Category: Drugs

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??????

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.

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.

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.

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!

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.

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.

• PubMed – An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia.

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?

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.

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!

Paid advertisements (not an endorsement):

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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Just wanted to drop a line. It’s been a weird cycle.

Started Propecia back in October 2006. Was around a NW 2.5, with rapidly fading temples and thinner hair on top. Hair also was easily pulled out. Mid December I saw the hair at its worst….temples thinning rapidly. Mid January was when I first saw tiny hairs on the temple coming in. It’s now March 2007. Temples have come back within this short amount of time, the top is considerably thicker. I would deem this a success.

If the hair continues to come back at this rate, I am optimistic that I will get back to NW 1.5. It also helps that no one goes bald in my family, but have receded hair lines and thin hair up top.

Thanks for everything.

Thank you for sharing this with us.