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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 …