Finasteride and Dry Eye: An Underestimated Side Effect of Finasteride.

Finasteride may cause ‘Dry Eye” and and Array of Eye-related Side Effects

Recent research is emerging that suggests that finasteride, and possibly other 5 alpha reductase inhibitors, may cause dry eye. This has been studied in both animal and human models.

Regarding the human studies, Cermak and colleagues note that women with complete androgen insensitivity syndrome had meibomian gland dysfunction and were found to have altered lipid composition in their meibomian gland secretions. Krenzer et al noted that many patients undergoing anti androgen treatment had meibomian gland dysfunction and dry eye. Nguygen et al. reported similar findings with regard to dry eye but went further to propose that some retinal and optic nerve damage could be part of the constellation of findings.

In animal studies, research by Zhang et al and Li et al showed that finasteride administration to rats affected tear production.

Conclusion

Eye related side effects are likely underestimated. it’s clearly something that needs more study and more discussion. I would imagine that few prescribers of finasteride are aware of eye related side effects. This is an important area for future study.

Reference

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Krenzer KL, Dana MR, Ullman MD, Cermak JM, Tolls DB, Evans JE, et al. Effect of androgen deficiency on the human meibomian gland and ocular surface. J Clin Endocrinol Metab 2000;85:4874-82.

Li K, Zhang C, Yang Z, Wang Y, Si H. Evaluation of a novel dry eye model induced by oral administration of finasteride. Mol Med Rep 2017;16:8763-70

Nguyen et al. Finasteride Induced Clinical Ocular Toxicity. ARVO Annual Meeting Abstract | July 2018

Sullivan DA, Rocha EM, Aragona P, Clayton JA, Ding J, Gole- biowski B, et al. TFOS DEWS II sex, gender, and hormones report. Ocul Surf 2017;15:284-333.

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