“Acute Pancreatitis Following Finasteride Toxicity: A Rare Case Report"

“Acute Pancreatitis Following Finasteride Toxicity: A Rare Case Report" | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report “Acute Pancreatitis Following Finasteride Toxicity: A Rare Case Report" Mohammadreza Mohammadi, Arman Hakemi, Alireza Ghassemi Toussi, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4397098/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Finasteride, commonly used for benign prostatic hyperplasia and androgenetic alopecia, has a generally safe profile, primarily associated with sexual and psychological side effects. However, rare cases of acute pancreatitis associated with its use require careful investigation due to the severity of such an adverse effect. Case Presentation: We report a case of acute pancreatitis in a 32-year-old Iranian man following an intentional overdose of 200 tablets of 5 mg finasteride in a suicide attempt. The patient, with no significant medical or family history of pancreatic disease, presented with acute upper abdominal pain, nausea, and vomiting. Laboratory tests confirmed acute pancreatitis, characterized by markedly elevated amylase and lipase, high triglycerides, and mild metabolic acidosis. The patient was treated with aggressive hydration and total parenteral nutrition, resulting in significant clinical improvement over three days. Discussion : This case illustrates the potential for severe finasteride-induced pancreatitis, particularly in overdose situations. Although the mechanism by which finasteride may cause pancreatitis is not fully understood, disruption of steroid hormone metabolism may be involved. Recognition of drug-induced pancreatitis is important because of the common use of medications such as azathioprine, valproic acid, and diuretics, which are known to cause this condition. Conclusion : Given the rarity of finasteride-related pancreatitis, further investigation into its pathophysiology and risk factors is warranted. This case highlights the importance of considering drug-induced pancreatitis in patients presenting with abdominal symptoms and a history of medication use, particularly in the context of overdose. This could lead to a reassessment of the safety profile of finasteride and improved patient management strategies. Finasteride Acute Pancreatitis Drug Toxicity Overdose Drug-Induced Pancreatitis Introduction Finasteride is a selective type 2 5α-reductase inhibitor widely used to treat both benign prostatic hyperplasia (BPH) and androgenetic alopecia in men 1,2 . The 5α-reductase enzyme converts testosterone to dihydrotestosterone (DHT) in the prostate gland, skin, and liver. DHT is the potent androgen responsible for the development and enlargement of the prostate gland as well as androgenic hair follicle regression in men. Finasteride, therefore, inhibits androgenic hair loss and excessive prostate gland enlargement by reducing DHT concentration levels 3 . The most commonly reported adverse effects of finasteride are related to sexual dysfunction such as decreased libido, erectile dysfunction, and ejaculatory dysfunction. 4,5 In addition, some studies have reported psychological effects such as depressive behavior, and anxiety, particularly in patients at high risk of mood disorders 6 . Acute pancreatitis is a sudden inflammation of the pancreas, caused by the premature activation of pancreatic enzymes, leading to autodigestion of the organ 7,8 . Well-known causes of acute pancreatitis include bile duct obstruction, alcohol abuse, and hypertriglyceridemia although other uncommon etiologies such as drug-induced and autoimmune pancreatitis have been investigated 9 . Several drugs have been associated with acute pancreatitis but to the best of our knowledge, only one case of finasteride-induced acute pancreatitis has been reported to date 10,11 . Therefore, case reports are essential to identify potential drug-related risks for pancreatitis. In the current report, a rare and unique case of acute pancreatitis due to previous finasteride toxicity was investigated in a 32-year-old man who presented to the emergency department. Case presentation A 32-year-old Iranian man with no significant past medical and surgical history or family history of pancreatic disease presented to the emergency department with acute upper abdominal pain radiating to the back, nausea, and vomiting. He reported ingesting 200 tablets of 1 mg finasteride in a suicide attempt, resulting in severe drug toxicity. The