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Finasteride (Propecia)

What Is Finasteride (Propecia)

Finasteride is a remedy for stopping hair loss. Sometimes finasteride also allows new terminal hair to grow back, but this is rare. It is believed that the main goal is to stop further baldness. This medication is taken as tablets orally every day. Propecia, a finasteride-based drug, is approved for use by the U.S. Food and Drug Administration (FDA or USFDA, a government agency under the U.S. Department of Health). It is one of only two drugs approved by the FDA for the treatment of alopecia.

Description

The only finasteride-based medication for stopping baldness is Propecia. This drug has 1 mg of finasteride per pill. To treat baldness, 1 tablet a day is taken. There is also Finpecia, the Indian analog of Propecia (produced by the pharmaceutical company CIPLA), which does not differ from Propecia in composition and dosage – each tablet contains 1 mg of finasteride. This drug is much cheaper than Propecia.

But there are also other drugs in which the active ingredient is still the same finasteride, but which are designed to treat adenoma of the prostate. They do not differ in composition but differ in the dosage of finasteride in each tablet, which is increased to 5 mg compared to Propecia and Finpecia. These include Alfinal, Vero Finasteride, Penester, Proscar, Prosteride, Finasteride, Finast and others.

Phase III trials of Propecia were conducted over several years. The trials involved 60 dermatology clinics (33 in the U.S.) and 1,533 volunteers. Of that number, 1,215 volunteers continued to participate in the Propecia trial for the second year. Participant ages ranged from 18-41 years. The degree of baldness according to Norwood was 3-5. All participants took 1 mg of Propecia or placebo each day.

Objective and subjective measures were used to assess the results. The subjective analysis included questioning participants about their treatment outcomes. The objective analysis included measurements of hair density and thickness, duration of the anagen phase, and other measures. Subjective and objective measures were assessed by dermatologists who did not know what the participants were taking (Propecia or placebo).

The first year of the trial showed these results:

  • an increase in hair density of +86 per 1 inch2 (+11%) for those taking Propecia;
  • reduction in hair density -21 per 1 inch2 (-2.7%) for those taking Placebo;
  • new hair growth in 48% of those taking Propecia;
  • new hair growth in 7% of placebo users;
  • 30% (of 48%) slightly noticeable new hair growth for those taking Propecia;
  • 18% (of 48%) noticeable new hair growth for Propecia users;
  • 6% (of 7%) slightly noticeable new hair growth for those taking Placebo;
  • 1% (out of 7%) noticeable new hair growth for those taking Placebo.

The second year of the trial showed no further increase in hair density. But further improvements in overall hair health were noted, which was due to an increase in the anagen phase and diameter of the hair shaft. Patients taking placebo continued to lose hair.

Finasteride inhibits 5-alpha reductase type 2, which is about 70% of all 5-alpha reductase in the body. But there is also 5-alpha reductase type 1, which is not affected by Finasteride for hair loss. Therefore, this enzyme continues to exist in the hair follicles. In addition, if the follicles are hypersensitive to dihydrotestosterone, even a small amount will be enough to continue hair loss.

Propecia vs placebo

Finasteride Uses

First of all, make sure that hair loss (alopecia in the scientific sense) is not a hereditary problem. If it is, you need to get the process under control as early as possible. Contact a trichologist: he or she will prescribe medications, prescribe laser treatment or suggest transplantation. If it’s not genetics, but your hair has started to fall out more than usual, then look for the cause of the improper functioning of the body and consult a general practitioner.

It can be hormonal disorders associated with thyroid disease or taking low-quality contraceptives, prolonged Finasteride uses of antibiotics or antidepressants, infectious diseases, as well as diets that do not include beneficial elements for humans. The problem of loss can also occur due to anemia – a decrease in the concentration of hemoglobin in the blood. Finasteride is taken orally regardless of meals, 1 tablet (5mg) per day for 6-7 months.

How It Works

Finasteride, once in the bloodstream, binds to 5-alpha reductase type 2 instead of testosterone, thus preventing the conversion of testosterone to digital testosterone.

Finasteride inhibition curve

What Are The Possible Finasteride Side Effects

Finasteride side effects of finasteride include reversible loss of libido, decreased ejaculate volume, and erectile dysfunction, which occurs in about 2% of men. Long-term sexual dysfunction (post finasteride syndrome) has been reported, but its incidence is unknown. Rare side effects of finasteride have also been reported: mood changes/depression; gynecomastia; testicular pain; hypersensitivity reactions.

Common Side Effects

In the original study of finasteride, these side effects were found in only 2% of patients. However, a recent study has questioned the validity of this claim. It found that out of 34 clinical trials, none had adequate safety reports. Among the most shocking revelations about these trials were the following:

  • 53% disclosed a conflict of interest;
  • 56% had funding from the manufacturer;
  • 76% had a drug safety evaluation duration of less than 1 year.

If true, the incidence of sexual side effects from finasteride (Propecia and Proscar) may be much higher than the originally stated 2%. Because of its anti-androgenic properties, Finasteride is sometimes used in hormone replacement therapy in transgender men in combination with a form of estrogen. However, there are too few clinical trial data on Finasteride’s use for this purpose and the evidence for its efficacy in this area is very limited. Indeed, Finasteride, compared to conventional antiandrogens such as spironolactone and cyproterone acetate, is a significantly weaker substance.

Common Side Effects:

  • Breast Lumps
  • Breast Pain Or Tenderness
  • Nipple Discharge
  • Any Other Breast Changes

In addition, its use is associated with a high risk of developing depression and anxiety in both men and women; transsexuals are at particularly high risk because such symptoms are very common among this group of patients. Therefore, it is not recommended that Finasteride be prescribed as an anti-androgen for transsexual men because the drug increases the risks of harmful emotional side effects. Finasteride has also been found to help mitigate the effects of withdrawal after chronic alcohol use.

