I took finasteride/propecia for a while and thought it wasn't doing anything for me. Then I stopped and lost a huge amount of hair. I think it's good at maintaining your current hairline. I regret stopping it.
Finasteride
| Finasteride at a glance | |
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The good: One of the only oral treatments available that has been proven to do anything. The bad: Not a cure and will likely only slow down progression; possible sexual side effects. Bottom Line: If you're willing to brave the potential side effects, this is an important addition to your regimen. Price Per Dose: $0.77 USD
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Finasteride (marketed as Proscar, Propecia, Fincar, Finpecia, Finax, Finast, Finara, Finalo, Prosteride, Gefina, Finasterid IVAX) is a commercially marketed antiandrogen, DHT inhibitor and 5-alpha-reductase inhibitor. It is typically taken orally.
Finasteride was approved initially in 1992 as Proscar, a treatment for prostate enlargement, but the sponsor had studied 1 mg of finasteride and demonstrated hair growth in male pattern hair loss. On December 22, 1997, the FDA approved finasteride to treat male pattern hair loss.
[edit] Brand names
Drug trade names include Propecia and Proscar, both products of Merck & Co. (the former is marketed for hair loss in male pattern baldness, and the latter for BPH). There is 1 mg of finasteride in Propecia and 5 mg in Proscar.
Cipla also manufactures finasteride (trade names Fincar and Finpecia), as does Dr. Reddy's (trade names Finax and Finast), Ranbaxy (trade name Finara), Intas (trade name Finalo), and Aleppo Pharmaceutical (trade name Prosteride), all of whom who sell the drug at a significantly lower cost than Merck.
[edit] Side effects
Recognized side effects, experienced by around >1% of users, include erectile dysfunction, and less often gynecomastia (breast gland enlargement). [4] As expected from its short 6-8 hour half-life, in trial studies, side effects ceased after dosage was discontinued.
Finasteride is not indicated for use by women. Finasteride is in the FDA pregnancy category X. This means that it is known to cause birth defects in an unborn baby. Women who are or who may become pregnant must not handle crushed or broken finasteride tablets, because the medication could be absorbed through the skin. Finasteride is known to cause birth defects in a developing male baby. Exposure to whole tablets should be avoided whenever possible, however exposure to whole tablets is not expected to be harmful as long as the tablets are not swallowed. It is not known whether finasteride passes into breast milk, and thus should not be taken by breastfeeding women. Finasteride may pass into the semen of men, but Merck states that a pregnant woman's contact with the semen of a man taking finasteride is not an issue for concern. (See Male hair-loss treatment, indication, and safety information at propecia.com.)
Finasteride has been linked with depression [1] The drug also caused reductions in allopregnanolone, a potent, endogenous positive modulator of the GABA-A receptor, in very large doses in rodent studies.[2]
Finasteride can also be used to mask steroid abuse, and many professional sports have banned finasteride use for this reason. [3]
Finasteride is under investigation by the Swedish Medical Products Agency for possibly causing irreversible sexual side effects [4].
[edit] Use as a treatment for hair loss
In a 5-year study of men with mild to moderate hair loss, 48% of those treated with Propecia (finasteride 1mg) experienced some regrowth of hair, and 42% had no further loss. Average hair count in the treatment group remained above baseline, and showed an increasing difference from hair count in the placebo group, for all five years of the study.[5]. Propecia is effective only for as long as it is taken; the hair gained or maintained is lost within 6-12 months of ceasing therapy (Rossi, 2004). In clinical studies, Propecia, like minoxidil, was shown to work on both the crown area and the hairline,[5] but is most successful in the crown area.
Some users, in an effort to save money, buy Proscar instead of Propecia, and split the Proscar pills to approximate the Propecia dosage. Doing so is generally considered unadvisable if women of pregnancy age are in the household; this is because finasteride, even in small concentrations, can cause birth defects in a developing male fetus. The birth defects involve the development of male genitalia (no such effects have been noted in developing female fetuses). On most product inserts, it will be mentioned that the dust or crumbs from broken Propecia tablets should be kept away from pregnant women.
Propecia has been shown to be ineffective for treating hair loss in women. However, Propecia's supporters respond that the study was on post-menopausal women whose hair loss was more likely related to the loss of estrogen versus a sensitivity to testosterone. Many doctors prescribe it for women, but not without either careful birth control measures or assurance that the woman cannot become pregnant.
[edit] Possible health concerns
The UC Berkeley Wellness Letter expressed concern in March 2003 about the unproven long-term safety of Propecia and recommended cutting a standard 1 milligram dose of Propecia into quarters to reduce the cost without reducing its effectiveness. This claim appears to be supported by clinical pharmacological data reviewed by the FDA during Propecia's approval process that suggested that the advantage of taking 1 mg per day over 0.2 mg per day is statisticially small.[6] Some people have unsuccessfully petitioned the FDA to re-examine the approved dosage in light of the statistical evidence and unknown long-term risks.[7] The FDA responded and said that just because the level of DHT found in the scalp was not significantly different does not mean there is a correlation with hair loss. A study would have to show that the benefits of using 0.2 mg and 1 mg were not statistically different. According to the FDA such a study has been performed and a 1 mg dose has a greater benefit whilst remaining equally safe. The same study also concluded that doses of 0.01 mg per day were found to be ineffective in treating hair loss.[7]
In the Prostate Cancer Prevention Trial (PCPT), 25 percent fewer men taking the drug finasteride developed prostate cancer than men not taking the drug. However, men who developed prostate cancer while taking finasteride were more likely to have high-grade cancers, which can spread quickly even if the tumors are small. [8]
[edit] Propecia's effects in detail
See DHT Inhibition Side Effects
[edit] Patent expiration
Merck's patent on Finasteride (for the treatment of BPH) expired on June 19, 2006.[9] Merck was awarded a separate patent for the use of Finasteride to treat Male Pattern Baldness. According to the FDA, this patent will not expire until Nov 2013.[10] Generic Propecia will not be legally available in the United States for some time, although it can be purchased online from overseas pharmacies.
[edit] References
- http://www.phc.vcu.edu/Feature/oldfeature/finasteride/finasteride.html by Cynthia S. Dowd, Ph.D.
- ↑ [1]
- ↑ [2]
- ↑ [3]
- ↑ Template:Sv icon Ger Propecia nedsatt sexuell funktion efter avslutad behandling?, 2006-12-11
- ↑ Layden, J.; Dunlap F, Miller B, Winters P, Lebwohl M, Hecker D, et al. (in press). "Finasteride in the treatment of men with frontal male pattern hair loss". J Am Acad Dermatol.
- ↑ Center for Drug Evaluation and Research, Application Number NDA 20-788 (PDF). U.S. Food and Drug Administration.
- ↑ 7.0 7.1 Letter to Dr. Sherman Frankel, University of Pennsylvania (PDF). U.S. Food and Drug Administration.
- ↑ http://www.nci.nih.gov/newscenter/pressreleases/PCPTQandA
- ↑ Primary Patent Expirations for Selected High Revenue Drugs
- ↑ fda.gov - Patent Expiration for Propecia
[edit] See also
- Dutasteride
- Search for "Finasteride" at: HairLossTalk.com, HairLossHelp.com, Hairsite.com
[edit] External links
- Propecia Manufacturer's website
- Proscar Manufacturer's website
- Propecia Research Latest studies