patient was taking finasteride for male pattern baldness but had no history of benign prostatic hyperplasia or any chronic medical conditions. There was no history of recent trauma, infection, cigarette smoking, or alcohol consumption. The patient was promptly admitted to the hospital and on examination, appeared agitated with a heart rate of 98 beats per minute(bpm), blood pressure of 130/75 mmHg, respiratory rate of 18 breaths per minute, and a temperature of 37.5°C. Abdominal examination revealed severe epigastric tenderness without rebound or guarding. There was no jaundice or palpable abdominal mass. Initial laboratory tests were significant for markedly elevated levels of amylase (460 U/L) and lipase (510 U/L), confirming acute pancreatitis. His triglyceride level was abnormally high at 1200 mg/dL, and arterial blood gas analysis indicated mild metabolic acidosis. His complete blood count, electrolytes, and troponin levels were within normal limits, helping to rule out other complications. Liver function tests were slightly elevated. The patient was managed with aggressive intravenous hydration and total parenteral nutrition while maintained on NPO (nothing by mouth) to preserve the pancreas. Pain management was carefully monitored and administered intravenously. Over the course of three days, his clinical condition showed marked improvement. Follow-up laboratory tests showed a reduction in amylase (81 U/L), lipase (28 U/L), and triglycerides (430 mg/dL). The abdominal pain was significantly reduced, and the patient was switched to oral intake without complications. The diagnosis of acute drug-induced pancreatitis in this patient was made based on a comprehensive evaluation that included a complete medical history, thorough physical examination, and diagnostic workup. Key laboratory tests supporting the diagnosis included significantly elevated amylase and lipase levels and liver function tests. These findings, together with the patient's history of excessive finasteride use, confirmed the diagnosis. We followed our patient for six months after he stopped taking finasteride, during which time he had no further episodes of acute pancreatitis. Discussion This case report describes a rare case of acute pancreatitis caused by an overdose of finasteride, a medication commonly prescribed for the treatment of benign prostatic hyperplasia and male pattern baldness. While finasteride is well-known to cause sexual dysfunction and psychological impacts, reports of its association with acute pancreatitis are extremely rare 12 . Drug-induced pancreatitis is a well-recognized clinical condition and several common drugs have been implicated. Examples include azathioprine, valproic acid, diuretics such as furosemide and thiazides, and certain antibiotics such as tetracyclines and sulfa drugs 13–15 . Recognizing the potential for drug-induced pancreatitis is crucial in the clinical setting, especially when patients present with abdominal symptoms and have a history of drug use. The exact mechanism by which finasteride may cause pancreatitis is not well understood. However, given that finasteride interferes with steroid hormone metabolism by inhibiting the conversion of testosterone to dihydrotestosterone, it is plausible that this interference could extend to other pathways involving steroid precursors and derivatives that could affect pancreatic tissue 3 . This case highlights the need for clinicians to be aware of the potentially serious adverse effects of finasteride, especially in cases of misuse or overdose. It also highlights the importance of educating patients about the safe use of the drug and monitoring for unusual side effects. Conclusion Further research is needed to investigate the association between finasteride and pancreatitis, in particular, to understand the dose dependency and possible underlying mechanisms. Pharmacovigilance reports and further case studies may help to establish a clearer association and may prompt a review of the safety profile of finasteride, particularly with high-dose exposures or in populations with pre-existing risk factors for pancreatic disorders. Although finasteride is generally considered safe for its approved uses, this case report serves as a reminder of the potential for serious adverse reactions in cases of overdose. Healthcare providers should take this into account when assessing symptomatic patients and report unusual cases to drug safety authorities to improve risk assessment of the drug and guidelines