ixesha elide.

Lo mngcipheko wale meko ukwanda ngokobudala. Isiqingatha sawo onke amadoda aphakathi kweminyaka engama-51, kunye nama-60% ukuya kuma-90% abo badala kunama-80 abafumana iimpawu ezibangelwa kukwanda kweprostate, ngokwe IZiko leLizwe leSwekile kunye nokuGaya kunye neZintso (NIDDK). I-Finasteride inokulawula i-BPH, kodwa ayiyinyangi. Kwabanye abantu, kunciphisa isidingo sotyando lweprostate.

Impandla yomntu oyindoda

Ipropecia inokunyanga i-androgenetic alopecia-impandla yendoda. Eli yeza yidosi ephantsi ye-finasteride kuneProscar. Inceda ukuphucula ukubuya kweenqwelomoya kunye nokulahleka kweenwele ngaphezulu kwesikhumba. Nangona kunjalo, ayincedi ukucheba iinwele etempileni, ngokwe I-Medline Plus .

Ipropecia inciphisa ukulahleka kweenwele kwaye inokuba negalelo ekukhuleni kweenwele ezintsha, ngokwe UKaiser Permanente . Uninzi lwabantu aluboni kuphucuka kwiinyanga ezintathu ukuya kwezintandathu emva kokuqala amayeza, kwaye kusebenza kuphela ukuba uyaqhubeka nokuwasebenzisa. Ukuba uyayeka, ukukhula kweenwele zakho ezintsha kuya kuphuma kungaphelanga iinyanga ezintandathu ukuya kwezili-12 zokuyeka.

I-Finasteride iyasebenza ngakumbi kunyango lwesihloko sokuphulukana neenwele zamadoda, ngokwe UGqirha Jeffrey. Olunye uphononongo lwenza ukuba amadoda afezekise ukubuyela kwakhona kweenwele emva kweminyaka emibini yokusetyenziswa kunye nophuculo olubaluleke nangakumbi kumadoda amancinci aphakathi kweminyaka ye-18 kunye ne-41.

Ngamanye amaxesha iFinasteride isetyenziselwa ukunyanga ezinye iimeko ngaphandle kwelebheli. Ngaphandle kwelebheli kuthetha ukuba i-FDA ayilamkelanga iyeza kunyango lwale meko; Nangona kunjalo, ubungqina be-anecdotal bubonakalisile ukuba bunokunceda. Ezinye zeemeko zibandakanya:

IHirsutism

Le meko ibangela ukukhula kweenwele ngokugqithileyo kwabasetyhini. Ukukhula kweenwele kubonakala kwiindawo zomzimba apho iinwele zingakhuli khona, ezinje ngomlomo ongasentla, isilevu, isifuba, isisu nasemqolo. Phakathi kwe-5% kunye ne-10% yabasetyhini abane-hirsutism, ngokwe- Ikliniki yaseCleveland . Izizathu eziqhelekileyo zibandakanya i-polycystic ovary syndrome (i-PCOS), ukuya exesheni, amanye amayeza, kunye nezinye iimeko zempilo ezibangelwa ngamanqanaba aphezulu e-testosterone.

Unyango lweTransgender hormone (eyindoda ukuya kwabasetyhini)

I-Finasteride ngamanye amaxesha iluncedo kunyango lwehomoni kubafazi be-transgender ukunciphisa ukukhula kweenwele kwiindawo zomzimba ngaphandle kwentloko.

Uthintelo lomhlaza wedlala lobudoda

I-Finasteride inokunciphisa umngcipheko womhlaza ophantsi webala le-Prostate. Isifundo esikhulu sifumanise ukuba i-finasteride iwunciphise kakhulu umngcipheko womhlaza wedlala lobudoda kumadoda aneminyaka eyi-55 nangaphezulu, ngokuka IZiko leSizwe loMhlaza . Olu phando lunye lubonisa ukuba nangona ichiza liwuthoba umngcipheko womhlaza webala lobudoda, lonyusa umngcipheko wokufumanisa umhlaza webala lobudoda, onobundlongondlongo kwaye kunzima ukunyanga. Nangona kunjalo, a Uphononongo olutshanje , eyayilandela amadoda ethatha i-finasteride kangangeminyaka engama-20, akafumananga ukonyuka kokubhubha okunxulumene nomhlaza wedlala lesinyi.

