Category: Drugs

Dr. Rassman,

I am a 22 year old male who just started on Propecia. I am currently taking Lamictal and Lithium for anxiety, do you think these drugs could interfere with the effectiveness of propecia?

You should always check with your prescribing doctor or pharmacist if you have questions about any medications interacting, but the probable answer is no.

For what it’s worth, Drugs.com shows no known interactions in their database:

• Lamictal and Propecia
• Lithium and Propecia

I bought generic 5mg finasteride at costco to save money, but now I’m really confused. The 5mg pills, blue color, are the EXACT same size as my 1mg propecia that I have left over. I even took both of them out, put them next to each other, and compared them.

How will cutting the 5mg finasteride into 4-5 pieces give you 1mg finasteride for hair loss like the original 1mg propecia? The pill is way smaller when you cut it into 4 pieces. So how is the 5mg finasteride, which is the same size as the 1mg propecia, have different potencies? I’m worried that cutting the 5mg generic finasteride like I was told will not really give me the 1mg. Please help. Thank you.

You should speak with the pharmacy. Maybe they got the pills mixed up? I haven’t seen every generic pill out there, but I wouldn’t expect the 5mg to appear exactly the same as the name brand Propecia.

Dr. Rassman,
I have been taking propecia for a little over three months now and I have not noticed that my shedding has slowed. My doctor put me on the propecia without any kind of real analysis. I expected a more scientific approach. For example, why not take blood or hair samples to see how much DHT is in my system before starting the drug… then a few months later check again to see if the DHT level is lower? Then adjust the dosage of propecia accordingly. Does anyone do this? Or is it always this rough experiment?

If a doctor can make a diagnosis of genetic androgenic alopecia, then one of the medical treatments for men is Propecia. You do not need blood tests to confirm genetic androgenic alopecia and you do not need a blood test to start Propecia.

For example, if you have high blood pressure, or hypertension (HTN), there isn’t a blood test you need have done before starting a blood pressure lowering medication. If you have a diagnosis of HTN, the doctor will put you on a medication and your blood pressure will be monitored. If you are on Propecia for hair loss, you hair loss status will be (should be) monitored with miniaturization tests, hair bulk analysis, and even photos.

Studies were done (approved by the FDA) that show the best and most effective dose for Propecia based upon safety and this does not require blood test or monitoring. This is not an experiment and I would not know what blood tests you think are needed. Dosages of finasteride (Propecia) are fixed by the drug company’s studies. Propecia does not require monitoring or adjusting of the dosing. Measuring testosterone or DHT in your blood stream will not impact how you take the drug or how the drug will respond. There is no clear correlation.

Hello doc,

I’m 26, almost 27 years old and have chronic telogen effluvium for almost 18 months. I’m losing a lot of hair everyday on top, front and in the back; all-over. My question is.. Is it possible that CTE can recede a hairline a little? Less volume.. and little receding.. Is it possible to use minoxidil for CTE? What side-effects does minoxidil have with collagen, acne and wrinkles?

I do not believe there is a medication that really works (or proven to work) for treating telogen effluvium. If you have a diagnosis of chronic telogen effluvium, I would unfortunately think that your response to a drug would be even less. I don’t think it would help to a point that you’ll be able to notice worthwhile gains, but I suppose it doesn’t hurt to try.

Take note that some people who try Rogaine (minoxidil) report increased shedding in the first several weeks. I don’t know of any studies that show minoxidil causes wrinkles or aging in humans, though there was a mouse study about minoxidil on collagen synthesis from from years ago. Lots of anecdotal stories are on the Internet though, so take that as you will.

If you apply the minoxidil all over your head, be aware of the complications and/or side effects listed in the literature given in the package insert.

Hi,
I’m 19 and i have currently been taking proscar cut into 4 for nearly a month now. i have no real problems apart from the top of my cheek on the left side of my face under my eye feeling a bit weird like it is numb. at first it was really annoying so i stopped taking the proscar until it went away, which was about a week. After it went i started to take the drug again to see if it came back, which it did, but it is less noticeable and it fades off a bit during the day.

