TLDR Starting 5-alpha reductase inhibitors does not significantly increase the risk of rhabdomyolysis in older men, but is linked to a higher risk of muscle conditions.
In a study of 93,197 men aged 66 years or older in Ontario, Canada, researchers found that the initiation of 5-alpha reductase inhibitors (5ARIs) was not significantly associated with an increased risk of rhabdomyolysis, with a hazard ratio (HR) of 1.21 and a 95% confidence interval (CI) of 1.00-1.48. However, the study did reveal that men had an elevated risk of rhabdomyolysis before starting 5ARI medication (HR 1.31, 95% CI, 1.05-1.64). Additionally, the use of 5ARIs was significantly associated with a higher risk of myositis and myopathy (HR 1.63, 95% CI, 1.48-1.80). The study was limited by its inability to confirm rhabdomyolysis through laboratory tests and did not include younger men using 5ARIs for androgenic alopecia. The research was ethically approved and supported by grants, including one from the Canadian Institutes of Health Research, with no conflicts of interest reported by the authors.
90 citations,
March 2017 in “JAMA Internal Medicine” Men over 66 taking medication for prostate enlargement have a higher risk of depression and self-harm, especially in the first 18 months of treatment.
3 citations,
January 2015 in “Clinical and Experimental Dermatology” A man developed a serious muscle breakdown condition after using a hair loss medication not known to cause this side effect.
44 citations,
July 2012 in “Endocrine Practice” We need to learn more about 5α-reductases and neuroactive steroids to safely make drugs targeting these enzymes.
10 citations,
December 2008 in “Journal of Clinical Neuromuscular Disease” Finasteride can cause muscle pain and high creatine kinase levels, but stopping the medication may resolve symptoms.
15 citations,
April 1997 in “Muscle & Nerve”
June 2023 in “Clinica Chimica Acta” Finasteride and dutasteride effectively reduce DHT in hair, which may help evaluate their treatment success for hair loss.
6 citations,
January 2018 in “Pharmacoepidemiology and Drug Safety” Starting 5-alpha reductase inhibitors does not significantly increase the risk of rhabdomyolysis in older men, but is linked to a higher risk of muscle conditions.
January 2018 in “Surgical and Cosmetic Dermatology” 5-alpha reductase inhibitors like finasteride and dutasteride are effective for treating enlarged prostate and male pattern hair loss.
27 citations,
March 2017 in “Current Clinical Pharmacology” Dutasteride is becoming a popular hair loss treatment, proving more effective than finasteride with similar side effects.
