Is there a better time of the day to take Propecia?
I am under the belief that there is a diurnal variation in testosterone levels which are higher in the early morning than other times of the day. That might suggest that the best time to take Propecia is in the morning as the half life of the drug is only 4 hours. The half life of a drug is the time it takes for the body to reduce its concentration to half of what was taken.
Hi Dr Rassman
Ive been on propecia for over 6 months and in that time my hairloss espically in the front has thinned dramtically much faster than it did in the previous 2 years. Could I be having a bad reaction to propecia?..Would you recommend me quitting trying another product? Im thinking the increased testorone in my body due to the lack of dht may be cuasing me to have a faster rate of frontal loss..its much worse than it was when i started..could it still reocver on propecia? Im just very down about it and regret going on the drug as recommended by a derm i saw this past november..does propecia increase androgens?
You did not state your age, so I am assuming that you are under 28 years old or so. Assuming that you have genetic balding, you probably are seeing an acceleration of the process. If you are in the early 20s, you may be in rapid hair loss and stopping the Propecia may be the worst thing you can do. You need to see a good doctor, document the degree of miniaturization of the scalp and then lay out a plan. It is very hard for me to react to what appears to be a real crisis, without having you in front of me to ask you all types of questions and having the chance to examine you thoroughly.
thanks so much for your reply i really appreciate it. i dont mind taking all the medication for the hair loss but i would rather prefer to get the hair transplant because it will last forever and then i dont need to worry about taking a tablet or putting minoxidil on twice a day. i would rather just get it over and done with so i dont have to worry about it anymore and it will also be good for my self esteem and confidence. what do you recommend?
Here, my age and experience come into place for value. If you are not going to get really bald because your final hair loss pattern is a simple Class 3, 3A or 4A, then you can take the view you discussed. If however, you eventually bald to a Class 6 or 7 pattern (advanced balding), then you will run out of donor hair before the process is complete, unless you are unusually blessed with very high densities. None of us have a crystal ball into our future. The question you should have is, “How bald will I become?” Hair loss is progressive, so chasing hair loss can be a losing proposition for some men. For that reason, I strongly suggest the use of Propecia because there is almost no down side to it, and it will slow down or stop the hair loss for some reasonable time so that you can enjoy your hair. Getting hooked on having expensive hair transplants surgeries on a yearly basis to keep up with progressive hair loss, until you run out of money or donor hair is not what you need.
Propecia is a simple, safe way to make sense of this entire genetic hair loss process.
Hello Dr. Rassman.
Thank you for taking the time to respond. I also wanted to ask you about going on Avodart (Dutasteride) or it’s Generic Dutagen. I have been on Propecia since 1999, and I think it is no longer working. I read Merck’s official report on Propecia’s 5 year efficacy, and it looks like after 5 years Propecia stops growing any hair at all, and it’s ability to keep hair is weakened. Dutasteride appears to block 93% of DHT production, where Propecia can only block 38-45% DHT. Can I get a prescription form you or Dr. McClellan? I am noticing that my “own” non-transplanted hair is thinning, and hopefully the Dutasteride or it’s generic version can stop any more loss.Also, I am using Nizoral shampoo (Ketoconazole) 2 times a week, and Head and Shoulders shampoo (Pyrithione Zinc) on the other days. Is it safe to mix the Ketoconazole and P. Zinc? A friend told me that the P. Zinc can cause miniaturization of the hair follicle, and mixing the 2 shampoos can have disastrous results. Then on the the other hand, many people on online hair loss forums are saying it is fine to mix the two shampoos. Only using Nizoral 2x a week does not stop my newly acquired incessant itching. It would be great if I knew it was safe to use Ketoconazole and P.Zinc.
Thank you so much for you time, I’m sure you hear all these worries all of the time. Now that I see my new hair sprouting, I want to keep it growing, and keep or grow more of my own.
Here is a link to some of my other posts with my comments on Avodart. I will make a decision with regards to prescribing Avodart in early September, after I return from the International Society of Hair Restoration Surgery meetings in Sydney, Australia.
With regard to the various questions you had concerning the shampoos you mentioned, I really do not know the answer, as many people respond differently to each. Experiment with each and when you find something working, then stick to it. Mixing shampoos should not be a problem.
Dr Rassman
I have heard anecdotal reports that the use of Minoxidil for diffuse thinning in men can cause the good terminal hair one currently has to become Minoxidil dependent and change the “good hair” into a fuzzier Minoxidil produced hair—any truth to that? Thank you
Minoxidil dependence does occur for the thinning hair associated with balding in both men and women. When it works, it can be dramatic, but the dependence is a reality that you must face, for if you stop the drug, you will lose all of the benefits including the hair that is preserved. Those men and women with normal hair do not have to worry about minoxidil dependence.
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I am consuming propecia for the past 6 month and i can see good results. My question is, i and my wife would like to have a baby. Is it safe to have a baby while i am on this medication because i have been told by a pharmacist that i should stop consuming propecia for at least 1 month before planning to do so. He said that it will probably do damage to a newly born child.
