Category: Drugs

Hey doc,

I want to know if there is any problem if I switch brands. Lets say i’m using brand A of generic minoxidil and switch to brand B of the same type (i.e: 5%), would there be any problems?

Thanks

As long at the minoxidil concentration is the same, there should be no difference. The FDA has rules that control the quality of the drugs and the claims in ingredients.

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Hello Dr. Rassman,
I understand that your overall opinion on askdocweb isn’t too good.. however, I read something on their website that I thought I should consult you about.

The “doctor” mentioned that it is possible for users to develop a tolerance towards minoxidil and propecia. Is it true? Also, this “doctor” mentioned that the FDA reports stated that hair regrown by minoxidil does not last more than 48 weeks. Is that true as well? Here’s the link: AskDocWeb

Thank you, Doctor! Best Regards

Minoxidil, originally and still used for the treatment of hypertension, was incidentally found to increase hair growth and is now used in products such as Rogaine. When used as an antihypertensive, it has been shown in one study published in the Journal of Cardiovascular Pharmacology (J Cardiovasc Pharmacol. 1980;2 Suppl 2:S93-106), that there was no development of tolerance if it was administered long term. I would suspected that the same may be the case for topical minoxidil, but have not seen any evidence to support this.

The same can be the case for Propecia. Propecia (finasteride) has been used by urologists for the treatment of benign prostatic hyperplasia (BPH), and is currently the only FDA approved medication to treat hair loss by decreasing the levels of DHT, one of the key cause of male pattern baldness. In a recent study published in the Journal of Urology in July of this year, the authors noted that “long-term (more than 4 years) treatment with finasteride … led to a consistent, clinically significant reduction in total prostate volume compared to placebo in patients“. Again, extrapolating this information to the hair transplant/treatment arena, we can suspect that the same may be true for hair regrowth.

As for whether minoxidil hairs don’t last more than 48 weeks — read this study from Journal of the American Academy of Dermatology. The trial was 48 weeks long, and I’m guessing this other site you referenced either got confused or they’re making stuff up.

Can propecia work for a while, stop working, and then start working again? Or once it stops it stops?

Propecia is constant, but your hair loss is not constant, as it comes in waves. That is why it pays to stay on the drug so that you do not mix up the therapy cycle.

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I am a 23 year old male who has been using propecia for one year. I wanted some clarification on whether or not propecia can have an effect on brain function. I have read various sites that claim it does. Some users post confusing scientific data related to rats and state that it proves their allegations. They claim that propecia has caused, “brain fog, memory problems, aniexty, and depression” to name a few side effects.

In your expert opinion, can daily 1mg doses of finasteride change brain function? Specifically, change GABA function. Am I at risk if I continue to take the medication? If not, why do so many users claim to be negatively effected by this drug?

Please note that the use of the Internet for researching such reports may be biased towards sensationalism or focusing on the unusual. The reports of mood changes with Propecia (finasteride) seem credible, after all, since it does cause hormone changes in the body. For example, we have seen major mood alterations in women with mild hormone fluctuations. Propecia will alter hormone balances and this could be claimed to impact brain function, because I would think that mood alterations are connected with brain function. With regard to “brain fog” (confusion, forgetfulness) though, well, I really don’t know what it is that you are addressing and there is no way to really know what it does to the brain in any meaningful study that is currently available in the medical literature.

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Dear Doctor,
after 6 years of Propecia, I have started to take also 1mg of Dutasteride daily. Would the daily combination of finastride and dutasteride run the risk of making both drugs ineffective?

I would not suggest that you take both medications at the same time — as both are prescription medications, you should be discussing that with your doctor. That being said… no, they won’t cancel each other out. These medications work roughly the same way on the mechanism for hair loss. There is a suggestion that dutasteride is a bit more powerful than finasteride, but there are more side effects and the dose in dutasteride to get a better DHT block is high (2.5 mg/day). There are reports that these higher doses may cause infertility in some men and we do not know if this is reversible. At this time, dutasteride is not FDA approved for the treatment of hair loss. For more on dutasteride, see past posts here.

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Doctor,
I have read that Dutasteride is metabolised by the CYP3A4 enzyme. I am taking Acomplia (obesity treatment drug) which is a CYP3A4 inhibitor and I have read that has been proved that, in combination with CYP3A4 inhibitor, Dutasteride level in the blood have raised Would this mean than Dutasteride would be ineffective in my case? Would the same be for Propecia?

Thanks very much

Drugs like this (metabolized by CYP3A4) may impact liver metabolism and therefore impact the length of action of other drugs in your body. Take note of the following diseases: impaired liver or kidney function. For finasteride, the presence of epilepsy may put you at risk with this drug. It drug may have side effects with antifungal, HIV, antibiotics, antidepressive medications.

I found nothing about dutasteride, but I would imagine the same rules apply as discussed above.

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