Ugqirha Howard Parnes, omnye wababhali bophando, ukholelwa ukuba iziphumo zokuqala ezibonisa ukonyuka komhlaza kwinqanaba eliphezulu zichazwa ngokulula, ubuncinci ngokuyinxalenye, ngokufumanisa okuphuculweyo ngenxa yeziyobisi. Ukunciphisa ubungakanani beprostate gland kwandise amathuba okufumana isampulu elungileyo kwi-biopsy yokufumanisa isifo, kwaye i-finasteride ibonakala ngathi iphucula ubuntununtunu bovavanyo lwe-PSA lokufumanisa umhlaza webala lobudoda.

I-FDA ayamkelanga i-finasteride yokuthintela umhlaza.

Imilinganiselo yeFinasteride

IFinasteride iyafumaneka kwi-1 mg kunye neepilisi ze-5 mg, ngokwe Isalathiso seDesika yoGqirha ( I-PDR ). Iidosi eziqhelekileyo zeemeko ezahlukeneyo zezi:

• BPH: 5 mg yonke imihla, ithathwa kunye okanye ngaphandle kokutya, ubuncinci iinyanga ezintandathu, ukuya kuthi ga kwiinyanga ezili-12 ukuba kukho imfuneko. Yisebenzise yodwa okanye ngokudibeneyo neCardura (doxazosin).
• Ukuphulukana neenwele kwindoda: 1 mg yonke imihla ubuncinci iinyanga ezintathu. Kuya kufuneka uqaphele ukuphucula phakathi kweenyanga ezili-12. Ukuba akukho phuculo, unyango olongezelelweyo mhlawumbi aluyi kusebenza. Kuya kufuneka uqhubeke nokusebenzisa ukugcina izibonelelo zonyango.
• IHirsutism kwabasetyhini: 5 mg yonke imihla, nokuba iyodwa okanye idityaniswe nezinto zokucwangcisa zomlomo.
• Unyango lweTransgender hormone: 1 ukuya ku-5 mg yonke imihla, ngokwe Katie Imborek , MD, umlawuli-kunye kwiYunivesithi yase-Iowa ye-LGBTQ Clinic.

Zithini iziphumo ebezingalindelekanga?

Njengawo onke amayeza, i-finasteride inokubangela iziphumo ebezingalindelekanga. Asinguye wonke umntu ohlangabezana neempembelelo ezimbi; Nangona kunjalo, kuya kufuneka wazi ngeziphumo ebezingalindelekanga ezinokuthi zibandakanye ukungasebenzi kakuhle ngokwesondo. Ngokwe- I-PDR , Iziphumo ebezingalindelekanga eziqhelekileyo zibandakanya:

• Ukungasebenzi kakuhle kwe-Erectile
• Ukunciphisa umnqweno wesondo
• Iingxaki nge-ejaculation, kubandakanya ukunciphisa umthamo we-ejaculate
• Intlungu kumatyhalarha
• Uxinzelelo

Iziphumo ebezingalindelekanga ezibi kakhulu, kubandakanya neempendulo,

• Irhashalala
• Ukurhawuzelela
• Imihlathi
• Ukudumba kwemilebe nobuso
• Kunzima ukuphefumla okanye ukuginya

Ukuba ufumana naziphi na iziphumo ebezingalindelekanga ezimandundu, kuya kufuneka unxibelelane nogqirha wakho okanye ufune iingcebiso kwezonyango kwangoko.

I-Finasteride inokunyusa umngcipheko wokuba nomhlaza webele, ngokwe KwiYunivesithi yaseMichigan . Kuya kufuneka unxibelelane nengcali yezonyango ukuba uqaphela:

• Amaqhuma amabele
• Intlungu yesifuba okanye ukuthamba
• Ukukhutshwa kwengono
• Olunye utshintsho lwebele

Ngaphandle kweziphumo ebezingalindelekanga ezinokubakho, i-finasteride kunjalokukhuselekile ekusebenziseni ukuphucula ukukhula kweenwele kwenxalenye yamadoda amancinci. Akufanele isetyenziswe ngaphandle kwengxoxo. Ukuphononongwa ngononophelo kweziphumo ebezingalindelekanga zexesha elifutshane kunye nexesha elide kunye nokuqonda ukuba ilahleko yokuphuculwa kweenyanga ezilithoba ukuya kwezili-12 emva kokumisa i-finasteride kubalulekile ukuba iphononongwe ngaphambi kokuqala, utshilo uGqirha Jeffrey. Kuba i-finasteride ityekele ekwehliseni amanqanaba e-PSA ifuna ukuba i-PSA ibekwe esweni kwaye iphinde ibe novavanyo lwe-digital rectal Exal (DRE) ukukhangela iprotrate. Kukho ithuba lokufihla umhlaza wedlala lobuchopho ngenxa yokwehla kwe-PSA. I-DRE kufuneka yenziwe ngaphambi kokuqala konyango kwaye kwiinyanga ezintandathu emva kokuqala kwayo. I-DRE yonyaka emva koko ibalulekile.