for patient management. Declarations Ethics approval This case report was conducted under the ethical standards of the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was granted by the Ethics Committee of Mashhad University of Medical Sciences, Mashhad, Iran. Written informed consent was obtained from the patient for publication of this case report and any accompanying data. Data availability declaration Due to the sensitive and confidential nature of the data associated with this case report, detailed clinical data, including laboratory results and patient history, are not publicly available. However, de-identified data that support the findings of this study are available from the corresponding author upon reasonable request. Requests for access to these data will be reviewed by the corresponding author and will require compliance with applicable privacy regulations and approval by the institutional review board. The data is available in Parse laboratory, Mashhad, Iran. Here is the laboratory online link: https://parselab724.ir/ Conflicts of interest The authors declare that there are no conflicts of interest regarding the research, authorship, and/or publication of this article. Funding declaration The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Authors contributions Conceptualization Mohammadreza Mohammadi, Arman Hakemi Writing – original draft Mohammadreza Mohammadi Data curation Arman Hakemi, Reza Mousavi Critical revision: Alireza Ghassemi Toussi, Bita Dadpour, Reza Mousavi, Anahita Alizadeh Ghamsar Acknowledgments Not applicable References Tacklind J, Fink HA, Macdonald R, Rutks I, Wilt TJ. Finasteride for benign prostatic hyperplasia. Cochrane Database Syst Rev . Oct 6 2010;2010(10):Cd006015. doi:10.1002/14651858.CD006015.pub3 Gupta AK, Venkataraman M, Talukder M, Bamimore MA. Finasteride for hair loss: a review. J Dermatolog Treat . Jun 2022;33(4):1938-1946. doi:10.1080/09546634.2021.1959506 Chaudhary UB, Turner JS. Finasteride. Expert Opin Drug Metab Toxicol . Jul 2010;6(7):873-81. doi:10.1517/17425255.2010.495944 Said MA, Mehta A. The Impact of 5α-Reductase Inhibitor Use for Male Pattern Hair Loss on Men's Health. Curr Urol Rep . Jun 16 2018;19(8):65. doi:10.1007/s11934-018-0814-z Fertig RM, Gamret AC, Darwin E, Gaudi S. Sexual side effects of 5-α-reductase inhibitors finasteride and dutasteride: A comprehensive review. Dermatol Online J . Nov 11 2017;23(11) Deng T, Duan X, He Z, Zhao Z, Zeng G. Association Between 5-Alpha Reductase Inhibitor Use and The Risk of Depression: A Meta-Analysis. Urol J . Aug 23 2020;18(2):144-150. doi:10.22037/uj.v16i7.5866 Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet . Jul 4 2015;386(9988):85-96. doi:10.1016/s0140-6736(14)60649-8 Mederos MA, Reber HA, Girgis MD. Acute Pancreatitis: A Review. Jama . Jan 26 2021;325(4):382-390. doi:10.1001/jama.2020.20317 Yang AL, McNabb-Baltar J. Hypertriglyceridemia and acute pancreatitis. Pancreatology . Jul 2020;20(5):795-800. doi:10.1016/j.pan.2020.06.005 Wolfe D, Kanji S, Yazdi F, et al. Drug induced pancreatitis: A systematic review of case reports to determine potential drug associations. PLoS One . 2020;15(4):e0231883. doi:10.1371/journal.pone.0231883 Lin YH, Perng CL, Lin HJ, Chang FY. Acute pancreatitis possibly related to finasteride. J Clin Gastroenterol . Mar 2001;32(3):276. doi:10.1097/00004836-200103000-00027 Traish AM, Hassani J, Guay AT, Zitzmann M, Hansen ML. Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients. J Sex Med . Mar 2011;8(3):872-84. doi:10.1111/j.1743-6109.2010.02157.x Chadalavada P, Simons-Linares CR, Chahal P. Drug-induced acute pancreatitis: Prevalence, Causative agents, and Outcomes. Pancreatology . Oct 2020;20(7):1281-1286. doi:10.1016/j.pan.2020.07.401 Nitsche C, Maertin S, Scheiber J, Ritter CA, Lerch MM, Mayerle J. Drug-induced pancreatitis. Curr Gastroenterol Rep . Apr 2012;14(2):131-8. doi:10.1007/s11894-012-0245-9 Badalov N, Baradarian R, Iswara K, Li J, Steinberg W, Tenner S. Drug-induced acute pancreatitis: an evidence-based review. Clin Gastroenterol Hepatol . Jun 2007;5(6):648-61; quiz 644. doi:10.1016/j.cgh.2006.11.023 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4397098","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":305997666,"identity":"7b069e69-9164-4c8d-9377-3dd857db14c6","order_by":0,"name":"Mohammadreza Mohammadi","email":"","orcid":"","institution":"Tehran University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Mohammadreza","middleName":"","lastName":"Mohammadi","suffix":""},{"id":305997667,"identity":"41bbe65b-a326-4e8b-9ec4-32d62665cf8e","order_by":1,"name":"Arman