Category: Drugs

I’ve been reading a lot about one’s thinning hair becoming dependent on minoxidil on this blog. How long would one have to use minoxidil to become dependent on it?

Minoxidil dependence only occurs in hair that sees benefits from using the medication. The better the hair gets, the more the dependence upon minoxidil. I would imagine that if there is dependence, stopping it will cause any benefits to disappear and return your hair to its state prior to taking the minoxidil, plus adding whatever hair loss might have occurred from the time minoxidil was started until the time it was stopped. Generally it takes many months for the benefits to be seen, so I would expect that the dependence upon it takes many months as well.

I was prosribed propecia two months ago to have every other day. My hairloss already seems to be beginning to stabilize over this short time. Hopefully I might get some regrowth in the coming months! I was told the 5 alpha reductase reduction with propecia is still just as effective as if I was taking it every day. However I have read elsewhere that you need to take it every day. While I don’t doubt the advice of my medical professional, I have read here, and elsewhere that I need to take it every day to get maximum benefit. Are there two schools of thought as to the appropriate dosage? Or is it that, as the onset of my MBP is very recent my medical advisor is of the view that I would get an effective response on a less frequent dosage. He claims to have many patients who get a good response taking propecial every other day. Thanks for your help

The recommended Propecia dosage is one tablet once a day.

Some doctors may prescribe half a tablet once a day or one tablet every other day, however these are not the official recommended dosages. One reason is that official clinical research has found that the once a day dosing gave the maximum benefit from male pattern hair loss. Another more important reason is that the half life (the time it takes for half of the drug to be eliminated by the body) is only 5 to 6 hours. So theoretically on the days you do not take Propecia, your thinning hair will have no benefit from the drug. You should always follow the advice of your primary doctor and discuss these concerns with him or her, especially before stopping or changing any drug regimen.

A group of experts in the hair restoration field, were polled on the issue of dosing minoxidil and finasteride. What I am quoting below are some unofficial opinions that are not the standard FDA line for these drugs. I present them for the interested readers on this blog. The authors of these thoughts would rather not identify themselves, as these opinions are not in-line with standard treatment recommendations, even for the doctors who believe what is written below…

Comments on minoxidil:

Once a day topical dosing with minoxidil is probably close to, or equivalent to, twice a day. When given orally, minoxidil has a relatively short half like of several hours, but when topically applied, it has a half life of 22 hours in the skin. This makes once a day dosing a very reasonable option which I often suggest to patients.

Comments on finasteride:

Unfortunately, there are no references in the literature, that I am familiar with, concerning the “functional” half like for finasteride.

The serum half life of finasteride is only 4-6 hours. If we assume the worst, 4 hours, then there is far less remaining from a 5 mg dose 48 hours after dosing than there is from a 1 mg dose 24 hours after dosing. Similarly, a 2.5 mg dose does even less well. So, from a simple serum level of finasteride standpoint, every other day 2.5 or 5 would not maintain consistently high enough serum levels.

It gets interesting though when you consider the half life of the finasteride / reductase complex. The half life of this blocked enzyme complex is around 30 days. This is the most likely reason that when you stop taking finasteride (after chronic dosing), it takes 3 months for your DHT levels to return to baseline. This part of the story implies that, once you get up to steady state levels, every other day dosing would surely be enough..

I just think that there might not be enough of the drug around to keep the enzymes saturated using chronic alternate day dosing. These are the reasons that I recommend daily dosing but point out to my patients that it doesn’t matter if you miss a dose now and then.

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I have been on propecia for the last three month. I am bout to end month three and have noticed that my temple hairs have become noticably thinner than before I started propecia. I have increased sex drive and more morning erections. For a while I was having some scalp irritation which has gone away. Is it possible I am being affected by androgenecity? Prior to taking propecia I had my total test. checked and it was at about 250. I am 24 years old. I am hoping that my temple hairs have been pushed into telogen and this is why I have thinned in these areas. I have a good amount of hair on my head and want to maintain it. What do you think? Also, many of my hairs that have been falling out look to have a white type of pulp on the end near root.

Your report of an increased sex drive is a well known side effect of Propecia (most people seem more concerned and worried about the decreased sex drive which occurs in 1/100 to 1/200 patients). Men generally get an increased testosterone level of about 18% on Propecia in the initial month or so. This often returns to normal after 1-3 months. Testosterone is a far more potent that DHT as a male hormone for sex drive.

Your hair loss may just be a normal progression of your male pattern hair loss and Propecia may actually be slowing its progression (even if it seems you are losing hair). If you are concerned about hair loss, you may consider visiting a hair specialist who is able to quantitatively record the miniaturization of your scalp hair and perhaps even determine the degree of future hair loss.

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Hi.

I’m 35 and loosing hair. It’s likely that Propecia could be one good solution. However, from what I understand Propecia blocks DHT by limiting the creation of testosterone which is why it can stop balding process.

Now, I am working out seriously 4 times a week and trying to add on muscle. Muscle growth is due to testoterone. My question: how can my work out be still beneficial in terms of muscle growth if the testosterone is lowered because of use of Proprecia.

Thanks for your time.

Propecia does not decrease testosterone. It decreases the byproduct of testosterone known as dihydrotestosterone (DHT). DHT is what is implicated in male pattern hair loss. Taking Propecia increases testosterone by about 15% and benefit (although not proven) muscle building. Propecia can also apparently be used to mask muscle enhancers. You may recall from the recent Olympic games the controversy surrounding Propecia — Olympic Athlete Banned from Competition for Propecia Use.

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