Category: Drugs

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Shouldn’t I Take Propecia Twice a Day? – Hair Loss Information – Balding Blog

Dr. Rassman,

Why is it not necessary to take propecia more often than once a day??? If I take 1mg at 6am, then 12 hours later, I only have 0.125mg in my bloodstream which has to last me another 12 hours. Since 0.125mg doesn’t block hair loss—aren’t I losing hair for the second half of the day??????

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The studies done by the drug company for the FDA showed that the value of the 1mg daily dose was as good as twice the dose. The goal was hair counts, and the benefit on hair count was the same for 1mg as it was for 2mg.

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How Much Avodart Should Be Taken for Treating Hair Loss – Hair Loss Information – Balding Blog

if i were to take avodart, what do you recommend as far as dosage on a daily basis. Im reading online that it should 2.5mg.

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At this point, we don’t know the optimum dose for this medication, but most doctors that do prescribe this are prescribing 0.5mgs a day for treating hair loss. Where I have a problem is that since the half life of the drug is 5+ weeks, a daily dosing does not seem reasonable. Let us leave the answer to this question until the time that we have more results available from clinical research.

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Propecia Half-Life Question – Hair Loss Information – Balding Blog

Dr. Rassman, I had a few questions about the use of Propecia: You claim in other posts that the half-life of the drug is four hours, and that by then it will be out of your system – and while I claim no knowledge of drugs or physiology, it seems to me that if the drug had a half life of such a small amount of time the dosage would be more freqent than 1mg a day. Wouldn’t the beneficial effects be flushed from your system well before 24 hours? And wouldn’t any side effect (in my case: low libido, dull groin/testicle pain) go away the first day you skipped the pill? Thanks!

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Although a half life is 4-5 hours, there may be tissue levels that exceed the half life. I believe that there are such tissue levels and that these are maintained for a few days after you stop taking the pill. However, I do not know if anyone knows the effectiveness of these tissue levels. Some people who have negative sexual side effects do tell me that it took a week or two for it to go away. Is that psychological? No one knows for sure. I would imagine that a half pill twice a day may be better than a pill once a day. There are suggestions that even smaller doses work. The science is lacking so we have little help in understanding anything that the FDA does not validate as safe and effective. You will have to trust Merck, which is a good company, but obviously biased.

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Which One Is More Effective in Male Androgenetic Alopecia: Finasteride or Minoxidil? – Hair Loss Information – Balding Blog

A lot of our patients who are debating to take finasteride (Propecia) vs. minoxidil (Rogaine) ask about the effectiveness of one treatment regimen vs. the other. These two medications have been compared regardless of their side effects or their ease of use. The result of this randomized study that was done in Turkey indicated both medications were effective, but oral finasteride 1 mg/day was significantly more effective than topical solution of minoxidil (5%) in the treatment of mild to severe AGA.

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Phytotrixil and Hair Loss – Hair Loss Information – Balding Blog

I’m 21 yrs old and losing hair frantically. I’m not bald yet but even my hairstylist commented on the obvious loss of hair and visible patches of the skull, an said i’ve got an oily skull. I suspect its becoming more and more visibly obvious. While i’ve managed to slow down the loss a bit with vitamin b, there is no hair growth yet. i’ve heard of this product phytotrixil but don’t know if its effective. I’ve started using oil control shampoo. What would you recommend for my problem?

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I’ve written about this before — Phytotrixil to Prevent Balding?

I would not recommend some strange potion like phytotrixil with promises and no proof of value. Get your diagnosis properly by getting your hair mapped out for miniaturization and you will know what is happening to you and a good doctor will tell you what to do. At 21 years old, you must learn not to believe everything you read or hear.

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Trying to Keep Looking Full – Hair Loss Information – Balding Blog

I am working harder and harder to keep my hair looking fuller and it is progressively getting more difficult. Been on Propecia since it first came out and in the past year or so, I spend more and more time in the morning trying to maintain my look. God forbid, the styling gel does not hold it! Should I switch to Avodart? If it is safe enough for prostate disease, why Avodart be safe for me, age 31?

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Avodart is safe and approved for prostate problems which only occur in men over 50, most often over 60. If there were a Vioxx type of problem to come about after taking this medication for 20 years in a 70 year old man, I doubt that we would ever see it. In someone your age, I can’t say that. There are trials underway for treating hair loss, however.

Thank you for coming into the office after sending your email. Examining you (see pictures below) showed the following:

  1. You still have your childhood hairline.
  2. You do not look bald or thin from any angle.
  3. When we separate your hair, is is clear that you work hard to keep this full look.
  4. There is 50% miniaturization.
  5. With styling in a dark hair, light skin person, 50% is almost as good as 100% density with any reasonable styling. Your hair is medium-fine thickness and has a slight wave to it. Many men would be happy to be where you are now and with 50% miniaturization I would not consider you a transplant candidate. Drugs (DHT blockers) like finasteride (Propecia) or dutasteride (Avodart) are the best way to maintain where you are.