Hakemi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5klEQVRIiWNgGAWjYBACAwY2MClnf5j5AFz0AC7lyFqMGY6zJZCihYEhseE8jwFxDjNnP5b46EaBXWJjM8/Xzbw5dQz87QcYD1fg0WLZk3bYOMcg2biZmXfbbd5thxkkziQwHDyDz2EH0tukcwyYZdsgWoC+uMHAcLABn5bzz9t/5xjUM/Yw8zwDaqljkCeo5UbaMeYcg8OKM5h52IBamIEiBLU8SwY67LixATOb2c252w7zGJ5JbCDgsDTDzzl/quUM+A8/u/F2W52c3PHDhz/i04IBeBgYGEnSMApGwSgYBaMACwAAecdPism65toAAAAASUVORK5CYII=","orcid":"","institution":"Mashhad University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Arman","middleName":"","lastName":"Hakemi","suffix":""},{"id":305997668,"identity":"b70c3c43-3073-4ee2-ac41-9519afa11d30","order_by":2,"name":"Alireza Ghassemi Toussi","email":"","orcid":"","institution":"Mashhad University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Alireza","middleName":"Ghassemi","lastName":"Toussi","suffix":""},{"id":305997671,"identity":"d554a4cb-c746-4bd0-b2f6-75bd346260e7","order_by":3,"name":"Bita Dadpour","email":"","orcid":"","institution":"Mashhad University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Bita","middleName":"","lastName":"Dadpour","suffix":""},{"id":305997672,"identity":"a03e33f6-807d-4be0-ae94-692094834c6f","order_by":4,"name":"Reza Mousavi","email":"","orcid":"","institution":"Mashhad University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Reza","middleName":"","lastName":"Mousavi","suffix":""},{"id":305997676,"identity":"74fd1ff1-9022-4b90-9aa8-e65bfe6b82e3","order_by":5,"name":"Anahita Alizadeh Ghamsar","email":"","orcid":"","institution":"Clinical toxicologist, Mashhad University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Anahita","middleName":"Alizadeh","lastName":"Ghamsar","suffix":""}],"badges":[],"createdAt":"2024-05-09 20:53:49","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4397098/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4397098/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":58562503,"identity":"1dfa1f2a-89b5-4657-a50d-5bc5d6074e77","added_by":"auto","created_at":"2024-06-18 09:19:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":211240,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4397098/v1/c3c6fad7-5f5e-481f-ae26-6a2cddb119c4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"“Acute Pancreatitis Following Finasteride Toxicity: A Rare Case Report\"","fulltext":[{"header":"Introduction","content":"\u003cp\u003eFinasteride is a selective type 2 5α-reductase inhibitor widely used to treat both benign prostatic hyperplasia (BPH) and androgenetic alopecia in men \u003csup\u003e1,2\u003c/sup\u003e. The 5α-reductase enzyme converts testosterone to dihydrotestosterone (DHT) in the prostate gland, skin, and liver. DHT is the potent androgen responsible for the development and enlargement of the prostate gland as well as androgenic hair follicle regression in men. Finasteride, therefore, inhibits androgenic hair loss and excessive prostate gland enlargement by reducing DHT concentration levels\u003csup\u003e3\u003c/sup\u003e. The most commonly reported adverse effects of finasteride are related to sexual dysfunction such as decreased libido, erectile dysfunction, and ejaculatory dysfunction. \u003csup\u003e4,5\u003c/sup\u003e In addition, some studies have reported psychological effects such as depressive behavior, and anxiety, particularly in patients at high risk of mood disorders\u003csup\u003e6\u003c/sup\u003e. Acute pancreatitis is a sudden inflammation of the pancreas, caused by the premature activation of pancreatic enzymes, leading to autodigestion of the organ\u003csup\u003e7,8\u003c/sup\u003e. Well-known causes of acute pancreatitis include bile duct obstruction, alcohol abuse, and hypertriglyceridemia although other uncommon etiologies such as drug-induced and autoimmune pancreatitis have been investigated\u003csup\u003e9\u003c/sup\u003e. Several drugs have been associated with acute pancreatitis but to the best of our knowledge, only one case of finasteride-induced acute pancreatitis has been reported to date\u003csup\u003e10,11\u003c/sup\u003e. Therefore, case reports are essential to identify potential drug-related risks for pancreatitis. In the current report, a rare and unique case of acute pancreatitis due to previous finasteride toxicity was investigated in a 32-year-old man who presented to the emergency department.