Category: Drugs

I have been on Propecia for just over 2 weeks. This second week, I have experienced notable fatigue and a cloudy head with a lowered ability to concentrate. My lifestyle has stayed the same; if anything I’ve been getting more sleep than normal.

Have you heard of this type of side effect? Is it something that might go away as my body adjusts? Should I decrease my dosage from 1mg to .5mg?

Thanks for any advice you can provide.

I have not heard your type of complaint before from any of my patients. I would wonder if you have been too focused in looking for changes on this drug. If you look hard, you can make these changes occur on a psychological etiology. If you were my patient, I would advise you to ‘stay the course’.

Hi Dr. Rassman:

Could you please summarize the findings of scientific studies that examine the effect of combining Minoxidil and Propecia?

I’ve been using Propecia for about a month, and am considering also taking Minoxidil. I’m a 26 year old male, and ONLY have baldness near my forehead.

Thank you

An animal study done on monkeys in 1992 has shown that finasteride and minoxidil have additive effect on density of the hair. Human comparisons are speculative. I would suggest that you run out the course of 1 year on finasteride before adding minoxidil. This way you will know what the effect is, answering your own question.

Reference: Hair growth effects of oral administration of finasteride, a steroid 5 alpha-reductase inhibitor, alone and in combination with topical minoxidil in the balding stumptail macaque. J Clin Endocrinol Metab. 1992 Feb;74(2):345-50. Diani AR, Mulholland MJ, Shull KL, Kubicek MF, Johnson GA, Schostarez HJ, Brunden MN, Buhl AE.

I have been taking Propecia for just under a year with really no ill effects, and some good results. But in early November 2006 about 5 weeks ago I noticed discomfort and some swelling in my right nipple. I had a sonogram and was put on two different antibiotics for one week, each to no avail. The doctor thought it was mastitis or a staph infection. I had blood work done and all appears normal. I spoke with a surgeon today and he said I had Gynomastia and needed surgery next week. I want another opinion.

Can I simply stop using propecia and substitute with another treatment? Must I have the surgery? Please help thanks

It is very difficult for me to judge your nipple problem over the internet. My answer therefore will be in the general view, not specifically targeted to give you a medical opinion. If I were to examine you directly, my opinion would be based upon having all of the facts, which is simply not the case right now.

There is usually no rush to tackling even a small nipple mass in a male when there is pain present. Stopping Propecia is a reasonable thing to do and if the nipple pain is induced by the drug, then the pain should go away in a week or so. I am not sure if your sonograph found anything positive (a mass or tumor) that is driving your doctor to push you to a surgery. Ask this question to your doctor.

Dr. Rassman

• Yahoo Answers Italia – Dutasteride for Hair loss

The first post caught my attention and I was wondering if you take a medication that has a higher DHT suppression does the body have a “reversal effect” and create more DHT because more is being suppressed in the body causing hair loss after some time?

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).

Hi, Recently I have started using propecia (3 months). I am only 22 and have seen no effect really yet. I have been evaluating my hair carefully for the last 2 years and have noticed it thinning particularly on the crown. I am probably only losing 100 hairs per 24 hour period but feel my hair is not replacing at the same rate, as my hair is shedding more noticably then in the past. I still have a fairly good head of hair and want to save it before its too late. Besides propecia and minoxidil, do you recommend any other measures, whether they are scientifically backed or not, based on your experience?

It usually takes 8-12 months for Propecia to give you benefits you can see. The 100 hairs lost per day is normal for any person. The best and only significant medication for a 22 year old with early MPB is Propecia (finasteride).

I’ve been on Propecia for 9 months with little sign of improvement and i’ve been seriously considering Dusteride or increasing my dose to 2mg instead of 1. What are your thoughts on this?

I am not your doctor, but going to 2mgs of finasteride should not be a problem. Discuss this with your doctor, though. The ideal dose of 1mg finasteride is an average for average people with average hair loss. I can not imagine that twice the dose should be a problem provided that there are no side effects noted. There are some doctors who actually suggest 2mgs, but there is no evidence that I know of which shows that 2mgs is more effective than the 1mg dose. The statistics on effectiveness were based upon general populations and large numbers, and clearly this would have some bell curve variation, so it would not be unreasonable to assume that some people will be more or less sensitive to the benefit. If you take 2mgs, take one mg twice a day (12 hours apart morning and evening).