The photo on the left is this man’s hairline from the front. The photo on the right shows the miniaturization in his parted hair. Click the photos to enlarge.

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Medication for the Hairline and Corners? – Hair Loss Information – Balding Blog

Hello Dr. Rassman, You are doing a great job by answering people’s questions about hair loss. Propecia and Rogaine both say they only work if the hair loss is on the vertex (top of the head). Is it useless to use these if we lose hair on the side corners of front? Is there any medicine available for the front side corners?

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I believe that Propecia (finasteride) will slow or stop hair loss in the front and corners. This is probably less common than the impact on the crown. On a few patients, I have seen hair loss reversal in the front, but only a couple that I can think of. There are no other medications that I would suggest at this point.

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Taking 5mg Finasteride Once Every 3 Days – Hair Loss Information by Dr. William Rassman

Hi, I have been told by my doctor that taking 5mg Finasteride tablet(Proscar)once every three days is also effective for treatment for balding. I’m 21 years old and was told that I’m having genetic alopecia. Can I have your opinion or recommendation?

I don’t have a problem with this suggestion if it works. The reason we recommend daily dosing is because that is the way the data was collected and the official recommendation of the drug company (1mg/day). It is logical as a daily dose, because the half life of the drug in the body is about 5 hours. Maybe your doctor has a great deal of experience with this every 3 day dosing routine. It may work OK!

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Worried About Hair Getting Worse Before Propecia Effects Kick In – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman, I know you’ve been asked a billion times about Propecia but I just have one question about it.

I understand we need to wait at least 8-12 months to see whether it is ‘working’ and I also realize that by taking Propecia we’re at least slowing down the rate of balding. With this said I have a hypothetical question.

It’s been 3 months since I’ve been taking Propecia (much too early to tell) but let’s say hypothetically, Propecia will actually stop my hair loss. Before my 8-12 months trial period is up, can my hair still become miniaturized before Propecia “locks in” the hair I have? I’ve been on Propecia for 3 months and I’m starting to see significantly more thinning in the front and I’m curious whether or not I’m going to lose a big chunk of my frontal hair before propecia stops the recession.

Any help would be appreciated. Thanks.

When Propecia works, it works very fast. You may not see the full impact for 8 or so months, but you do not have to wait to get the benefits. Be patient, as it sounds like you are doing the right thing.

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Woman with Androgenic Alopecia Being Treated with Avodart – Hair Loss Information by Dr. William Rassman

I am a 42 year old female with diffuse hair loss diagnosed as androgenic alopecia from a scalp biopsy. I am currently being treated with Yazmin, continuous active pill, spironolactone 200mg and Avodart since May 2006. I have had significant progress but some reaction (dry and itchy) to the spiro. I am considering trying a different protocol because I don’t like being on 3 meds especially when I am not gettin as much improvement as I would like, and some concerns about being on 3 medications. I looked in to a hair loss clinic that uses the following combination – 1. An herbal DHT blocker that includes many supplements I have read about for hair loss, 2. A topical treatment that include minoxidil in a carrier solution to neutralize the negative effects of etoh on the scalp, 3. Regular in clinic laser therapy that has 70 lasers (as opposed to 1 used in the comb) 4 A co-enzyme to stimulate hair growth. Do you think this regime is a viable alternative to the three medications? I know any of these treatments takes months to show effect so I am trying to make as informed a decision as possible since the prospect of counting 250 hairs in the shower again is very scary to me.

You are on several treatments and are considering more. Of those treatments, some are not proven effective for women with male pattern baldness and some have exclusive and limited indications. The DHT blocker finasteride has been studied in women with androgenetic alopecia. Although effective for men, this medication was not proven to be effective for women. Dutasteride (Avodart), another DHT blocker, has never been studied for this purpose in women.

Using lasers for treatment of hair loss has been controversial and although advertised extensively, is not yet (in my opinion) proven to be effective. If it helps at all, the benefit will be new hair growth in the 10% range. Application of spironolactone for treatment of alopecia is limited to some patients with elevated levels of androgen. Topical DHT blockers have a theoretical value in men, but they have not been studied and should be no better in women than systemic DHT blockers like finasteride.

You seem to be determined to fight the baldness, an admirable trait. The best thing you can do is to find a good dermatologist for a thorough evaluation to be assured that you do not have a medical cause of hair loss which is common in women. Using anecdotal modalities for treatment of your condition may be disappointing at the end, let alone the money and time that you lose.