\u003c/p\u003e "},{"header":"Case presentation","content":"\u003cp\u003eA 32-year-old Iranian man with no significant past medical and surgical history or family history of pancreatic disease presented to the emergency department with acute upper abdominal pain radiating to the back, nausea, and vomiting. He reported ingesting 200 tablets of 1 mg finasteride in a suicide attempt, resulting in severe drug toxicity. The patient was taking finasteride for male pattern baldness but had no history of benign prostatic hyperplasia or any chronic medical conditions. There was no history of recent trauma, infection, cigarette smoking, or alcohol consumption. The patient was promptly admitted to the hospital and on examination, appeared agitated with a heart rate of 98 beats per minute(bpm), blood pressure of 130/75 mmHg, respiratory rate of 18 breaths per minute, and a temperature of 37.5°C. Abdominal examination revealed severe epigastric tenderness without rebound or guarding. There was no jaundice or palpable abdominal mass. Initial laboratory tests were significant for markedly elevated levels of amylase (460 U/L) and lipase (510 U/L), confirming acute pancreatitis. His triglyceride level was abnormally high at 1200 mg/dL, and arterial blood gas analysis indicated mild metabolic acidosis. His complete blood count, electrolytes, and troponin levels were within normal limits, helping to rule out other complications. Liver function tests were slightly elevated. The patient was managed with aggressive intravenous hydration and total parenteral nutrition while maintained on NPO (nothing by mouth) to preserve the pancreas. Pain management was carefully monitored and administered intravenously. Over the course of three days, his clinical condition showed marked improvement. Follow-up laboratory tests showed a reduction in amylase (81 U/L), lipase (28 U/L), and triglycerides (430 mg/dL). The abdominal pain was significantly reduced, and the patient was switched to oral intake without complications. The diagnosis of acute drug-induced pancreatitis in this patient was made based on a comprehensive evaluation that included a complete medical history, thorough physical examination, and diagnostic workup. Key laboratory tests supporting the diagnosis included significantly elevated amylase and lipase levels and liver function tests. These findings, together with the patient's history of excessive finasteride use, confirmed the diagnosis. We followed our patient for six months after he stopped taking finasteride, during which time he had no further episodes of acute pancreatitis.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis case report describes a rare case of acute pancreatitis caused by an overdose of finasteride, a medication commonly prescribed for the treatment of benign prostatic hyperplasia and male pattern baldness. While finasteride is well-known to cause sexual dysfunction and psychological impacts, reports of its association with acute pancreatitis are extremely rare\u003csup\u003e12\u003c/sup\u003e. Drug-induced pancreatitis is a well-recognized clinical condition and several common drugs have been implicated. Examples include azathioprine, valproic acid, diuretics such as furosemide and thiazides, and certain antibiotics such as tetracyclines and sulfa drugs\u003csup\u003e13\u0026ndash;15\u003c/sup\u003e. Recognizing the potential for drug-induced pancreatitis is crucial in the clinical setting, especially when patients present with abdominal symptoms and have a history of drug use. The exact mechanism by which finasteride may cause pancreatitis is not well understood. However, given that finasteride interferes with steroid hormone metabolism by inhibiting the conversion of testosterone to dihydrotestosterone, it is plausible that this interference could extend to other pathways involving steroid precursors and derivatives that could affect pancreatic tissue\u003csup\u003e3\u003c/sup\u003e. This case highlights the need for clinicians to be aware of the potentially serious adverse effects of finasteride, especially in cases of misuse or overdose. It also highlights the importance of educating patients about the safe use of the drug and monitoring for unusual side effects.