Two Cases of Stroke Associated with the Use of Finasteride, an Approved Drug for Male-Pattern Hair Loss in Japan

The document describes two cases of young men in Japan who suffered strokes while on finasteride, a medication for male-pattern hair loss. The first, a 35-year-old, had been on 1 mg/day of finasteride for six months before experiencing a headache and seizures, leading to a diagnosis of sinus thrombosis and successful treatment with anticoagulants. The second, a 41-year-old, was on 1 mg/day of finasteride and 6 mg/day of minoxidil for two years before a brain MRI showed a stroke in the left parietotemporal lobe, with subsequent recovery after treatment with antiplatelet and anticoagulation medications. The Japan PMDA reported 14 cases of thrombosis linked to finasteride, including strokes and myocardial infarctions. The paper suggests finasteride may raise estrone and estradiol levels, potentially leading to thrombosis, and emphasizes the importance of considering finasteride use in patients with unexplained strokes.