I have looked around on the internet and i have seen little on this side effect so was wondering if any of your patients have had this and if they ended up getting more serious side effects later due to this or not? I cant go to my doctor about this because i order off one of them online sites and he does not believe any hair loss drug such as finasteride or Minoxidil work anyway, so would be wasting time. so wondering if you know anything about this?

It would be highly unusual in my experience, but there are very rare reports of mild neurologic sensory side effects reported. I personally have never seen it at my practice in thousands of patients whom I have treated.

Whenever you have a complaint, you need to see a doctor, as it would be wrong to attribute your symptoms to the drug alone. For example, a brain tumor could present this way. I did not mean to scare you, but just to show you that this is not a mix and match (symptoms and disease) on a random basis. Doctors significantly add value to the analysis of complaints such as yours.

I am a pharmacist and I think someone is “playing” me to get some finasteride. He got #60 5mg tabs yesterday (a Saturday) and told me this morning that a hotel maid threw them away when she cleaned his room. I do not know the patient; he has traveled here for work. He is young and told me that he cuts the 5mg in quarters for hair loss. I told him I would contact his MD Monday morning. This bugged me all day and I can’t find much about finasteride abuse but none of it is sitting right with me.

I saw this page on your site (The Impact of Higher Doses of Propecia). Are people abusing finasteride? I don’t really want to provide this guy with more finasteride, even if I get a new prescription from his physician. I’d appreciate your help.

You may be right, and the lost prescription may be a ‘tool’ for supplying his friends with the drug. Or it could just be that a hotel maid threw out his pills. This is a judgment call for you as a pharmacist and for his doctor who would know him better.

Finasteride is not an addictive painkiller or something like that which tends to be abused.

I have been on propecia for about 10 years now with great results. Still a NW1-1.5. Just last year my pharmacy stopped putting my propecia in the original bottle with the silica packet/capsule to keep it fresh and block out humidity. They started putting it in those orange plastic cylinder bottles. So this past year I have noticed more hair thinning in the crown a bit and on the right side. I have been using this non original bottled propecia for about a year now and noticing thinning. Haven’t noticed much shedding but thinning though. This past month I went to a another popular retail chain and got propecia in the regular bottle with the silica packets/capsules in like how I had it before. I am noticing sheds now around 15-25 hairs but most of them are regular thick dark hairs. Maybe 5 of those hairs on thin miniaturized ones.

My question is was the non original bottle propecia pills destroyed by not having the capsules in it? Is losing 15-30 hairs a day in the shower a sign of propecia working again and I am going through a mini shed that will grow back as a start of a new treatments since the destroyed propecia didnt count as medication since they were not working? Are thick dark hairs a bad sign to shed compared to thin miniaturized ones?

I am so confused on what to do..Any help would be greatly appreciated

I am not a drug manufacturer or a pharmacist, so I can’t speak with direct knowledge about pharmaceutical packaging. Silica packet are there to absorb moisture, so unless you are storing your medication in a sauna, it’s my opinion that it would not have much impact on the efficacy of the drug.

Normal non-balding men and women can lose 100+ a hairs a day, but I don’t quite follow the questions you posed at the end of your email. Losing 15-30 hairs in the shower doesn’t prove that Propecia is working or not. There is a big market for counterfeit drugs, even in good pharmacies, so you should be careful when buying these drugs.

With all that said, I am not sure if a Norwood 1 would really even benefit from Propecia, but that is another topic.

Hi Dr Rassman, have you seen the latest findings on the prostate cancer prevention trials? The current info seems like good new for finasteride users.

see link — Finasteride Reduces the Risk of Low-Grade Prostate Cancer in Men 55 and Older

Yes, this is a consistent finding by the government sponsored studies.

Here’s the summary:

“Long-term follow-up results from a phase III trial called the Prostate Cancer Prevention Trial (PCPT) continue to show that regular use of finasteride (Proscar®) for up to 7 years decreased the risk of low-grade prostate cancer in men age 55 and older compared with that in men who received a placebo. Although high-grade cancers were more common in the finasteride group, the finasteride and placebo groups had similar 15-year overall survival rates.”