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eFurther research is needed to investigate the association between finasteride and pancreatitis, in particular, to understand the dose dependency and possible underlying mechanisms. Pharmacovigilance reports and further case studies may help to establish a clearer association and may prompt a review of the safety profile of finasteride, particularly with high-dose exposures or in populations with pre-existing risk factors for pancreatic disorders. Although finasteride is generally considered safe for its approved uses, this case report serves as a reminder of the potential for serious adverse reactions in cases of overdose. Healthcare providers should take this into account when assessing symptomatic patients and report unusual cases to drug safety authorities to improve risk assessment of the drug and guidelines for patient management.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003eEthics approval\u003c/p\u003e\n\u003cp\u003eThis case report was conducted under the ethical standards of the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was granted by the Ethics Committee of Mashhad University of Medical Sciences, Mashhad, Iran. Written informed consent was obtained from the patient for publication of this case report and any accompanying data. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eData availability declaration\u003c/p\u003e\n\u003cp\u003eDue to the sensitive and confidential nature of the data associated with this case report, detailed clinical data, including laboratory results and patient history, are not publicly available. However, de-identified data that support the findings of this study are available from the corresponding author upon reasonable request. Requests for access to these data will be reviewed by the corresponding author and will require compliance with applicable privacy regulations and approval by the institutional review board.\u003c/p\u003e\n\u003cp\u003eThe data is available in Parse laboratory, Mashhad, Iran.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHere is the laboratory online link:\u003c/p\u003e\n\u003cp\u003ehttps://parselab724.ir/\u003c/p\u003e\n\u003cp\u003eConflicts of interest\u003c/p\u003e\n\u003cp\u003eThe authors declare that there are no conflicts of interest regarding the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003eFunding declaration\u003c/p\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003eAuthors contributions\u003c/p\u003e\n\u003cp\u003eConceptualization Mohammadreza Mohammadi, Arman Hakemi\u003c/p\u003e\n\u003cp\u003eWriting \u0026ndash; original draft Mohammadreza Mohammadi\u003c/p\u003e\n\u003cp\u003eData curation Arman Hakemi, Reza Mousavi\u003c/p\u003e\n\u003cp\u003eCritical revision:\u0026nbsp;Alireza Ghassemi Toussi, Bita Dadpour, Reza Mousavi, Anahita Alizadeh Ghamsar\u003c/p\u003e\n\u003cp\u003eAcknowledgments\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eTacklind J, Fink HA, Macdonald R, Rutks I, Wilt TJ. Finasteride for benign prostatic hyperplasia. \u003cem\u003eCochrane Database Syst Rev\u003c/em\u003e. Oct 6 2010;2010(10):Cd006015. doi:10.1002/14651858.CD006015.pub3\u003c/li\u003e\n\u003cli\u003eGupta AK, Venkataraman M, Talukder M, Bamimore MA. Finasteride for hair loss: a review. \u003cem\u003eJ Dermatolog Treat\u003c/em\u003e. Jun 2022;33(4):1938-1946. doi:10.1080/09546634.2021.1959506\u003c/li\u003e\n\u003cli\u003eChaudhary UB, Turner JS. Finasteride. \u003cem\u003eExpert Opin Drug Metab Toxicol\u003c/em\u003e. Jul 2010;6(7):873-81. doi:10.1517/17425255.2010.495944\u003c/li\u003e\n\u003cli\u003eSaid MA, Mehta A. The Impact of 5\u0026alpha;-Reductase Inhibitor Use for Male Pattern Hair Loss on Men\u0026apos;s Health. \u003cem\u003eCurr Urol Rep\u003c/em\u003e. Jun 16 2018;19(8):65. doi:10.1007/s11934-018-0814-z\u003c/li\u003e\n\u003cli\u003eFertig RM, Gamret AC, Darwin E, Gaudi S. Sexual side effects of 5-\u0026alpha;-reductase inhibitors finasteride and dutasteride: A comprehensive review. \u003cem\u003eDermatol Online J\u003c/em\u003e. Nov 11 2017;23(11)\u003c/li\u003e\n\u003cli\u003eDeng T, Duan X, He Z, Zhao Z, Zeng G. Association Between 5-Alpha Reductase Inhibitor Use and The Risk of Depression: A Meta-Analysis. \u003cem\u003eUrol J\u003c/em\u003e. Aug 23 2020;18(2):144-150. doi:10.22037/uj.v16i7.5866\u003c/li\u003e\n\u003cli\u003eLankisch PG, Apte M, Banks PA. Acute pancreatitis. \u003cem\u003eLancet\u003c/em\u003e. Jul 4 2015;386(9988):85-96. doi:10.1016/s0140-6736(14)60649-8\u003c/li\u003e\n\u003cli\u003eMederos MA, Reber HA, Girgis MD. Acute Pancreatitis: A Review. \u003cem\u003eJama\u003c/em\u003e. Jan 26 2021;325(4):382-390. doi:10.1001/jama.2020.20317\u003c/li\u003e\n\u003cli\u003eYang AL, McNabb-Baltar J. Hypertriglyceridemia and acute pancreatitis. \u003cem\u003ePancreatology\u003c/em\u003e. Jul 2020;20(5):795-800. doi:10.1016/j.pan.2020.06.005\u003c/li\u003e\n\u003cli\u003eWolfe