Does finasteride (Finasteride) affect blood pressure (BP)?

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From the Guidelines

Finasteride is not recommended to help with blood pressure (BP) management. Finasteride is primarily prescribed to treat male pattern baldness and benign prostatic hyperplasia (enlarged prostate) by inhibiting the enzyme that converts testosterone to dihydrotestosterone (DHT) 1. While finasteride affects certain hormonal pathways, it does not have significant effects on blood pressure regulation.

The 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults emphasizes the importance of considering substances that may impair BP control, including prescription medications, over-the-counter substances, illicit drugs, and herbal products 1. However, finasteride is not mentioned as a treatment for hypertension in this guideline.

Instead, medications specifically designed for hypertension, such as ACE inhibitors, ARBs, calcium channel blockers, diuretics, or beta-blockers, would be more appropriate for managing high blood pressure. These medications target different mechanisms involved in blood pressure regulation. Key considerations for BP management include:

  • Careful history-taking to identify substances that may impair BP control
  • Reducing or discontinuing drugs associated with increased BP when feasible
  • Using alternative agents that do not adversely affect BP
  • Selecting antihypertensive medications based on individual patient needs and characteristics 1.

If you're experiencing high blood pressure, it's essential to consult with a healthcare provider who can recommend appropriate treatment options based on your specific health needs, rather than considering finasteride for this purpose.

From the Research

Finasteride and Blood Pressure

  • There is no direct evidence in the provided studies to suggest that finasteride helps with blood pressure (BP) management 2, 3, 4, 5, 6.
  • The studies primarily focus on the use of finasteride for treating benign prostatic hyperplasia (BPH) and male androgenetic alopecia (MAA), as well as its side effects, such as erectile dysfunction and decreased libido 3, 4, 5, 6.
  • One study discusses the treatment of hypertension, but it does not mention finasteride as a potential treatment option 2.
  • The treatment of hypertension typically involves lifestyle modifications and medications such as thiazide diuretics, angiotensin-converting enzyme inhibitors, and calcium channel blockers 2.

Side Effects of Finasteride

  • Finasteride has been associated with several side effects, including:
    • Erectile dysfunction 3, 5, 6
    • Decreased libido 3, 5, 6
    • Ejaculatory dysfunction 5, 6
    • Gynecomastia 4, 6
    • Mood disorders, such as depression and anxiety 6
  • These side effects are generally considered to be rare, but their true association, prevalence, causality, and clinical significance remain unclear 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Finasteride in the treatment of alopecia.

Expert opinion on pharmacotherapy, 2004

Research

Finasteride for benign prostatic hyperplasia.

The Cochrane database of systematic reviews, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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