Finasteride

Originally used as a treatment for prostate cancer, finasteride is the chemical name for Proscar (5% finasteride) developed by Merck. Merck discovered one of the side effects Proscar was the stop of hair loss, and hence consequently created Propecia (1% finasteride) as a non-surgical solution for hair loss. Merck’s Propecia’s patent will expire in November 2013, and Proscar’s patent expired on June 19th 2006. Currently in the market, finasteride is available under the following brand names: Proscar, Propecia, Fincar, Finpecia, Finax, Finast, Finara, Finalo, Prosteride, Gefina, Finasterid IVAX, Finasterid Alternova

How Finasteride stops hair loss.

Clinical Trial

Proscar, Propecia, Fincar, Finpecia, Finax, Finast, Finara, Finalo, Prosteride, Gefina, Finasterid IVAX, Finasterid Alternova 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 a further 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. In clinical studies, Propecia, like minoxidil, was shown to work on both the crown area and the hairline, but is most successful in the crown area.

Treatment

Finasteride is effective only for as long as it is taken; the hair gained or maintained is lost within 6-12 months of ceasing therapy. The clinical trials were based on men aged from 18-41 years old, who had mild or moderate hair loss at the crown and frontal areas. Hair growth was seen within in a period of 3 to 12 months. No studies have been carried out to test the effectiveness of Finasteride on individuals who are over 41 and who experienced severe hair loss.

Side - Effects

Around 1% of finasteride users experience side-effects: erectile dysfunction and gynecomsastia. Side-effects cease after the user stops medication, however this means that hair loss returns.

Finasteride reduces DHT production, this causes a rise in testosterone levels, because testosterone that would normally be converted into DHT remains testosterone. Continual high levels of testosterone in the body could possibly have negative side effects.

Finasteride reduces DHT production, this causes a rise in testosterone levels, because testosterone that would normally be converted into DHT remains testosterone. Continual high levels of testosterone in the body could possibly have negative side effects.

At the same time, artificially low levels of DHT is also harmful to the body. Men also produce a small amount of the female hormone estrogen. DHT works as an antagonist of estrogen, by reducing DHT with drugs, a man’s protection from the effects of estrogen may also be reduced. This could result in gynecomastia.

Possible health concerns

The UC Berkeley Wellness Letter expressed concern in March 2003 about the unproven long-term safety of Propecia (finasteride) and recommended cutting a standard 1 milligram dose of Propecia into quarters to reduce the cost without reducing its effectiveness (meaning that each dosage is 0.25mg).

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. Some people have unsuccessfully petitioned the FDA to re-examine the approved dosage in light of the statistical evidence and unknown long-term risks. 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.

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.

Finasteride and Women

Finasteride 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.

Finasteride and Pregnancy

Women are recommended to not use finasteride. As stated earlier, Finasteride is in the FDA pregnancy category X. This means that there is positive evidence of human fetal risk. Evidence has shown that finasteride mainly effects male fetus – specifically in it’s the development of abnormalities of external genitalia.

Women who are or who may become pregnant must not handle crushed or broken finasteride tablets, (e.g. splitting Proscar pills) because the medication could be absorbed through the skin. 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.

Finasteride and Sports

Since 2005, finasteride has been on the World Anti-Doping Agency's list of banned substances. Notable athletes who used finasteride for hair loss and were banned from international competition include skeleton racer Zach Lund, bobsledder Sebastien Gattuso, and ice hockey goaltender Jos-Theodore. Many sports organizations have banned finasteride because it can be used to mask steroid abuse. See these articles: http://www.tsn.ca/nhl/story/?id=154231 http://www.ishrs.org/articles/olympic-athletes.htm

Cost of Treatment Analysis

Propecia (1mg of Finasteride)

Proscar (5mg of Finasteride)

The size of the Proscar pill and the Propecia pill are identical, and the price is roughly the same. However, as Proscar’s price is roughly the same as Propecia, there are many users who purchase Proscar and CUT the pill into quarters. This makes their dosage 1.25 mg per day.

The change in dosage from 1mg to 1.25mg has no proven difference in the efficacy of Finasteride. However, there are dangers when cutting the pill. It is unadvisable to split the Proscar pill 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. In fact, it is finasteride is in the FDA pregnancy mcategory X. (products to avoid when pregnant).

Budgeting for a Non-Surgical Chemical Treatment

Note: Once you stop your finasteride treatment, hair loss will resume and all the new hairs grown will fall off within 6-12 months.