D, Kanji S, Yazdi F, et al. Drug induced pancreatitis: A systematic review of case reports to determine potential drug associations. \u003cem\u003ePLoS One\u003c/em\u003e. 2020;15(4):e0231883. doi:10.1371/journal.pone.0231883\u003c/li\u003e\n\u003cli\u003eLin YH, Perng CL, Lin HJ, Chang FY. Acute pancreatitis possibly related to finasteride. \u003cem\u003eJ Clin Gastroenterol\u003c/em\u003e. Mar 2001;32(3):276. doi:10.1097/00004836-200103000-00027\u003c/li\u003e\n\u003cli\u003eTraish AM, Hassani J, Guay AT, Zitzmann M, Hansen ML. Adverse side effects of 5\u0026alpha;-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients. \u003cem\u003eJ Sex Med\u003c/em\u003e. Mar 2011;8(3):872-84. doi:10.1111/j.1743-6109.2010.02157.x\u003c/li\u003e\n\u003cli\u003eChadalavada P, Simons-Linares CR, Chahal P. Drug-induced acute pancreatitis: Prevalence, Causative agents, and Outcomes. \u003cem\u003ePancreatology\u003c/em\u003e. Oct 2020;20(7):1281-1286. doi:10.1016/j.pan.2020.07.401\u003c/li\u003e\n\u003cli\u003eNitsche C, Maertin S, Scheiber J, Ritter CA, Lerch MM, Mayerle J. Drug-induced pancreatitis. \u003cem\u003eCurr Gastroenterol Rep\u003c/em\u003e. Apr 2012;14(2):131-8. doi:10.1007/s11894-012-0245-9\u003c/li\u003e\n\u003cli\u003eBadalov N, Baradarian R, Iswara K, Li J, Steinberg W, Tenner S. Drug-induced acute pancreatitis: an evidence-based review. \u003cem\u003eClin Gastroenterol Hepatol\u003c/em\u003e. Jun 2007;5(6):648-61; quiz 644. doi:10.1016/j.cgh.2006.11.023\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Finasteride, Acute Pancreatitis, Drug Toxicity, Overdose, Drug-Induced Pancreatitis","lastPublishedDoi":"10.21203/rs.3.rs-4397098/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4397098/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Finasteride, commonly used for benign prostatic hyperplasia and androgenetic alopecia, has a generally safe profile, primarily associated with sexual and psychological side effects. However, rare cases of acute pancreatitis associated with its use require careful investigation due to the severity of such an adverse effect.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase Presentation:\u003c/strong\u003e We report a case of acute pancreatitis in a 32-year-old Iranian man following an intentional overdose of 200 tablets of 5 mg finasteride in a suicide attempt. The patient, with no significant medical or family history of pancreatic disease, presented with acute upper abdominal pain, nausea, and vomiting. Laboratory tests confirmed acute pancreatitis, characterized by markedly elevated amylase and lipase, high triglycerides, and mild metabolic acidosis. The patient was treated with aggressive hydration and total parenteral nutrition, resulting in significant clinical improvement over three days.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion\u003c/strong\u003e: This case illustrates the potential for severe finasteride-induced pancreatitis, particularly in overdose situations. Although the mechanism by which finasteride may cause pancreatitis is not fully understood, disruption of steroid hormone metabolism may be involved. Recognition of drug-induced pancreatitis is important because of the common use of medications such as azathioprine, valproic acid, and diuretics, which are known to cause this condition.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Given the rarity of finasteride-related pancreatitis, further investigation into its pathophysiology and risk factors is warranted. This case highlights the importance of considering drug-induced pancreatitis in patients presenting with abdominal symptoms and a history of medication use, particularly in the context of overdose. This could lead to a reassessment of the safety profile of finasteride and improved patient management strategies.\u003c/p\u003e","manuscriptTitle":"“Acute Pancreatitis Following Finasteride Toxicity: A Rare Case Report\"","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-05 11:55:28","doi":"10.21203/rs.3.rs-4397098/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8b6d561c-eda3-45e9-9840-faeeaea1eacd","owner":[],"postedDate":"June 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-07-02T09:37:46+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-05 11:55:28","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4397098","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4397098","identity":"rs-4397098","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}