Serious Side Effects

UK pharmacovigilance has data on several cases of major depression and suicidal ideation in patients receiving finasteride. However, these side effects have been reported in patients with and without a history of depression.

  1. It should be noted that cases of depressive mood have been reported before on finasteride. However, a recently published review suggests a potential risk of major depression. It is likely that this data will serve as a reason to update information about the drug.
  2. Practitioners and patients should also be aware of sexual dysfunction that may be associated with taking finasteride. These include decreased libido, erectile dysfunction, and impaired ejaculation (reduced ejaculation volume).

Many sports organizations have banned Finasteride because the drug can be used to disguise steroid use. Since 2005, Finasteride has been on the World Anti-Doping Agency’s list of banned substances. However, the drug was removed from the list in 2009. A number of famous athletes who had used Finasteride as a remedy for hair loss and had been excluded from international competitions are skeleton Zack Lund, bobsledder Sebastian Gattuso, soccer player Romario, and ice hockey goalie Jose Theodore.

Serious Side Effects:

  • Loss Of Interest In Sex.
  • Impotence.
  • Trouble Having An Orgasm.
  • Abnormal Ejaculation.

Women of childbearing age and pregnant women should avoid contact with the drug, it has teratogenic properties (its ability to inhibit the conversion of testosterone into dihydrotestosterone may cause abnormal genital development in the male fetus), penetrates into the seminal fluid. Causes a decrease in prostate-specific antigen after 6 and 12 months of use by 41 and 48%, respectively. Patients should be screened to rule out prostate cancer during therapy with finasteride.

How To Take Propecia Finasteride

Taken orally with liquids and swallowed as a whole (tablets should not be divided or crushed), regardless of meals. The recommended dose is 5 mg (1 tablet) once a day. Duration of treatment is up to 6 months; if necessary, treatment may be continued until the clinical effect is achieved.

No dose adjustment is required in patients with hepatic impairment. Dose adjustment is not required in patients with renal insufficiency of varying severity (when CKD decreases to 9 ml/min). No dose adjustment is required in elderly patients.

Dosage For Male Pattern Hair Loss

In case of male pattern baldness: take 0.2 mg of the active ingredient once a day. Note that 1 tablet contains 1 mg o the active ingredient. Your doctor may adjust the dosage depending on your age and symptoms. But the maximum dose of 1 mg of the active ingredient per day should not be exceeded.

Finasteride DHT

Dosage For Benign Prostatic Hyperplasia

For benign prostatic hyperplasia: Take 5 mg active ingredient once a day. The prescribing physician may adjust the Finasteride dosage according to age and symptoms.

How The Medication Is Supplied

They are supplied as follows:

  • NDC 0006-0071-31 bottles of 30 (with desiccant)
  • NDC 0006-0071-54 PROPAK bottles of 90 (with desiccant).

Finasteride Dosage Forms And Handling

For the treatment of male androgenic alopecia androgenic, the recommended dosage of finasteride is 1 mg per day. The medication may be taken with or without food.

Storage And Handling.

Store the drug in a dry place protected from light. Keep out of reach of children.

Drugs, Substances, Or Supplements Interaction

Since other medications (Alfinal, Vero Finasteride, Pentester, Proscar, Prosteride, Finasteride, Finast, and others) contain 5 mg of finasteride in 1 tablet, you need to divide each tablet into 5 parts and take 1/5 tablet each day. This way you will get 1 mg of finasteride every day, just like when you take Propecia Finasteride.

 

PROPECIA

N=945

Placebo

N=934

Decreased Libido

1.8

1.3

Erectile Dysfunction

1.3

0.7

Ejaculation Disorder (Decreased Volume of Ejaculate)

1.2 (0.8)

0.7 (0.4)

Discontinuation due to drug-related sexual adverse experiences

1.2

0.9

 

Overdosage & Contraindications

Hypersensitivity, pregnancy, women of childbearing age, children. Take the drug with caution. Liver failure, obstructive uropathy. Patients received finasteride in a single dose of up to 400 mg and in multiple doses of up to 80 mg/day for 3 months, with no adverse effects observed.

There are no recommendations for specific treatment of finasteride overdose.

Finasteride Warnings

In patients with large residual urine volumes and/or sharply reduced urine flow, the possible development of obstructive uropathy should be closely monitored. The agency concluded that although there was no significant increase in the overall incidence of breast cancer in men in clinical trials when Finasteride was taken at a dose of 5 mg, the possibility of an increased risk of breast cancer in men cannot be excluded with Finasteride. A warning about this risk will be included in the product information. Merck has revised the warning on consumer and medical leaflets in the U.S. to include the risk of breast cancer in men.

Allergy Warning

Allergic reactions: common – skin rash; rarely – skin itching, urticaria, angioedema of the lips and face.

Warnings For People With Certain Health Conditions

Before initiation of therapy, diseases simulating benign prostatic hyperplasia – prostate cancer, urethral stricture, hypotension of the bladder, disorders of its innervation, and infectious prostatitis – should be excluded.

Contact With Drug Warning

People suffer from side effects when taking Finasteride (Propecia). Medications affect different people differently. However, taking finasteride is probably not as dangerous as some people imagine.

Propecia hair loss was approved as a treatment for hair loss in 1997, so it has been quite a long time. This drug has undergone many tests and has been proven safe. It has also been proven to be effective.

Alternatives To Finasteride (Propecia)

The results show that Ecklonia cava extract can be effective in the treatment of hair loss and can be used topically as a natural alternative to finasteride and minoxidil. Ecklonia cava even shows a stronger effect on increasing hair follicle length than minoxidil.

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