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Show PATTENT INFORMATION AROotT PROSCAR’ (Prahs-car) Generic name:finasteride (fin-AS-tur-eyed) PROSCAR is for the treatment of anduseoni. Your doctor may PROSCAR if you have a medical condition called benign prostatic hyperplasia or BPH. This occurs only in men. Please read this information, as well as the leaflet which accompanies your medication, before you start PROSCAR. Also, read theleaflet each time you renew your prescription, just in case anythin—_ changed. Remember,this leaflet does not take the place of careful discussions with your doctor. You and your doctor should discuss PROSCAR whenyoustart taking your medication and at regular checkups. What is BPH? BPHis an enlargementof the prostate Snlongued prostates. prose aThe sronate tonheated is below the bladder. As the—_ enlarges, it may slowly restrict the of urine. This can lead to symptoms such as: *a weak or interrupted urinary stream *a feeling bI that comp! cannot empty your *a feeling of delay or hesitation when you start to urinate . *a need to urinate ofte:n, especially ial y at nee *a feeling that you must urinate right away. Treatment options for BPH There are three main treatment options for BPH: *Program of monitoring or “Watchful Waiting”. Ifa_— has an e WS prostate no symptoms orif hi — 2 bother him, he an his ioctor may © on a program of monitor*Medication. Your doctor may prescribe DDOMNGMAY C._ Ws a 2 UU UE 2 ik. Oe oer . WHALE PROSCAR does” below. °Si . Some patients may need u . Your doctor can describe several dif ee procedures for BPH. Which p is best depends on your symptoms and medical condition. What PROSCAR does PROSCAR lowers levels of a key hormone called DHT (dihydrotestosterone), which is a major cause of— growth. Lowering DHTleads to shrinkage of the enlarged poset gland in most men. This can lead to gradual improvement in urine flow and symptoms over the next several months. However, since each case of BPHis different, you should know that: Even though the prostate shrinks, you may NOT see an improvementin urine flow or symptoms. *You may need to take PROSCAR for six (6) months or more to see whether it helps you. Even though you take PROSCAR and it may helpyou, it is not known whether PROSCAR reduces the need for surgery. Seen eee te ae ee taking *You must see doctor regularly. While taki PROSCAR, you must have Follow your doctor’s ice about to have these checkups. *About side effects. Like all prescrip- tion cng PROSCAR maycause side effects. Side effects due to PROSCAR may include impotence (or inability to have an erection) and less desire for sex. Each of these side effects occurred in less than 4% of natients in clinical studies. In some cases side effects went away while the patient continued to take PROSCAR. Some men taking PROSCAR mayhave a decrease in the amount of semen released during sex. This decrease does not appear ioiter fere with uurmai sexuai function. You should discuss side effects with your doctor before taking PROSCAR® i and anytime you think you are having a side effect. *Checking for prostate cancer. Your doctor has i PROSCAR for symptomatic BPH and notfor cancer— but a man can have BPH and prostate cancer at the same time. Doctors recommend that men be checked for prostate cancer once ayear when they turn 50 (or 40 ifa famil miember has had prostate cancer). These checks should continue while you OSCAR. PROSCAR is not a treatment for prostate cancer. -Saent poets eae antigen (PSA). Your doctor have done a blood test called PSA. PROSCAR can alter PSA — For more information, talk to your loctor. °A warning about PROSCAR and pregnancy. PROSCAR is for use by MEN only. PROSCAR is generally well tolerated in men. However, women who are pregnant, or women who could become should avoid the active aan PROSCAR. If the active ingredient is absorbed a woman whois pregnant with a mohBe it may cause the male baby to be born with abnormalities of the sex Therefore, any woman who is pregnant or who could become pregnant must not comeinto direct contact with the active ingredient in PROSCAR. Two of the ways in which a woman might absorb the active ingredient in PROSCAR are: Sexual contact. Your semen may contain a small amountof the active ingredient of the drug. If your partner is t, or dg and your partner deci to have a phog must stop orgs PROSCAR and to your doctor. your partner could become pregnant, proper use of a condom can reduce the risk of exposing her to your semen (discuss this further with your doctor). Handling broken tablets. Women who are pregnant or who could become Pp of must handle tablets PROSCAR. PROSCAR tablets are coated to prevent contact with the active ingredient i i i normal handli dling. If this coating is broken, the tablets should not be handled by women who are pregnant or who could become pregnant. If a woman whois pregnant comes into contact with the activei ient in pbigedaggdepen a . Remember, these only if the woman sed to PROSCAR is pregnant or could e pregnant. How to take PROSCAR Follow doctor’s advice about how to take P’ AR. You must take it every day. You may take it