Category: Drugs

Hi Dr Rassman, I thought I recently heard you say on this site that minoxodil stays effective for 22 hours, did I hear you right? Because my thoughts are that I would like to cut down my use of minoxodil to once a day if it would have the same effect and save $ or did I misunderstand what you may have been saying? Thank you. Great blog.

Minoxidil is a twice daily treatment for best results. You might get benefit once a day, but why take it once if twice a day is better (and the recommended dosage). It is not a very expensive medication, so go for it the right way.

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Hi Doc. I had taken 1mg of propecia for 4 months with great results for hairloss. I started to notice some sexual side effects and went off the med. I’d like to take it in smaller doses or take 1mg once or twice a week. Any info. available regarding much smaller dosage to avoid side effects?

That is a very good question. In my practice I generally tell my patients (if they are experiencing any negative sexual side effects which occur in about 1% of patients) to cut the pill in half and and then take a half pill daily. It is better to do this than take one pill every other day because the half life (the time it takes for half of the drug to be out of your blood stream) is 5 hours. So if you skip a day you will not benefit from the drug since it will be completely out of your blood stream the next day. Even a quarter of a pill a day may have value. See what you need to keep the side effect away and then watch the hair carefully to see if the dose is holding on to the hair. The reason that Propecia is a prescription drug is for advice like this and you should be getting it from the doctor who prescribed it.

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I’m a male, age 27. When I began seeing a dermatologist 4-5 yrs ago, he prescribed finasteride 5 mg and had me cut it into quarters.

That went on for about a year or so, but then he said that there was some sort of regulation restricting physicians from doing this. Since then, I’ve been paying the higher cost of the daily 1 mg tablets. Was the doc telling the truth? I understand that the clinical indication calls for a 1 mg tablet, but are doctors really not allowed to prescribe the higher dosage with the understanding that the patient will do his part and cut the pill into the appropriate size?

thanks

Many doctors prescribe medicines for off label use. Proscar (finasteride 5mg) is a medication marketed for benign prostatic hypertrophy. Propecia (finasteride 1mg) is a medication marketed for androgenic hair loss (male pattern hair loss). They are the exact same drug with different strength dosing. That being said, if someone (or a computer, such as your insurance company) sees that you have been prescribed Proscar, they may think you have a prostate problem even if you were prescribed it for the intention of using it for hair loss. This is a story that is told by my Propecia drug representative – so there is obviously a bias there and I am not sure how true this story is — but it is plausible.

I give a choice to all my patients and do not favor one or the other, because they are the same medication in different dosages.

I noticed on the pamphlet with my rogaine bottle that it says the medication has not been proven to work past 48 weeks. Does this mean that Rogaine doesnt work pass that many weeks or that the study was only conducted for 48 weeks? I have been using rogaine for 4 months and have seen fantastic results. Before then I was only using propecia without any results, now I use both.

I found the following statement, “hair regrowth has not been shown to last longer than 48 weeks in large clinical trials with continuous treatment with 5% minoxidil topical solution for men”. This implies that the study only went out 48 weeks. I have seen people on this medication for years and years and when and if they stop it, they lose hair. This phenomenon suggests that the Rogaine held the effect and benefit for the years it was used.

Dear sir, I am 29 years old. My hair loss(from crown moving to the left frontal area) started 4 years back. I have been taking Finax(Finasteride)for last 9 months. I have not seen much or benefit from it, instead there is increase in my see-through hairs on the right side when i see it from the top in the mirror. I do not think it is working, still I am not going to stop it. My question is if my hair loss is still progressing and I am not a candidate for transplant, what are my options in the long run. Please reply.

If is my belief that finasteride (assuming that the medication is really finasteride) always works to slow down the natural course of male pattern hair loss. You are right to stay on the medication, but as the medication is not coming from Merck (drug company in the U.S.), then you should be sure that the company who makes the version you are taking is really that medication. I’m still not familiar with the various brands of finasteride that are available in other countries (or the legitimacy of those brands). I’m a U.S. based doctor, and as such, I am familiar with what is available to my patients here. If you still see progression of the hair loss, then this drug may not be strong enough. Hair transplants may be the only option for you.

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