Izilumkiso ngefinasteride

Amanye amadoda afumana i-post-finasteride syndrome (PFS) xa eyeka ukuthatha amayeza. I-PFS ibandakanya ukuqhubeka kwezesondo, imithambo-luvo, umzimba kunye neziphumo ezibi zengqondo.I-post-finasteride syndrome ayichazwanga kakuhle kwaye imele isifo esiphikisayo. Inxulunyaniswa neqela lesini, lomzimba, kunye neempawu zengqondo ezikhula ngexesha okanye emva kokuba i-finasteride iqalile kwaye ingaqhubeka emva kokuyekiswa. Iimpawu zibandakanya ukwehla kwe-libido, i-ED, kunye nokungasebenzi kakuhle koxinzelelo kunye noxinzelelo, ngokukaGqirha Jeffrey. Ngamanye amaxesha, iimpawu zanyamalala ngokuhamba kwexesha nangona kwezinye zahlala iminyaka emininzi.

Akukho lunyango kwaye bambalwa, ukuba lukhona, unyango, ngokwe Isiseko sePFS .Isiseko sibonisa ukuba bekukho iingxelo ze-16,198 ezichaseneyo nokusabela kweziyobisi kwihlabathi liphela, ukuzibulala okungama-63, kunye namazwe angama-23 anikezela izilumkiso malunga nonyango. Basebenza ngenkuthalo ukususa ichiza kwintengiso, okanye, ubuncinci, ukuba babe nezilumkiso ezinamandla eziprintwe kuyo yonke imigqaliselo kunye namaphepha olwazi ngesigulana.

Nangona i-finasteride inxulunyaniswe nokwehla komhlaza webala lobudlala ophantsi, i Ufundo luka-2003 ufumanise ukuba unokunyusa umngcipheko wokuba nomhlaza webala le-Prostate, ekungumhlaza weprostate. Izifundo ezilandelayo, ezinjengaleyo ipapashwe kuyo Uthintelo loMhlaza , ekugqibeleni akafumananga lonyuko lubalulekileyo kumhlaza webala lobudoda kwabo bathatha i-finasteride.

Abasetyhini abakhulelweyo okanye abanokukhulelwa akufuneki bachukumise iipilisi ze-finasteride njengoko eli yeza linokubangela iziphene zokuzalwa.

Ngaba zikhona ezinye iindlela zokwenza imali?

Ezinye iindlela zokwenza i-finasteride zixhomekeke kwisizathu sokuba uthathe amayeza.

I-Avodart (dutasteride) ye-BPH

I-Avodart yinto edibeneyo ye-4-azasteroid ephatha i-BPH. Isebenza ngokuthintela ukuguqulwa kwe testosterone ukuyadihydrotestosterone (DHT), ephucula ukuhamba komchamo kwaye inokunciphisa isidingo sotyando lweprostate. Yisebenzise wedwa okanye amayeza eFlomax (tamsulosin).

I-Alpha-blockers ye-BPH

I-Alpha-blockers isebenza ngokuphumla kwezihlunu esinyini nakwiprostate kwaye inceda malunga nama-70% yamadoda ane-BPH, ngokwe Ezempilo zeHarvard . Oku kuqala ukusebenza malunga neveki enye ukuya kwezimbini kwaye baneziphumo ebezingalindelekanga ezimbalwa. I-Alpha-blocker ibandakanya:

• I-Rapaflo (isilodosin)
• I-Flomax (itamsulosin)
• Uroxatral (alfuzosin)

Azinampembelelo kwithuba lokuhlaselwa ngumhlaza wedlala lobudoda.

Ezinye iindlela zempandla yamadoda

Ukongeza kwi-finasteride, unyango olungaphezulu kwekhawuntari lunokulwa ne-baldness yeepateni zamadoda. I-Rogaine (minoxidil) iyafumaneka njengolwelo okanye amagwebu, irubhiweyo entlonzeni yonke imihla, ngokwe Ikliniki yaseMayo . Ingathatha ubuncinci iinyanga ezintandathu ngaphambi kokuba uqalise ukulahleka kweenwele kunye nokukhula kweenwele ezintsha. Unyango lusebenza kuphela ngelixa ulisebenzisa. Xa uyeka, naluphi na ukukhula kweenwele ezintsha kunokulahleka.

Unyango olungelulo unyango lubandakanya utyando lotyando lweenwele, okanye utyando lokubuyisela, kunye nonyango lwe-laser. Unokufuna into engaphezulu kwesinye, kwaye i-inshurensi ayigubungeli olu nyango.