with or between meals. To avoid forgetting to take PROSCAR, it may be helpful to take it the same time every day. Do not share PROSCAR with anyone else; it was prescribed only for you. ee ofchildren. FOR MORE INFORMATION ABOUT PROSCAR AND BPH, TALK WITH YOUR DOCTOR. IN ADDITION, TALK TO YOUR PHARMACIST OR OTHER HEALTH CARE PROVIDER. BAPPrie"ie ‘s” EVELINA © 1993, Merck & Co., Inc. West Point, PA 19486 J3PO036V2(701)-PSA558 TREMBLING WITH HOPE/continued each other by transmitting chemicals from one to the other. These neurotransmitters set off or block electrical discharges in adjacent nerves. One of these chemicals is called dopamine. Oneorgan in the brain stem, a bundle of nerve cells no bigger than a grape, is rich in dopamine.It is called the substantia nigra. Ultimately, it feeds dopamine into neighboring clusters of neuronsthat control your movements: No dopamine,no control. There are many theories about why the substantia nigra stops producing dopamine. For example, some scientists say an environmental poison could be the cause. Others say your genes may increase sensitivity to everyday materials, such as aluminum.Noproofyet. If the brain doesn’t get enough dopamine, you cannot control your movements without concentrating. I can keep myright hand perfectly still by just looking atit. But if I have not taken Artane, and I am watching a movie orjust talking to someone, my hand jumpsaroundlike a flag in a breeze. When I am broadcasting, I hide my hand. In a conversation, I am often amused by the other fellow’s attempts to look and notto look at my shaking hand. So thetrick is to get more dopamine io ine brain. Oral doses oflevodopa often help do this. I don’t yet take levodopa, sometimes called L-dopa. This is converted within the brain to dopamine, which I am growing less able to produce. Other medicines curb enzymesthat break down dopamine, leaving more of the chemical intact in your brain. There also are drugs that behave like dopamineitself. Finally, you can take medicines that hinder the action of other neurotransmitters, chiefly acetylcholine. If not checked by natural dopamine, acetylcholineis the culprit that makes my handflutter. Myheart leaps with hope whenI realize that my doctor can prescribe two or three other drugsthat I haven’t tried yet and that more medicines are on the way. PerhapsIll be lucky enough to hold Parkinson’s at bay until the more effective chemicalsarrive. All this drug research was stimulated in 1982, when what was intended to be synthetic heroin was produced in an illegal laboratory. Seven people between the ages of 20 and 40 arrived for treatment in hospital emergency TOOms aicr Having iyected the illegal substance.It was tainted with impurities, primarily the toxic chemical MPTP, whichkilled the dopamine cells in their brains. They were affected severely with irreversible immobility, a symptom of Parkinson’s later stages. Dr. J. William Langston, now president of The Parkinson’s Institute in Sunnyvale, Calif., saw the first case while working at the Santa Clara Valley Medical Center. He published that discovery in 1983. From this devastating incident, scientists found a way to create an animal model of Parkinson’s on which to test the new surgeries and drugs before trying them on humans. The model works best in monkeys. And progress has been rapid. Once treated with MPTP, the monkeys becameParkinson’s patients, and Swedish surgeons implanted them with dopamine-producing cells from the brains of monkey fetuses. Brain surgeons in Sweden,at Yale and at the University of Colorado later tried human-cell implants with humans. They reported improvements. Scientists are developing techniques of changingthe patient’s own skin cells so that they make dopamine whensurgically implanted in the substantia nigra region ofthebrain.If the implants succeed, the body would notrejectits own tissue, and scientists would not have to dependonfetal cells. Success may be five or 10 years away. A dozen or more pharmaceutical companiesare testing drugs on monkeys with MPTP-induced Parkinson’s. Somescientists have tried electrical stimulation of the brain to control tremors. It may work. In Manhattan, neurologists and neurosurgeons from the New York University Medical Center are working with others at the Hospital for Joint Diseases, rewiring the brain’s dopaminecircuits by cutting certain nerve pathways. They are optimistic. I am one of abouthalf a million Americans with Parkinson’s. Our ages range from the 20s to the 80s, but the average age at onset is 61. Weare all lucky. In the 1960s, patients could anticipate being wheelchair-bound three to five years after the first symptoms and dead three to five years afterthat. Now,living 15 functional years is usual. And more help is on the way. So far, nothing has crippled me.I can still take Parkinson’s as a challenge. Myjob is to keep on going and to get the best out of myfuture life. If it includes tennis, work, family and friends—great. forfurther information, write to the United Parkinson Foundation, Dept. P, 833 W. Washington Blvd., Chicago, Ill. 60607. PAGE 18 - OCTOBER 10, 1993 - PARADE MAGAZINE |
