Category: Drugs

I was just wondering if you knew why the side effects of Finasteride can show up after 10 years or longer. Surely after this amount of time the body is used to the drug, are there any cases where Finasteride has been proven to be the cause of this and not from other conditions such as diabetes etc.

I find it worrying that the sides could strike at any time.

Thanks

I do not know. One guess is that after 10 years you have simply aged with all its age related issues. We know that the older a man gets, the less his libido and his performance abilities with regard to getting and holding an erection. It is believed that erectile dysfunction occurs as follows (as a simplified rule of thumb):

• Men in their 20s have a 20% incidence
• Men in their 30s have a 30% incidence
• Men in their 40s have a 40% incidence
• Men in their 50s an even greater rise in ED

As you get older, sexual issues become more of an issues even without any medication being the culprit. Please speak with your doctor. An unhealthy lifestyle, poor diet, obesity, and/or genetics cause diabetes – which is one of the main cause for erectile dysfunction (among a slew of other co-morbidities).

i quit propecia for 3yrs i did not get sides back then i tolerated the drug well but now im restarting i got sexual sides after a week of taking it which decided me to quit. i do not understand why did this happen? got no sides on first use but when i take again i get sides for the first time.

I am not sure how it is related. It is possible you can have side effects now even though you didn’t have side effects 3 years ago. It is also possible the side effects may be unrelated and you have other medical issues. I don’t know why you stopped the medication 3 years ago or which side effects you’re seeing now, so please discuss this with your prescribing doctor.

Doc..

I can’t take the PG in minoxidil formulas and the foam seems to get more on my hair than my scalp. I have been taking 5% non PG Formulas from Dr. Lee who is now out of business. How much hair can one expect to lose going from a 5% formula for years to 2%.. which I’m assuming has less PG. is that a correct assumption?

You can get 2% minoxidil from the drug store without propylene glycol (woman’s version of the product). I can not predict what the effect of reducing the dose would be, but I might suggest more frequent use than just twice a day as you ‘crank’ down the dose. As everyone is different in their response to minoxidil, I really can’t tell just will happen.

Although this isn’t a prescription medication, talk to your doctor about changing dosage, as there may be other effects that can occur based on your medical history.

Hi,

I have been advised by a doctor to begin taking Propecia, and have been researching it A LOT. I have read both horror stories and great success stories and agree that people should stop scaremongering. Just because you happen to have been taking Propecia does not mean all your ailments were caused by it! I bet 100% of those things happen to people who do not take it too.

My only concern is that the Propecia website has been all but closed down. Do you have any idea why this is? It is now the only thing stopping me from going ahead with the treatment. It just seems a bit strange? It makes me wonder, what if Merck were to go out of business and Propecia stops being made. What happens to all those people who have been taking it for years?

Thanks for all your great responses, this is a great place of understanding and comfort, when it seems nobody else does!

Your guess is as good as mine. Initially, I thought it may have to do with the Propecia patent expiring, but that doesn’t occur until November 2013. Once that happens, you wouldn’t have to worry about Merck going out of business (which I doubt would happen anytime soon, regardless).

Hair loss message boards have speculated about why the site was pulled down, but it’s just that — speculation. I really have no idea.

Dear Dr. Rassman,

I found this blog a very interesting read, and I appreciate you taking the time to answer questions online like this. It has been a wonderful resource in coming to terms with the somewhat shocking discovery of my hair loss.

I am about to start treatment with propecia for my thinning top, but there’s something that has been nagging me:

I want to heed this blog’s earlier recommendation and wait until after a year on propecia before trying Rogaine. But isn’t it “the earlier, the better” even with propecia working in the background? Wouldn’t this delay risk my potential for improvement? Wouldn’t it risk killing miniaturized or dormant hair?

It is my hope to completely eliminate the visible thinning with medical treatment. I realise my odds aren’t super great, but I also feel it wouldn’t take much improvement to achieve this. My hairline has receded to mature levels but seems stable. I will be 25 this year and I only noticed my thinning a month ago.

Generally, when I recommend a medical treatment for androgenic alopecia (AGA), I only have two proven medications I can recommend: (1) Rogaine (topical minoxidil), and (2) Propecia (oral finasteride 1mg). While you can start taking both treatments at once, it would be difficult to assess which medication had more or no benefit. So I usually give the patient a choice on one medication and they use it for 6 to 12 months to assess how it is helping their hair loss issue before we add on the second medication.

Also, in practical (real world) terms, it is a hassle for men who are not used to taking any medication to stick with the regimen of taking a pill every day (Propecia) and putting on a topical medication twice a day (Rogaine). Before they know it, most patients get lazy, forget to take the medication, or forget to resupply the medication when they run out. I find that in a good percentage of time, the failure of a medication is related to the poor compliance issue. This not only applies to Propecia, but many other medications.

So yes, while starting both at the same time allows you to potentially see your maximum benefits begin sooner, it’s a lot for most men to keep up with every day. And who knows — since you just noticed your thinning, only one of the meds might be all you need.

I take 5mg Finesteride daily and also used to take 0.4mg Tasulosin. My doctor ‘s PA took me off Tamsulosin with no reason given.

Is there a reason?

Thanks

The reason can be found by asking your doctor or your doctor’s assistant. Finasteride 5mg (Proscar) is used to treat the symptoms of an enlarged prostate. Tamsulosin (Flomax) is also used to treat the symptoms of an enlarged prostate. This is a site focused on hair loss issues, not prostate issues… and I have no insight into why your doctor did or didn’t prescribe certain medications to you.

The recommended dose of finasteride is 1mg a day for treating hair loss, and taking more will not make things better with respect to hair. Tamsulosin is not (and has never been) used for to treat male pattern baldness.

Hi Dr.Rassman, what are your opinions regarding the safety and effectiveness of topical spironolactone? Is it a safe alternative to proprecia or does it pose harmful side effects?

It does work for the treatment of balding, but the side effects are significant and far more common than Propecia, including the scope of side effects.

Spironolactone causes an increased risk of bleeding from the stomach and duodenum, gynecomastia, and testicular atrophy (kills off the testicles or makes them smaller and less effective). Erectile dysfunction would be common and it can cause a serious rise in potassium in the body (hyperkalemia). The side effects and complications go on and on.

It should never be used to treat the benign condition of male pattern hair loss.