Month: July 2011

Hello,

We have generic here for Propecia, and on the instructions they say that on propecia we should use a condom during intercourse. It seems that it is pretty new, and there is nothing on the intructions of Propecia. My first kid is a boy and was born while I was using propecia. It seems normal.

Is there really a risk ? What is the position of Merck on it ? It seems that we have different opinion and it is quite difficult to have an opinion. Why this warning has appeared ?

Is there a proof somewhere that a newborn has trouble while the father was on propecia ? Thank you for your answer.

There must be thousands of boys born whose father’s took Propecia (finasteride) during conception.

We know that in the womb during the first 3 months, if a woman is exposed to sizable doses of finasteride it can alter the sexual development of the fetus. If the man was taking it, however, there is no evidence that the drug will cross to the woman and into the fetus. I know that the formal concerns are published and they are unfortunately more a statement of what the lawyers want the drug companies to say rather than a scientific observable risk.

I haven’t seen the Propecia packaging that mentions using a condom during sex, but I will also refer you to this letter we received from Merck about this very issue a few years back. In part, it states that “no significant mechanism-based or non-mechanism-based teratologic effects have been observed in infants born to women exposed to finasteride via semen during pregnancy.”

Hey doc, been using Propecia for 2 1/2 years its slowed things down a lot, just added Rogaine Foam last week. Just wondering if I can get a straight answer on the effectiveness of Rogaine Foam. The commercial says 85% of men see regrowth, ive heard other people say it only works for 50% of men and then I saw a post from you in your archive where you say it only works well for 15% of men. Well which one is it?

We are prisoners of our words, so I will stick to what I said.

If you are in the 15% of good responders, then it moves you into the 100% category (playing with numbers, or course). Some people feel that the Rogaine Foam works better than standard liquid Rogaine drops, because it is easier to use and thus better for those who find the drops difficult to titrate. If there are 85% of men that see some growth, I’d estimate that maybe 15% of men see it work very well.

I am male, 25 years of age, 5’11 and 152 pounds. I have hair on both sides of my head but barely any in the middle. If I use Rogaine foam on the middle spot, will it help regrow hair on just that spot you put it on or your whole head regardless?

If you’re going to use Rogaine Foam, you need to apply it to the areas of the scalp that are thinning. The same goes for the non-foam version of Rogaine. Just putting it on a small spot won’t be effective on the entire area of hair loss.

Be sure to read the instructions that are included in the packaging for information on dosage and application. You can also check the Rogaine site for simple application instructions.

I’ve received a few emails directing me to the a publication in the New England Journal of Medicine from last month regarding finasteride, dutasteride, and prostate cancer reduction. We’ve written about this issue here and specifically, albeit briefly, about this NEJM piece here. So I’ll take the opportunity to highlight it again, since people are still finding their way to the article.

The authors’ take on the relationship between the use of these drugs (finasteride and dutasteride) and the risk/benefit relationship on prostate cancer concluded that the original reports of a cancer reduction in the studied men (about 10,000 men who received finasteride 5mg dose) showed that the lower risk was found only in men with low grade cancers. If men had a high grade cancer, they felt that there would be no benefit to taking these drugs and suggested a possible harmful risk that is clearly ill-defined at this time. On the basis of this conclusion, the use of finasteride or dutasteride as a preventative medication for prostate cancer is claimed not to be justified.

The FDA came out echoing this sentiment. It appears that “the labels of approved 5α-reductase inhibitors, which are currently indicated for the treatment of symptomatic benign prostatic hyperplasia and male-pattern hair loss, have been modified to include the observation of high-grade prostate cancers” found in the relevant trials.

I am sure that one result of this formal, official FDA change in position is that some men will consider abandoning the use of these drugs. I will be attending the annual ISHRS physician meeting in September, where this subject will be discussed amongst many doctors who are concerned about this announcement. I’ll be curious to learn about patient reactions to the FDA’s position.