Category: Drugs

I recently went hiking/camping on the Appalachian trail for 9 days, and only managed to bring 3 days of propecia medication. My poor packing skills brought up the question: What is the best way to ration/use propecia medication in this situation? – Once a day for the first 3 days? Once every 2 days? Cut the pills in half?

thanks for your time

I would have taken the Propecia every other day and cut the pills to spread it out. 6 days may not matter in the grand scheme of things, though. There is no right answer in a situation like that where you made a mistake. Do your best to spread the medication out so there’s not too much time in between dosings.

Paid advertisements (not an endorsement):

Hi Doctor,

Started Rogaine 16 years ago at 40. Now 56. Only applied it once a day after about a year. Developing scalp irritation and plan to stop. Are there any long term studies showing effectiveness? I’ve read about immunity after a few years but nothing specific. Could my hair still be dependent on it after so many years and at my age?

What works better or if at all at my age? minoxidil or propecia?

Thanks

I am not aware of any long term studies on topical minoxidil/Rogaine showing effectiveness. Your hair may be (or may not be) dependent on Rogaine after so many years. If you are going to stop the use of Rogaine, I would consider slowly weaning off of it over the course of several weeks. For example, apply once a day rather than twice a day. Then maybe every other day, etc. Perhaps even switching to a lower dosage. Unfortunately, hair loss may be a price that you have to pay for stopping the medication.

It won’t retain any benefits you’ve seen from the minoxidil, but Propecia might work for you.

You always say at the 8th – 9th month mark you should see Propecia’s regrowth/thickening of hairs. If you haven’t seen anything by then does it mean there is no possibility of thickening of miniaturized hairs or regrowth after that? I read that Propecia can take up to 1 year to see its benefits and some say up to 2 years (I personally doubt that), so what’s the deal here?

If you follow the process with miniaturization studies (see here) then you can state categorically that it is not thickening up the hair shafts. I don’t always say you’ll see regrowth… but the drug almost always works on preventing or slowing hair loss in those genetically prone to it.

I wrote once asking you if in 8-9 months you don’t see any thickening/regrowth on Propecia that later results are unlikely. You said there is no guarantee the medication will work for me. I understand that nothing is a guarantee but my question really was that “if” thickening/regrowth will happen for a man on Propecia does it “must” happen on the 8-9th month mark or can it happen later?

You will likely know by the 8 or 9th month mark, but keep in mind that if you also notice less hair loss (but no thickening or regrowth) it may still be working… even if it’s just slowing the process down. I don’t recall saying that if you didn’t see regrowth that results are unlikely. Just seeing the hair loss halt is also a benefit of finasteride.

To answer the question you’re asking directly though, if you’re expecting regrowth of your hair and you don’t see it by month 9, I don’t think that continuously taking the drug will result in regrowth by month 15. If you do take Propecia for 15 months (as an example) and decide to stop, you’ll see your hair loss continue and possibly speed up. This is what I call catch-up hair loss, in that any halting benefits the Propecia gave you would be gone after stopping the drug, and your hair loss catches up to the point that you’d be at had you never taken it at all.

Paid advertisements (not an endorsement):

I have been looking at your website for quite sometime and have sent pics of my receding hairline. After much thought, i decided to start on propecia and after taking it for 2 or 3 days i felt no side effects. on the 3rd or 4th day i felt my throat swelling ant tightening. I figured it was a virus due to the cold whether we have been having in Chicago and at night i would hear strange sounds in the middle of the night. I started on zithromax and after a couple of days i began to feel much better.(during this time i stopped using propecia.) after finishing the zithromax i started taking propecia again and within minutes i felt my throat swell up and started to itch. I went to the pharmacy and they gave me benedril which helped. Therefore, it seems i am allergic to propecia and am trying to prevent my hair line from receding any more, any suggestions???

I have never heard of such complaints from my own patients, but allergies do happen. This is something you should discuss with your doctor (who can run various allergy tests on you, for example), not someone like me over the Internet. The question you should pose to your doctor is, “Is this an allergic reaction?” and then work out a plan with him/her on what to do.

Aside from the 1mg of finasteride, Propecia pills have the following inactive filler ingredients: lactose monohydrate, microcrystalline cellulose, pregelatinized starch, sodium starch glycolate, hydroxypropyl methylcellulose, hydroxypropyl cellulose LF, titanium dioxide, magnesium stearate, talc, docusate sodium, yellow ferric oxide, and red ferric oxide. Perhaps there is something in there that you have an allergy to?

Paid advertisements (not an endorsement):

I was thinking of going on Propecia but found this article: Effect of androgen deprivation on penile ultrastructure

I was wondering why Merck hasn’t mentioned this as a side effect. Is this claim true in humans?

This may occur in humans at doses of finasteride much higher than the 1mg dose level that is the therapeutic dose for hair loss. The study doesn’t say how much finasteride was administered or the frequency of dosing, but as the study is in rats, I wouldn’t know how it could apply to humans. Merck likely hasn’t mentioned it as a side effect, because it hasn’t been proven to be a side effect in humans. I don’t know how else to comment on this question.

Why does it take 6 months for catch up loss to occur?

Everything happens slowly in hair as it only grows at a rate of 1/2 inch per month. Much of the hair loss or reversal of it from drugs like Propecia (starting or stopping it) occurs in the 6 month time frame to be detectable. Usually, when you stop the drug and the drug was working well, the loss will occur in the first 3 months.

Hi Doc. Thanks for a great website.

37 year old male, been on Propecia for three months now. Prior to Propecia, hair was falling out of vertex at a steady rate. Started Propecia and loss stopped immediately and completely within three days. One month later after continued Propecia use, hair begins falling out at same rate as before Propecia and continues falling out now.

I know that I can’t “build up a tolerance” to Propecia, so am I in a shedding phase? If so, how long will that last approximately? And is it a good sign that my loss stopped so dramatically at the outset of my treatment? Is that a sign of things to come after this shedding?

Any information would be appreciated. Thanks!

If this is not a short term shedding process, you could be in for trouble. I don’t have any idea if it’s a temporary thing or how long it’ll even last. Stick to the treatment and then work with your prescribing doctor. You might start to ask yourself if its time to consider adding minoxidil to the treatment plan.

Dear Doctor,
I am 33 yo, I took Propecia for two years with NO erection problems and good hair growth. I stopped October 2007. In April 2008, I got diagnosed with testicular cancer, had a left orchiectomy, chemotherapy, a retropertioneal lymphnode disection surgery and have been cancer free since early October 08. I have now retrograde ejaculation but I had NO decreased libido or erection problems until November 08. I started on Propecia on mid Nov 08 and I have been having serious erection problems since then. I can’t get an erection, rarely I do after a lot of help from my wife, but can’t maintain an erection. I stopped taking the drug five days ago, but the problem is still there. Any advice would be appreciated. Is it possible that it didn’t affect me before, but now it does because of either orchiectomy, chemo, or something else? Should I get my testosterone level checked? Will the problem go away now that I stopped? Please advise.

There are many things that you need to explore. Amongst them might be a visit to Boston Medical Group (for treating ED that does not respond to drugs like Viagra), but I would first ask your doctor about your problem. He must certainly have expertise to help you and knowing your testosterone levels might help.