Finasteride

Reduce hair loss with Finasteride (generic Propecia)

Finasteride is a prescription drug used by millions of men all over the world to fight male pattern hair loss. It’s well-tolerated in long-term use and has proven effective in many studies.

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Information

Reviewed by Dr Yasmin Aghajan, MD

Information last reviewed 07/20/19

About

What is Finasteride?

Finasteride, also known by the brand name Propecia, belongs to a class of drugs known as testosterone 5-alpha-reductase inhibitors. Finasteride is a prescription treatment used to treat hair loss in men (male pattern baldness). Finasteride is also used to treat enlarged prostate.  Finasteride is not intended for use in women and children, although in certain circumstances, it may be recommended by a doctor.

How does Finasteride work?

Finasteride is a type of medication known as a 5-alpha-reductase inhibitor. 5-alpha-reductase is the enzyme that converts testosterone into dihydrotestosterone (a hormone that stimulates the development of male characteristics, an androgen). Too much dihydrotestosterone has shown to be implicated in benign prostatic hyperplasia, prostate cancer and male-pattern baldness. As such, the 5-alpha-reductase inhibitor that Finasteride contains blocks the action of this enzyme by preventing testosterone from breaking down into dihydrotestosterone, which increases the levels of testosterone and improves hair growth.

Ingredients

Active ingredients

Finasteride tablets contain the active ingredient finasteride at a concentration of 1mg. Finasteride is a 5-alpha-reductase inibitor which increases the levels of testosterone, promoting hair growth. 

Inactive ingredients

Finasteride also contains the following inactive ingredients: lactose monohydrate, microcrystalline cellulose, pregelatinized starch, sodium starch glycolate, hydroxypropyl methylcellulose, hydroxypropyl cellulose LF, titanium dioxide, magnesium stearate, talc, docusate sodium, yellow ferric oxide, and red ferric oxide.

Dosage

How to take Finasteride

Finasteride is a tablet for long-term use and should be taken continuously for at least three to six months in order to start seeing the full effects. Take Finasteride tablet orally (by mouth) with a glass of water, with or without food. The recommended dosage is one tablet (1mg) taken once daily, or otherwise as prescribed by your doctor. For optimal effect, take this medication regularly and preferably at the same time each day. It may take up to 3 months for the effects to show. If you stop taking Finasteride, your hair loss symptoms may come back, possibly within 12 months.

Important: Before taking Finasteride, inform your doctor about your medical history, especially if you have had liver disease, prostate cancer, infections, urinary problems.

Finasteride dosage

The recommended dosage of Finasteride is a single 1mg tablet, taken once a day, at approximately the same time. In some situations, a doctor may prescribe a different dose. You should always follow the instructions of the prescribing physician when taking any medication. 

Side Effects

Side Effects

Get immediate medical help if you experience signs of an allergic reaction to Finasteride: skin rash (which may be itchy), swelling of your face, lips, tongue, throat; difficulty breathing.

Possible side effects:

  • Decreased libido (sexual desire)
  • Erectile Dysfunction (inability to get and maintain an erection)
  • Erectile Disorder (decreased volume of ejaculation)

Talk to your doctor immediately if any of the following serious side effects occur:

  • Lump in the breast
  • Nipple discharge
  • Breast enlargement/tenderness/pain
  • Pain in the testicles
  • Inability to urinate

Contraindications

Finasteride is contraindicated in pregnant or potentially pregnant women as Finasteride may cause abnormalities of the external genitalia of a male fetus. As such, pregnant or potentially pregnant women should not even handle crushed or broken Finasteride tablets because there is a possibility of absorption of finasteride.

Drug interactions

Finasteride does not have any known interactions with other medications. In the clinical studies where Finasteride 1 mg or higher was used with other drugs, there was no evidence of clinically significant interactions with the other medications. 

Treatment Options

Treatment Options

Finasteride versus Prostaglandin Analogues (Latanoprost and Bimatoprost)

Finasteride is the most commonly prescribed medication for the treatment of male pattern baldness (MPB). Finasteride provides an improvement in hair count and thickness. Results are typically notable in 6 months to 1 year with Finasteride 1 mg once a day. Finasteride is not approved for women with hair loss because it causes birth defects in male embryos. 

Prostaglandin Analogues are medications used to treat ocular hypertension and glaucoma. However, these medications (Latanoprost and Bimatoprost) have been shown to increase hair growth. In clinical studies, Latanoprost significantly increased hair density. There was some evidence to suggest that this medication might also promote pigmentation of the hair. 

Other treatment options for MPB include laser treatment, anti-androgens, Minoxidil (Rogaine), and surgical treatment. Other treatments are under investigation.
 

Q&A

Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.

  1. Drugbank, ‘Finasteride’, [website], 22 April 2019, https://www.drugbank.ca/drugs/DB01216 [last accessed 23 April 2019]
  2. Drugs.com, ‘5-alpha-reduced inhibitors’, [website], 1 April 2019, https://www.drugs.com/drug-class/5-alpha-reductase-inhibitors.html [last accessed 23 April 2019]
  3. WebMD, ‘Finasteride Tablet 5 Alpha-Reductase Inhibitors’, https://www.webmd.com/drugs/2/drug-1548-9167/finasteride-oral/finasteride-hair-growth-oral/details [last accessed 23 April 2019]
  4. Hims, ‘What Every Man Should Know About Finasteride for Hair Loss’, [blog], https://www.forhims.com/blog/what-every-man-should-know-about-finasteride-for-hair-loss  
  5. FDA, ‘Propecia’, [information leaflet], December 2010, https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020788s018lbl.pdf [last accessed 23 April 2019]
  6. Drugs.com, ‘Finasteride Drug Interactions’,  [website], 1 April 2019 https://www.drugs.com/drug-interactions/finasteride.html [last accessed 28 April 2019]
  7. Harvard Health Publishing, “Should I Worry about Finasteride Side Effect Reports?” (Harvard Health) <https://www.health.harvard.edu/mens-health/should-i-worry-about-finasteride-side-effect-reports> accessed July 18, 2019 
  8. McElwee KJ and Shapiro J, “Promising Therapies for Treating and/or Preventing Androgenic Alopecia” (2012) 17 Skin Therapy Letter 
  9. Meidan VM and Touitou E, “Treatments for Androgenetic Alopecia and Alopecia Areata” (2001) 61 Drugs 53 
  10. Shency NK and Prabhakar SM, “Finasteride and Male Breast Cancer: Does the MHRA Report Show a Link?” (2010) 3 Journal of Cutaneous and Aesthetic Surgery 102

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