Category: Drugs

I have been taking a generic finasteride for 2 years now,with good results. I am paying about $600.00 Canadian for a one year supply.I recently saw an advertisment on line for finasteride for about half that price. My question is what do you think about me alternating every other day the two different genertic finasteride,just in case the cheaper one is not as good as the one I am already taking?

Assuming this other generic is really finasteride, it should be the same. There may be different filler ingredients, but as long as both contain 1mg finasteride, alternating shouldn’t be a problem. Be sure that the manufacturer is reputable and that they are approved for sale by the FDA which will provide some assurance of purity in what you are buying.

Keep in mind that this is your body you are dealing with, so if you don’t trust the cheaper unknown brand, you may consider not buying it. I can understand if it is a car or a house or anything else and you’re looking for a great deal, but I wouldn’t recommend skimping on medications. Online prescription drug sales are also suspect in my eyes, particularly when they’re imported from other countries and violate various laws.

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hi dr,
i just have a question about dutasteride. ive heard that the half life of the medication tends to persist longer then propecia. why cant we just then take it on a bi weekly basis or something instead of taking it daily like propecia which half life is 6 hours? wouldnt this be something to try? just thought id get your opinion. thanks for your time and answer in advance

Bi-weekly dosing makes sense, but it is not what I recommend today. Remember, the medication is still not FDA approved to treat hair loss at this point. Some people suggest taking 2.5mg, some suggest 0.5mg. Once the formal clinical trials are made public, many questions will be cleared up. I am not experimenting on patients, so you will have to find a doctor willing to do what you are asking. The half life of dutasteride is measured in weeks.

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Dr. Rassman,

Love the site….it is a great resource…….I am 39….and have had receding hair for years and slowly started thinning in the crown……I got serious with Rogaine Foam a couple of years ago and added Propecia to the mix about 9 months ago (maybe 10)…..I have noticed MUCH thicker hair (I can style it differently) and the crown is looking great….in fact, today, I got my hair cut and my stylist did a double take when she worked on the crown. She said, “You have HAIR growing here!” I said yes….and explained what I was doing and about your blog, etc….

To say it made me feel good is an understatement. I can tell a HUGE difference…..and I will send some pix in a couple of months (after being on Propecia for a year).

Please share my story with your readers. The fearful e-mails are silly! Go see a doctor! Propecia will only work if you try it and stick with it!

Good for you! Thank you for sharing your experience and I’m glad to hear it’s working well for you. I think in many cases, patients that see good results with Propecia would not feel compelled to share their experiences, as opposed to those that get on the bullhorn if they have or think they have a bad experience (I can’t blame them for that). It just creates an unbalanced field of reviews. Thanks again for your note.

So if I start a new regimen and regrowth occurs would it start out as thin hairs then gradually grow thicker and thicker? Kinda like a reverse minituarization?

When we talk about hair regrowth, we are talking about two different phenomena:

1. The growth of new hair that was not there prior to the use of the medications
2. The thickening of the miniaturized hairs that will make the hairs that are there, thicker

The studies on hair regrowth usually refer to hair counts that show more hair numbers after 9 or so months, but the reality is that much of the fullness that is created by medications like Propecia, actually reflects the thickening of hair shafts. I can see this when I compare the metric I get examining hair a year apart with the microscopic miniaturization mapping of the hair that I do in most patients.

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I know it requires DHT, genes and age for MPB to start. Propecia reduces DHT a major cause of MPB. Surely it doesn’t lower all DHT but enough to keep hair years and years for most men. You always say that genes will eventually win over Propecia. How is that possible? Propecia supresses DHT removing what’s needed for MPB genes to work! Since that’s the case shouldn’t Propecia forever? Or is it because of the remaining DHT that Propecia doesn’t supress works slowly with genetics until one day makes MPB progress despite being on Propecia? So in that case how come they haven’t found a drug for 100% DHT suppression yet? That would do the trick!

Finasteride (Propecia) blocks about 70% of serum DHT. By comparison, dutasteride (Avodart) blocks about 90% of serum DHT…. but nothing is 100%. Also, we know that it takes more than just blocking DHT to stop hair loss. Our adrenal glands do produce androgens as well as the testicles and can contribute to hair loss. This may be a hard concept to some, so here’s a simplified attempt at answering your question with an example. You can take all the anti-aging pills you want, but you will still age and die one day. Final score — Genes 1, Pills 0.

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Hi Dr.,

After much consideration, I’ve decided to stop using minoxidil. And, as expected, I am now losing hairs the minoxidil was saving. But I suspect that some of the hair I’m losing now will grow back later.

My guess is that minoxidil lengthens the anagen phase for all hairs – indiscriminately – thus delaying those hairs’ telogen phases. And so, some of the hairs I’m losing post-minoxidil are “healthy” hairs whose telogen phases were delayed. Thus, I should regrow at least some of the hairs I’m losing post-minoxidil.

Do you agree?

No, I do not agree. People who develop minoxidil dependent hair will lose their hair if the drug is withdrawn and it will not grow back. If you don’t believe me, just wait a few months and I am sure you will be converted to my thoughts on your problem.

Dr, I stopped using minoxidil 5% 3 years ago but am still suffering from black rings around my eyes. Has any more information come to light since this was first reported? Thanks

I don’t know more about this condition other than what I have written before on this site. I did a Google search to see if I could find other cases and only saw a couple of posts with a question almost identical to yours (so I assume you asked your same question elsewhere). If more information comes available, I’ll certainly post it.