Month: January 2023

Hi Doc,

So a little background. Have been on finasteride for approximately 8 months. I think its working, since I have not progressed at all and maybe perhaps (don’t know if its my mind playing tricks) have seen very slight thickening.

I asked you a similar question before regarding the generic finasteride from pharmascience. You stated that I should be good with this drug as the company is a reputable one here in Canada.

However today my question is about the 5MG. I take that and cut it into quarters and have been doing so since the beginning of my treatment (so that its cheaper for me)…I read somewhere on your site that this is not recommended….and some people/doctors claim that the ingredients of the pill are not equally divided??? could you elaborate on this…am I fine with what I do or should I switch to the generic 1MG (which is available in Canada)…do you roughly (again roughly) still get 1.25 if you quarter the pill with a pill cutter?? So just wondering if I may be loosing ground with what I do, or that I am infact fine with the above regimen?

Thanks in advance

I am not sure where you read on this site that cutting the 5mg finasteride wasn’t recommended, but I’ve been suggesting doing this for years. You just need a doctor to prescribe the higher dose with the instruction that the pill is to be cut.

Cutting a 5mg tablet of finasteride in quarters is just as good as taking a 1mg pill. In a perfectly ideal world the drug companies would make a 1mg version and sell it cheaper than the 5mg version, but for now the 5mg version is about $30 for 90 pills while the 1mg version is $100 for 90 pills.

So in the interest of cost savings, you can cut the 5mg version into four pieces to make 1.25mg. If you know how to cut a small pill into 5 equal pieces to make 1mg each, go for it! In general, when you cut the pill you will never be precise and you may get more or less 1.25mg. This is alright in my opinion as long as you consistently take the medication on a daily basis. My reasoning behind this is that studies show 0.5mg is almost as effective as 5mg dose, so the daily variation should not matter as long as the drug is taken on a consistent basis.

Hi Dr. Rassman,

I’ve been on Propecia and Rogaine for 3 years and have been delighted with the results……up until now. Propecia and Rogaine thickened the hair all over my scalp and slowed the regression of my hairline. Unfortunately, it’s becoming apparent that my crown is now thinning, an area that had been strong prior to treatment.

I’m 28 now, and, if possible, I’d like to keep my crown hair for another few years, what are my options?

1) Would upping propecia dosage ever be advisable for a 28 year old?
2) Should I consider Avodart off-limits until it is FDA approved for hair loss?
3) What would you do if you were in this situation?

I’ve a check up with the doctor (who I’m very happy with) that originally prescribed the treatment in a couple of weeks, and will pose the same questions to him. However, your opinion is really important to me, and will help inform any decisions I may have to make. All the best

Upping the dose of Propecia (finasteride) usually does not work in your situation. Rogaine (minoxidil) is fairly effective in the crown and worth trying. Avodart (dutasteride) is an option and some doctors will prescribe it, however, the long term risks of sterility are there (probably remote), and the side effects are more frequent than on Propecia.

Try the minoxidil and give it at least 6 months. Then reassess your situation.

Since taking propecia for three months then switching over to avodart for a further six months, i seemed to be very agrivated all the time and angry to the point were i was arguing and getting into fights. Is there any connection with this and taking avodart.

Why the switch to Avodart (dutasteride) from Propecia (finasteride)? Propecia is the only FDA approved oral medication for the treatment of hair loss. Avodart is not. If the Propecia was working well for you and had an acceptable side effect profile for you, you should go back to using it. Avodart has not been shown to help with male pattern baldness better than Propecia unless the dose is three to four times higher than recommended dosages and even this information is suspect. Since it may be causing you severe emotional issues, you should strongly consider stopping this medication. We do on rare occasions see personality changes with these drugs. You may also consider talking to your doctor or therapist about your anger issues if in switching, your anger has not subsided.

I read someone’s comment in one of your blog entries from long ago, suggesting that Avodart was seeking approval from the FDA (something about being in Stage 2 trials). We know it hasn’t gotten FDA approval, but are they actually seeking it?

There is a report just published two weeks ago on the U.S. government website ClinicalTrials.gov which indicates that phase III clinical trials are in process for Avodart in Korea. That is great news for us, because the indications are strong that Avodart (dutasteride) will be more effective than Propecia for the treatment of male patterned genetic hair loss. The most pointed questions which need to be answered are the frequency of side effects, particularly sexual libido supression.

There are some studies out there proving the efficacy of Avodart (dutasteride) for prevention of hair loss. It is documented that blocking type one 5-alpha reductase may be as important as type two in treatment of baldness. Unfortunately, the study done at Duke University, published in December 2006, is limited to 24 weeks and we don’t have enough information on the long term effects of dutasteride on hair loss.