Who Cannot Use Finasteride? Contraindications and Safety Warnings

October 7, 2025 •

3 min read

Approximately 1-8% of finasteride users experience sexual side effects, but it is strictly contraindicated in specific populations. It's critical to understand who cannot use finasteride, including pregnant women, children, and those with certain allergies, to avoid severe health risks.

Quick Summary

Finasteride is unsafe for pregnant women, children, and individuals with known hypersensitivity. Patients with liver disease, depression history, or at risk for prostate cancer require careful medical supervision.

Key Points

Pregnant Women: Finasteride is absolutely contraindicated in women who are pregnant or may become pregnant due to the risk of birth defects in a male fetus.
Children and Adolescents: The medication is not approved or indicated for use in the pediatric population.
Allergy: Individuals with a known hypersensitivity to finasteride or its components must not use the drug.
Liver Disease: Patients with impaired liver function should use finasteride with caution due to extensive hepatic metabolism.
Mental Health: A history of depression or suicidal thoughts requires careful medical monitoring before and during treatment due to reported psychiatric side effects.
Prostate Cancer: At higher doses (5 mg), finasteride has been linked to a small, increased risk of high-grade prostate cancer.
Drug Handling: Pregnant women should avoid handling crushed or broken finasteride tablets, as it can be absorbed through the skin.

Finasteride is a medication used to treat male pattern hair loss (1 mg dose) and benign prostatic hyperplasia (BPH) (5 mg dose). It works by blocking the enzyme 5-alpha reductase, which reduces the amount of dihydrotestosterone (DHT) in the body. However, finasteride is not safe for everyone, and certain individuals should not use it.

Absolute Contraindications for Finasteride

Pregnant Women and Those of Childbearing Potential

Finasteride poses a significant risk to a male fetus and is therefore absolutely contraindicated in women who are pregnant or may become pregnant. Exposure to the drug can cause abnormalities in the development of external genitalia. Finasteride can be absorbed through the skin, so pregnant women should not handle crushed or broken tablets. Men taking finasteride with partners of childbearing age should consider using condoms or discuss contraception options with their doctor.

Children and Adolescents

Finasteride is not approved for use in children or adolescents. Its effects on hormone levels mean its safety and impact on development in this age group are not established.

Known Hypersensitivity to Finasteride

Anyone with a history of an allergic reaction to finasteride or its ingredients should not take the medication. Signs of an allergic reaction include rash, itching, hives, and swelling, and require immediate medical attention.

Cautions and Required Monitoring

Individuals with Liver Disease

The liver processes finasteride. Patients with liver disease or impaired liver function should be cautious when using finasteride, as it may stay in the body longer. While liver injury is rare, monitoring may be necessary for long-term users with liver issues.

History of Depression or Suicidal Ideation

Finasteride has been linked to psychiatric side effects, including depression and suicidal thoughts. Health authorities recommend monitoring patients for these issues. Those with a history of mental health conditions should discuss the risks with their doctor. Some individuals report these problems persisting after stopping treatment, a condition sometimes called Post-Finasteride Syndrome (PFS).

Prostate Cancer Risks

Finasteride may affect the risk of prostate cancer, particularly increasing the risk of a more aggressive form at the 5 mg dose. While it may reduce overall prostate cancer incidence, doctors must discuss these risks with patients. Regular prostate cancer screening is advised for men on finasteride.

Impaired Urinary Flow

Men with severe urinary flow problems should be monitored closely when starting finasteride. The medication might not be suitable for them due to a higher risk of urinary tract obstruction.

Comparison of Finasteride Usage Scenarios


Condition / Population	Standard Dosage	Suitable Population	Key Considerations
Male Pattern Baldness	1 mg once daily	Adult males (typically 18-41)	Sexual side effects, monitor for mood changes
Benign Prostatic Hyperplasia (BPH)	5 mg once daily	Adult males with enlarged prostate	Alters PSA test results, risk of high-grade prostate cancer
Pregnant Women	N/A	Contraindicated	Severe risk of birth defects in a male fetus
Children & Adolescents	N/A	Contraindicated	Safety and efficacy not established, potential developmental risks
Severe Liver Disease	Use with caution, potentially not suitable	Requires careful medical evaluation	Increased drug exposure due to altered metabolism
History of Depression	Use with caution	Requires careful monitoring for psychiatric symptoms	Risk of worsened mood or suicidal ideation

Conclusion

Finasteride is an effective treatment for specific conditions in men but is not suitable for everyone. It is strictly contraindicated in pregnant women, children, and those with a known allergy. Individuals with liver issues or a history of depression require careful evaluation and monitoring. Consulting with a healthcare provider is essential to assess individual risks and benefits before starting finasteride.

Learn more about finasteride safety and prescribing information from reputable sources, such as the FDA's official drug label.

Frequently Asked Questions

No, finasteride is not approved for use in women, particularly those who are pregnant or may become pregnant. The drug is strictly for men with conditions like male pattern baldness and BPH.

A pregnant woman or one who may become pregnant should not handle crushed or broken finasteride tablets, as the drug can be absorbed through the skin and harm a male fetus.

Finasteride is broken down in the liver. Individuals with liver disease or function abnormalities should use the medication with caution, as it may increase drug exposure and require additional monitoring.

No, finasteride is not indicated for use in the pediatric population. The safety and effectiveness in children and adolescents have not been established.

If you have a known allergy or experience symptoms like hives, rash, itching, or swelling of the face, lips, or tongue after taking finasteride, you should stop taking it and seek immediate medical attention.

Finasteride lowers Prostate-Specific Antigen (PSA) levels. A healthcare provider must be aware that you are taking finasteride to properly interpret PSA results, as a rise in levels could still indicate cancer.

Yes, finasteride has been associated with psychiatric side effects, including depression and suicidal ideation, in some individuals. Patients with a history of mood disorders should be carefully monitored.