The half life of Propecia is 4 hours. That means that in 4 hours, there is 50% of the dose remaining, in 8 hours 25% remaining, in 12 hours 12.5% remaining, in 16 hours 6% remaining, in 20 hours, 3% remaining and in 24 hours 1.6% remains in your system.
Now the official answer from Merck is that you can continue to take Propecia while you are trying to get you wife pregnant. Different opinions from different doctors who are generally skeptical, tell their patients the following:
Clearly, this is your decision. I tend to recommend #4, not because I believe it, but because it is reasonably safe and will minimize the time off the drug. I am always concerned about losing the benefits of the drug, and running the risk of a dramatic hair loss.
Please read and comment: Propecia (Finasteride) has been available since 1997 and is the first oral medication to ever be approved by the F.D.A. specifically for the prevention of hair loss. A physician’s prescription is required. The overwhelming majority of men using this drug experience some benefit from its use, sometimes dramatically. It takes a full year before the full benefits can be fully seen and appreciated. The recent 5-year research studies show that, for most patients, there is a substantial increase in the number and quality of hairs growing on the patient’s scalp for around 4 years. After that, the patient’s overall hair mass on top very gradually starts dropping ever so slightly each year, so that at the end of around 10 years, the patient is back to where he started 10 years earlier. So, in effect, for most patients it holds off the hereditary expression of hair loss for around 10 years. There also are many clinicians and investigators who believe that finasteride works nearly as well when administered in dosage amounts substantially lower (and cheaper) than that recommended by Merck.
Much of my opinion is projection and conjecture. Propecia hair loss curves show that hair loss continues, albeit slower, with the drug than without the drug after an initial gain in hair volume, but Propecia is still not the magic bullet for hair loss. After 5 years, the hair may return to the level that it was at prior to starting the drug, but that varies with patients. I had a discussion some years ago with researcher David Whitting, who told me that the Merck studies showed that Propecia was just as effective at 1mg, 5mg, 10mg and higher. The effectiveness dropped by 20% at ½ mg. So all I know is what the 7 years data shows (hair loss continues at a slower rate) and that lower doses than the recommended 1mg level are less effective. You are using generalities on what may happen at the 10 year mark. It may or may not happen. Avodart may be more effective than Propecia, but as of this moment, the data is not in my hands and the FDA has not ruled on safety and effectiveness issues.
I am going bald, but after reviewing the several sexual side effects from Propecia that are in the drug warnings, I am afraid to take this drug. Is this a real concern or am I over-reacting?
I believe that like most men, any potential threat to your manhood should scare the hell out of you. There are many ways to answer this question. The official FDA studies show that the difference between the placebo group and those that actual took Propecia, is less than 1% of men are impacted by a reduction of libido (sexual drive). There is also a very small percentage of men who have ‘sexual dysfunction’ (I hate this term because is implies that something is ‘broken’) which can be made worse by Propecia. The risk for worsening sexual dysfunction is in the order of 5%. So the proper answer to this question is that there is a very small risk of some type of libido or sexual performance impact by Propecia.
Men are highly suggestive, so if a man thinks that he is going to be the one out of a 100 men who have a decreased libido or sexual performance, men can easily talk themselves into this side effect. If the problem is one of sexual performance (unable to have the penis work the way the man wants it to work), then there may be issues that need to be treated with drugs like Viagra, Cialis, Levitra or the like. There is no need to sacrifice your hair just because your penis does not work as well as it did when you were 16 years old. Hair loss, libido and sexual function have one thing in common in that they are impacted by male hormones. If something is wrong with any of these three, please see a good doctor and fix the problem. I believe it is possible to have a good sex life and get your hair back or prevent it’s loss, so get a doctor involved with your problem if you have one.
Dear sir
I am 28 and for more than 6 years I have consumed FINPECIA tablets ( dosage which is 1 mg per day )which is made in India for preventing of hair lost.In this regard I would like to know that wehether this tables has any side effect such as sexual tendency,etc.
The pill you are taking appears similar in name to the drug Propecia (finasteride) made by the US drug company Merck. If it is finasteride (controlled by US and foreign patents), the side effects are four:
If the drug is not finasteride, then I have no way to know what the side effects or the effectiveness of these drugs might be. For whatever reason many people in the United States promote the idea that drugs made in India are not quality controlled like drugs made in the United States. I think the correct statement for this should be that the United States FDA has not verified that the generic drugs made in India meet the strict standards required in the United States.
Can you please tell me if its problematic as far as hair growth/loss to move the dose of Finasteride around ? Thanks
Your question is not clear but i will try to cover a wide scope in the answer. You can take finasteride anytime during the daytime, but best to keep taking it the same time each day. The dose should be 1mg, such as Propecia. A slightly higher dose of 1.25mg, for those that cut the Proscar pill into quarters, is not a problem. Increasing it to an even higher dose clearly produces more side effects. A dose lower than 1mg is less effective.
