Category: Drugs

First of all, I’d like to say that this site is very informative, and thanks for providing it. My question concerns Propecia. I take high blood pressure medication, specifically a beta blocker (Toprol XL) and a diuretic (Triam-Hctz, the generic of dyazide). Are there any known cases of these types of drugs having an unfavorable reaction with Propecia? I ask only because a friend told me he once knew someone who had to stop taking it after having chest pains that he hadn’t had since he started his high bp meds. I would like to get on Propecia, but I’d rather be bald than have a heart attack. I’m just wondering if my friend was exagerrating.

There is no impact to my knowledge of Propecia on blood pressure medications or diuretics. The medication minoxidil (brand name Rogaine) may impact blood pressure as it was originally defined as a blood pressure medication. Maybe your friend is confusing the two.

Can I buy Proscar instead of Propecia and put it on my insurance? Is it as good as Propecia?

Finasteride is the generic name for Propecia (1mg) or Proscar (5mg). They are exactly the same medication. The drug company that hold patents on the drug determines the pricing in such a way that the 1mg pill is almost the same price as the 5mg pill. Some people try to cut the 5mg pill into 1/4 or 1/5 sizes, so that it should be the same value as the 1mg pill. Certainly, 5mg pills are far less expensive mg-for-mg than 1mg pills.

With regard to using your insurance, most insurance companies will only cover prescriptions that are for medically necessary reasons, not for purely cosmetic reasons. When I write the prescriptions, if a patient asks me for Proscar, I will write the directions to cut the pill into 1/4 pill. If the drug store gets authorization for Proscar from the insurance company, then so be it, but most of the time they will not abe able to obtain insurance authorization for use by young men. I am not familiar with which insurance companies routinely authorize Proscar.

Hi DR,
I bought rogaine and I am using propecia as well. is this ok? im using rogaine twice a day.

It is not a problem to use both, but make sure you are not spending your money unwisely. If you have been taking Propecia for at least 9 to 12 months, you should be seeing the results, so taking Rogaine now to see if it will enhance those results is reasonable. If you have only just started on Propecia, taking Rogaine may cause confusion. Which is the product that is giving you the results? You may just be setting yourself up for a lifetime of paying for both, for fear that the one you stop taking was the only one working!

I just started loose my hair from the front side.Male pattern(Type 1). I am 28 years old and i started to use propecia 3 months ago. There is no proof that propecia stops balding on the front of the scalp. I feel like it is not helping. My father and my uncle they had lost their hair untill they are 45 and now they have type 3 male pattern baldness, no baldness at the top. We all have very thick hair. I just want to know,if their is anyway to stop hair loose. I am not worry about bring them back.At least for now.

Propecia has been proven to stop or slow hair loss down, provided it is started early enough in the balding process. The term ‘early enough’ varies with the genetics of the individual. Based upon the ‘Class 1′ pattern, you may just be migrating your frontal hairline to the mature position. If your father and uncle had a Class 3 pattern, the slowing of your hair loss is highly probable, but three months is just not enough time.

Many men do not notice their frontal hair loss until hair miniaturation is almost complete, and by that time Propecia will not be effective in the front. Since balding in the crown is generally slower, starting Propecia when it is too late for the frontal area, may still be early enough to work for balding in the crown.

As you have only been on Propecia for three months, you may want to give it some more time- it can take nine to twelve months of staying on Propecia before you will see the difference. I also suggest that you take a photo of your frontal balding now with your brow lifted high so that the creases show up well. Once a month photographs with comparasons over time will show subtle changes we might not see on close daily inspection.

To round out the collection of Minoxidil questions I’ve received in the past few days —

Hi Dr. Rassman,
I have recently decided to move to the Re-Mox III 15% minoxidil lotion for my frontal hair loss. Is there a danger to using such a high concentration of Minox? if not, why can’t one find this concentration in rogaine or other branded minox in the stores? Do you know of any side effects? Thanks!

You must remember that Minoxidil is a known anti-hypertensive and can cause low blood pressure and other reported side effects. Any medication that you get at the normally prescribed concentration will be worse in side effects at the higher dose. 15% Minoxidil must be formulated -I do not know where to get it. A pharmacist must prepare it if it is to be legally obtained.

When on a topical such as Rogaine does the “new” hair initally fill in as a finer thiner hair that thickens up over time —-or should the “new” hair start out as a thick terminal hair ? Thank you

I believe that it starts off finer as a rule, then it may or may not thicken. Please see the below blog entry for more on Rogaine / Minoxidil.

Two years ago i noticed that my hair was thinning on top. I found this strange because I was already 25 and my brothers all have full heads of hair. Two years later its noticeable and i cant stand the thought. What is the best treatment(NO TRANSPLANTS) available to me?

Once you make sure that there are no underlying medical issues that could be causing hair loss, and that the balding is genetic, I would suggest that you make an appointment with a hair loss specialist and find out whether Propecia is indicated. The drug slows or stops hair loss in the majority of young men.

I have been taking Propecia for 7 years. I started in my early 30’s when I noticed some thinning. It worked well for me, stopping any further hair loss, and possibly re-growing what had thinned. Recently though, I’ve noticed some significant overall thinning that seems to have come on quite suddenly in the past 2-3 months. I am still taking Propecia daily, and have not missed a day in 7 years.

My question is this… Does Propecia lose it’s effectiveness after a period of time? Would it be of benefit to switch to Proscar, or Dutasteride? Please advise! Thanks!

After the initial improvement in hair count you get from Propecia during the first two years, there is a slow decline in hair count. But this decline is much slower and less drastic than what you would have seen if you had not taken Propecia at all. Stopping Propecia at this time would cause you to lose all of the hair that Propecia has protected for the past seven years. Proscar is the same drug (finasteride) as Propecia, just a higher dose. It has not been proven that a higher daily dose of finasteride is more beneficial, and you do run the risk of having more side effects. Dutasteride is not yet an FDA approved drug for hair loss, so I do not prescribe it.