Month: November 2007

I have been taking Propecia since April 2007. Within one month of beginning the prescription, I began experiencing severe left shoulder pain without any prior traumatic event, injury or prior symptoms. I am still taking Propecia (prescribed dosage),and the pain continues. I am in physical therapy now for what they have diagnosed as “shoulder impingement”, but I wonder if I stopped Propecia if it would have any effect.

Have you heard of anyone else having this issue with acute joint pain while taking Propecia?

Thank you

No, I have not heard of this correlation (if it is a correlation) from any of my patients, though there have been a few reports from readers that I’ve received by email over the years of writing this blog. If you believe Propecia is causing the shoulder pain, you can try not taking Propecia for one week and see if your symptoms resolve. Stopping Propecia for one week should not have a negative impact on your hair loss treatment course. Keep in mind that there is also the power of a placebo effect when you start or stop a substance or an activity.

Paid advertisements (not an endorsement):

Dr.,

I have been on propecia for a around 2 years now. Recently I have developed Peyronie’s disease, which is utterly demoralizing and far worse than any hair issue I could imagine. Immediately I began searching for possible links between DHT deficiency and structural abnormalities that can dispose a person to penile fibrosis. I didn’t have to search long or hard:

Effect of androgen deprivation on penile ultrastructure

Recent insights into androgen action on the anatomical and physiological substrate of penile erection (human study)
^^^ more proof that androgens are necessary for proper sexual function in men

The Effects of Transdermal Dihydrotestosterone in the Aging Male: A Prospective, Randomized, Double Blind Study (human study)
^^^ take away DHT, you lose sexual function/libido — restore it, you recover function

Dihydrotestosterone is the active androgen in the maintenance of nitric oxide-mediated penile erection in the rat
^^^ DHT is necessary for NOS production so you can get an erection

My penis is hardly functional and I am quite upset that nobody showed me these studies before I took the drug. I acknowledge that it is not definite propecia is the cause. But does this research not certainly point in that direction? I feel betrayed by the FDA. This is not on any warning label, and I must live with this for the rest of my life.

Thank you

p.s. I am 20 years old

I am sorry for the problem that you are going through. As a physician all I can do is to follow the evidence based medication before convincing myself to prescribe a medication and that is pretty much true about every medication. As of yet, there is no evidence to show any ‘stastical’ association between finasteride use and Peyronie’s disease. The data that you found during your search points out different aspects of the effects of male hormone on sex function. Based on all available literature, there is really no evidence that can associate Peyronie’s disease to the use of DHT blockers.

The sexual side effect of finasteride is well documented and the question for us is whether we should include this type of disclaimer for all patients considering the use of finasteride. I personally spend a long time explaining the potential side effects of the medication to my patients, as well as discussing the commonly known and published potential complications. I make sure that patients can make an informed decision before starting the medication. I also offer methods for my patients to minimize or treat side effects should they occur. I appreciate your symptoms and belief that there is a connection in your case. I will send this blog posting to Merck, maker of Propecia, for any comments that they may have and will post a follow-up if/when I receive a response.

For more on Peyronie’s disease, see University of Virgina – Urology.

Hi from England.

It was mentioned on this blog that no reputable company would infringe on the patent Merck has for 1mg finasteride. However, this is irrelevant because if the drug is made abroad (e.g. by Cipla in India)the patent only applies to the process used to make the drug.

1mg Finasteride is 1mg Finasteride. Truth be told, Merck are ripping people off, and all for a brand name. I’m currently taking a reputable “generic” and my hair is improving after 5 months. Ah the wonders of the free global market.

Like I said, 1mg Finasteride is 1mg Finasteride.

I allowed the comments about Merck, because they reflect a view that may or may not be correct. Patents generally extend to the markets where the patented products are sold. I can not comment on the finasteride patent, for I don’t have an answer for you. As representatives from Merck do read this blog regularly, maybe someone from within the company would send me an email and I would either post it or reflect upon the content in it without posting the full communication.

I am not a lawyer and would have to review all of their documents in detail to render a layman’s opinion, something that will not add value to you or your question.

Paid advertisements (not an endorsement):

Doctor, I hope you find the time to answer this question. Today is my first day on propecia. I shave my head so my balding won’t be so noticable-for which I hope to stop after a few months(case being if propecia works). Does shaving the head limit the effectivness and growth of new hairs on propecia?

Next, you know it’s flu season. Right now i’m taking anti-biotics: Amoxicillin 500mg and PSE-GFN 120mg; does this affect propecia and the effectivness of it?

Thanks

Shaving your scalp will not impact the value of Propecia, but you will not see its effectiveness on the miniaturization issues to know if and to what degree it is working.

Antibiotics can be used with Propecia and there should be no reaction. The flu is a virus and antibiotics will not kill the virus, contrary to common belief.