Low-Dose Finasteride in Benign Prostatic Hyperplasia: A Comprehensive Narrative Review of Efficacy, Safety, and Preventative Potential

This review examines the use of low-dose finasteride (1 mg) for managing benign prostatic hyperplasia (BPH), highlighting its biological activity, such as PSA and DHT suppression, but noting a lack of direct clinical evidence for BPH benefits at this dose. While the 5 mg dose is effective for reducing prostate volume and symptoms, the 1 mg dose is primarily used for alopecia and is not recommended for routine preventive use in BPH without further large-scale randomized controlled trials. Safety concerns, including potential psychiatric effects, are emphasized, and PSA values should be adjusted for patients on finasteride to avoid underestimating prostate cancer risk.