Category: Drugs

have you ever heard of Elpecia? it is suppose to be a generic version of Propecia. i ordered it from a canadian pharmacy but the shipment came from India

thanks

There’s a lot of names that generic finasteride is sold as, with many of them being of Indian origin. I haven’t heard of Elpecia before, but it wouldn’t be shocking to know that yet another generic 1mg finasteride pill is being sold (illegally). I did a Google search and could only find a single reference to Elpecia being a name for generic finasteride, but I couldn’t say whether what you bought is even legitimate.

Note: The “logo” there is my great Photoshop work. Do not confuse that with the real logo, if there is one.

Dear Dr Rassman
You have said that you have given some of your patients Avodart. Can you tell me what results you saw and what was the strength that you used? Thanks

The few times I’ve prescribed 0.5mg of Avodart (dutasteride) for off-label use in treating hair loss, it has been successful but I must tell you that I did not do this with a research minded scientific approach. I didn’t see any substantial regrowth, but essentially the drug ceased further loss in patients that saw their hair loss start again after a number of years on Propecia. Again, this is just for a limited few that I’ve prescribed the medication to. I haven’t had reports of any side effects, but those patients had no side effects from Propecia either. I’m still concerned about long term use and safety when taken for treating hair loss. Like everyone else, I’m awaiting the results of the clinical trials completed earlier this year in Korea.

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how long is minoxidil need to be apart after a application. Is 8 hours apart ok?

The recommended application for minoxidil is twice a day. I suppose 12 hours apart is best, but that may not be practical to fit into your day.

Many years ago I had a dairy farm with nearly 150 cows. If you think about nursing mothers, they feed their babies every few hours and get their best milk production based upon the need to keep up with the close feeding schedules. For my farm, I figured that we would get the best milk production if we milked the cows every 8 hours, but I could not afford to do that and few workers would cooperate with me on this idea. Most of my farming neighbors started milking at 7am and then at 3pm so that they could have breakfast and dinner with the family on a reasonable time schedule that coordinated with their childrens school schedule. By spacing the milking 16 hours at night, the cows filled up with milk for overnight, which in the world of ‘biologic feedback’, they were telling their bodies to slow down milk production. As a compulsive person and to solve the problem, I decided to milk the cows at 3am and 3pm, but because of my heavy surgical schedule I just could not do that. Instead, I woke my wife up at 3am so she could milk the cows until 6am at which time the day crew came in and took over. What I’m saying is, life is full of compromises. If you can’t get that perfect “every 12 hours” between minoxidil applications, then yes, 8 hours apart (like the dairy farmer) should be fine.

And for the record, I am presently divorced.

DHT is the byproduct in the breakdown of testosterone. So more testosterone will produce more DHT, but if the DHT is blocked, the effect of the increase will be mitigated. What actually does happen is that testosterone levels rise by about 15% when you take finasteride and that is the body’s way to dealing with the change in DHT levels. Some people get an increased sex drive from this change (in my experience about 10% of the population). Does this mean that because testosterone levels rise by about 15% does that make more DHT. if my testosterone increases does it mean i will loose more hair?

Testosterone levels do go up by about 15% by taking finasteride. What is happening is that the drug competes with the enzyme, and although the enzyme may rise to offset that competition, the competition for the receptors is brisk enough to reduce the binding and the production of DHT. The overall drop in serum DHT levels is more significant than the rise in testosterone levels. The higher testosterone levels will not cause more hair loss because of the process discussed above.

Dear Dr. Rassman,

I was recently diagnosed with a peripheral neuropathy in my feet. Although, i feel it mostly in my right foot. I am mailing you because i have been taking propecia for a year now and thought that maybe finasteride could have be causing my neuropathy? I recently took a blood test(diabetes,hiv,lyme disease,etc), a 24 urine sample, a chest x-ray, a pulmonary test, and a brain MRI. Everything has come back normal, except my cholesterol was a little high and out of range and my enzyme count( i can’t rememember the exact name?) was out of range. When my neurologist saw my enzyme test was out of range she mentioned it could possibly be sarcoidosis, and just to make sure to have a chest x-ray and pulmonary test to rule them out. The x-ray and pulmonary tests were both normal.

I have seen an accredited hair specialist/hair transplant surgeon and a reputable one i might add….and after telling him about my neuropathy he tohught i should stop taking propecia for 3 months to see if it goes away…actually i had already decided to stop taking it, but, i w anted to see what he thought. Anyway, i have read your blog and respect you and your words and knowledge. If it isn’t an inconvenience could you please let me know what you think. Also, i asked my doctor if stop taking propecia cold turkey would that be okay and he said yes. I also asked if i started propecia would it still be effective and he said yes. he just said i might lose some hair but it should still work if i decided to use again.
By the way, i am in my thirties and have good general health. I am also a Norwood 2.

Thank you very much

I really am not in a position to give you advice here. I am unaware of peripheral neuropathy being a known side effect of Propecia. If you stop the medication, you will lose the value of it over a 2-3 month period of time, some of which may come back if you restart it by then. Any decision to do this and any schedule on restarting it needs to be made between you and your prescribing doctor.

Dr. Rassman,

Hello.

Question for you. I wrote you before, and so have others, about puffy or “swollen” faces from minoxidil use. You said if this happens it would be due to an allergic reaction. I was reading the clinical side effects and it listed water retention as a side effect. Wouldn’t this be the cause and NOT an allergic reaction? Also, if your answer is a “yes” could this also be the reason for the weight gain which is also listed as a possible side effect or would that be caused by an entirely different mechanism?

Have you seen this “puffy face” thing in any patients? If yes, is it common? And if you have, does the side effect remain as long as you are using minox or does your body eventually acclimate? Finally, if one did develop this, does the symptom last the whole day or does it abate after so many hours of last usage?

Water retention seems to be present in 7% of people starting on the minoxidil therapy. There are reports of weight gain as well. Most of the severe side effects come about when minoxidil is taken in pill form for the treatment of high blood pressure and the reports do indicate cardiac side effect, fluid buildup around the heart, etc.

As some of the minoxidil is absorbed through the skin, I would expect that the systemic dose should be less when used topically, but I can imagine that in some people absorption could be very high and the sensitivity to this drug high as well. Best to stop the medication and see a doctor in the case that this may be pointing to some silent heart disease and very early congestive heart failure.

Hi Doc,

I’ve seen expired Rogaine foam on ebay selling for rather cheap. I could understand that overtime, a drug might lose its effectiveness, but I can’t imagine that Minoxodil spoils like milk.

From a business standpoint, it would make a lot of sense for Pfizer to put an expiration date on their product in order to minimize competition with 2nd hand merchants. I acknowledge my ignorance in the subject, so I am appealing to you. Do you think using Minoxodil that’s a month or a year past its expiration date is any less potent?

Thanks for all of your hard work.

My official response is to follow the general advice on all expired medications and trash it.

Off the record, I think that expiration dates are often accelerated for the very reasons you are probing and would expect that if I was taking minoxidil that is properly stored 1 year past its expiration date, I would be comfortable using it. But don’t quote me on that, of course. Oh, this blog is public?!