Medication questions Safety and side effects

Is finasteride safe to take long term?

Short answer

For most men, finasteride is considered safe to take for years. The NHS says many people take it "for many months or even years without any problems", and it was studied for 5 years for its licence. It is not risk-free: the MHRA warns about depression, suicidal thoughts and sexual side effects that may persist after stopping, so regular review matters.

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Key facts

  • Finasteride 1 mg was studied for up to 5 years for its UK licence.
  • MHRA Drug Safety Updates (29 April 2024, 11 May 2026) warn about depression, suicidal thoughts and sexual side effects that may persist.
  • Every finasteride pack now contains a patient alert card.
  • Finasteride roughly halves PSA, so tell your doctor before a PSA test.

What the long-term evidence shows

Finasteride 1 mg has been licensed in the UK for male pattern hair loss for many years. The studies behind the licence followed men aged 18 to 41, and the UK summary of product characteristics (SmPC) reports that 290 men completed 5 years of treatment in the crown hair loss studies.

The NHS says: "Finasteride is generally safe to take for a long time. Many people take it for many months or even years without any problems." It adds that breast cancer has been reported in some men taking finasteride, "but this is rare".

Long-term use is also how the medicine is meant to be taken. The SmPC says "continuous use is recommended to sustain benefit", because the effect fades after stopping.

The MHRA warnings on mood and sexual side effects

The MHRA, the UK medicines regulator, has issued two Drug Safety Updates on finasteride. The first, on 29 April 2024, reminded prescribers and patients of the risk of psychiatric and sexual side effects and introduced a patient alert card in every finasteride pack. The second, on 11 May 2026, strengthened the warnings and added that "sexual dysfunction may contribute to mood disorders".

The MHRA's advice to patients is that finasteride "is associated with low mood, depression, suicidal thoughts and sexual dysfunction (decreased sex drive, erectile dysfunction and ejaculation disorders)". It says to "stop finasteride 1mg immediately if you develop depression or suicidal thoughts and contact your doctor as soon as possible". UK Yellow Card data from 1994 to 31 May 2025 included 170 reports of suicidal ideation for finasteride.

Sexual side effects were uncommon in the trials: the SmPC reports decreased libido in 1.8% of men on finasteride against 1.3% on placebo, and erectile dysfunction in 1.3% against 0.7%. They may persist after stopping. Our pages on depression and persistent sexual side effects explain more. If you need to talk to someone now, Samaritans are free on 116 123.

PSA tests and breast changes

PSA. Finasteride lowers PSA (prostate-specific antigen), a blood test sometimes used to check for prostate cancer. In the UK trials, average PSA fell from 0.7 to 0.5 ng/ml at 12 months, and the SmPC says doctors should consider doubling the PSA result in men taking it. Always mention finasteride before a PSA test. See finasteride and the PSA test.

Breast changes. The SmPC says male breast cancer has been reported in men taking finasteride 1 mg since it was marketed. Report any lumps, pain, enlargement or nipple discharge to a doctor promptly. See finasteride and breast changes.

Taking it safely over the years

Long-term safety is partly about the medicine and partly about how it is looked after. The MHRA asks prescribers to check for a history of depression before prescribing and to review patients regularly for psychiatric and sexual side effects. A sensible routine looks like this:

Keep your alert card and leaflet, and reread them if anything changes.

Tell someone close to you that finasteride can affect mood, so they can say if they notice a change.

Report side effects to your prescriber, and through the MHRA Yellow Card scheme if you wish.

Keep your reviews. Your circumstances change over the years, including your mental health, relationships and family plans.

Stopping is always a valid choice. Our page on stopping finasteride explains what happens. If you are considering treatment, the free online assessment asks about your mental health history so a doctor can judge whether finasteride is appropriate for you.

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Related questions

Can I take finasteride for the rest of my life?

Many men take it for years, and the benefit lasts only while you take it. There is no fixed limit, but long-term use should come with regular reviews, so you and your prescriber can keep weighing the benefit against any side effects.

Do finasteride side effects go away if I stop?

Most side effects resolve after stopping. However, the MHRA and the UK product information say sexual side effects have persisted after stopping in some men. Report any side effect to your prescriber rather than waiting.

What is the finasteride patient alert card?

A card included in every finasteride pack since the MHRA's April 2024 update. It reminds you about the risk of psychiatric and sexual side effects and what to do if they happen. Keep it with you or somewhere you will see it.

Does finasteride affect prostate checks?

Yes. It lowers PSA, so the result needs adjusting. The UK product information says doubling the PSA result should be considered for men taking finasteride 1 mg. Tell the doctor or nurse before any PSA test.

How often should my finasteride be reviewed?

The MHRA asks prescribers to review patients regularly for mood and sexual side effects. At WMG Meds the first review is at around 3 months, then again at around 6 months, with ongoing reviews after that.

Sources

Facts checked against these sources on 4 October 2026. This page is general information, not personal medical advice. Read our editorial policy.

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