Category: Drugs

Pfizer Inc. subsidiary Greenstone LLC recalled one lot of its Citalopram depression medicine and its prostate drug Finasteride because the wrong labels may have been put on the bottles, said the U.S. Food and Drug Administration.

Greenstone said in a recall notice that bottles of Citalopram, a generic drug with trade names including Celexa, may contain Finasteride, used to treat prostate problems and baldness in men. Finasteride’s trade names include Proscar, Propecia and several others.

Read the rest — Fear of Switched Labels Prompts Recall of Antidepressant, Prostate Drugs

The recall includes 100 count bottles of 10mg citalopram and 90 count bottles of 5mg finasteride. Both are generic, non-name-brand varieties (so you’re fine if you have Proscar; Propecia is not included in the recall).

The article does say — “Both have the lot number FI050058-A on the label.” So if you are taking 5mg finasteride, double check the lot number on the bottle.

Time to say good bye to propecia …

after 3 years on propecia, all this venture end with a gynecomastia surgery ! According to my surgeon the breast gland size was like a lemon…

He also said to me that finasteride drug is also gives to men who want to be a female (transgender…). according to the drug compagny, gynecomastia is a rare side effect… Now i think it is more a common side effect but impossible to really know at least at the beginning of taking this drug… like me….

Anyway this is my own story, i simply want to warning those guys that might thinking of taking this drug…PLEASE READ TWICE THE SIDE EFFECT SECTION, ESPECIALLY THE “RARE SIDE EFFECT SECTION” BEFORE ENROLL TO PROPECIA.

While I’m not entirely familiar with medications transgender patients might take, consider this — most male to female transgender patients do not want male pattern baldness, so finasteride is a good choice to prevent that. Propecia is not a medication to make you transgendered. In other words, transgender people do not take Propecia to make them “more” transgendered.

One of the potential side effects of Propecia is gynecomastia. This side effect is rare (my recollection is 1 in 300 or 500). Most of the time it is reversible, at least in my 14 years of experience… and most men will complain of breast enlargement when it is early, way before their breast turns to the size of a lemon.

In general, for older men (not taking Propecia) the prevalence of gynecomastia is 24-65% (source: eMedicine). But statistics aside, if it happens to YOU it is 100%, right?

Drugs other than Propecia that can cause gynecomastia are:

• Cimetidine (Tagamet), ranitidine (Zantac), to treat heartburn
• Nifedipine (Adalat, Nifedical, Procardia), to treat high blood pressure
• Spironolactone (Aldactone), to treat high blood pressure and heart failure

Hey there.have you ever heard of a product called Prorestora? Claims to be fda approved. Thanks alot, really helpful site!

ProRestora isn’t by itself FDA approved, but it probably contains minoxidil (I couldn’t find a list of ingredients, so I’m just speculating). There are only two FDA approved hair loss medications — minoxidil and finasteride. Finasteride requires a prescription, minoxidil does not. Minoxidil is otherwise known as Rogaine/Regaine (depending on country). There are a lot of products that include minoxidil as the active ingredient since it is proven and available over the counter.

Either that… or it could be a scam. Even the bottom of their site says “All statements and information on this website have not been evaluated by the Food and Drug Administration“.

Hi DR, I have two questions: is it possible to get any heart disease by using topical minoxidil? And if I have chest pain what exactly is happening inside my body?
Thanks for your answer

If you have chest pain, you need to go to the Emergency Room or call your doctor right away. Topical minoxidil does not cause heart disease and I’ve addressed the chest pain before. Minoxidil (when taken orally) is a blood pressure lowering drug and was originally used to treat high blood pressure, but it was not very effective or consistent. Side effects of topical minoxidil can include dizziness or palpitations, but this is rare (especially if you are using the recommended 5% solution).

This is part of a comment someone posted that I wanted to address:

I was disheartened last night to read that Dr. Rassman was paid to present to a Merck Committee which could perhaps explain his bias. I don’t know how much he was paid, how often it occurred, or if the company used any psychological manipulation on him, but I am starting to feel he’s lost for good. It is a very scary world in which we live, if one can trust their own animal instincts over the educated and experienced opinions of doctors.

To clarify, I was never paid by Merck. Anyone can post comments on forums, but this is bordering on slander.

Over the years of writing my BaldingBlog, I have come across a select group of critics who have an issue with Propecia and I address those issues here without censorship. To clarify again, I prescribe Propecia, the only FDA approved oral medication for genetic androgenic alopecia (AGA) to my patients who have been diagnosed with AGA. The risks and benefits are explained to them as an optional medication.

I do not make money from selling Propecia, as I sell it in my office for almost my cost (just enough extra to cover stocking costs). In fact, most of my patients go to a drug store to get the generic finasteride 5mg, which they cut in quarter doses. I have nothing financially to gain from recommending Propecia (finasteride). Since I make most of my income from hair transplant surgery, it would actually be advantageous for me NOT to recommend Propecia. So where is my bias?

Hello Doctor,
I am 26 years old and have been taking Propecia 5mg for almost 2 years. Till last month I used to get prescription refilled from Duane Reade. Then I came to know about Target Pharmacy they give 30 tablets for 10$ only. To save some bucks, I had last prescription refilled from Target, but for last two days, I am experiencing more hair fall. Is it just a coincidence or something else?

Thanks

I would say it is coincidence, mostly because nothing changes in the matter of days. And generic finasteride 5mg should be same everywhere, unless it is a counterfeit medication that is widely sold through the internet. There was just a segment on the 60 Minutes TV show about the fight against counterfeit drugs. But… seeing as how you bought it at a large New York based pharmacy chain, I wouldn’t think fake meds would make it into their system.

Generic aspirin or Tylenol (acetaminophen) works just the same no matter where you buy it or how much money you spend, but I would assume there is a negative placebo effect where people believe a product is not as good when you pay less. Think about that when you buy expensive brand name shoes or clothes. I have heard from a few readers that say they’ve had similar problems to what you’re experiencing after switching to generic, but there is very little information on it.

Snippet from the study abstract:

Methods. We conducted standardized interviews with 71 otherwise healthy men aged 21–46 years who reported the new onset of sexual side effects associated with the temporal use of finasteride, in which the symptoms persisted for at least 3 months despite the discontinuation of finasteride.

Results.  Subjects reported new-onset persistent sexual dysfunction associated with the use of finasteride: 94% developed low libido, 92% developed erectile dysfunction, 92% developed decreased arousal, and 69% developed problems with orgasm. The mean number of sexual episodes per month dropped and the total sexual dysfunction score increased for before and after finasteride use according to the Arizona Sexual Experience Scale (P < 0.0001 for both). The mean duration of finasteride use was 28 months and the mean duration of persistent sexual side effects was 40 months from the time of finasteride cessation to the interview date. Study limitations include a post hoc approach, selection bias, recall bias for before finasteride data, and no serum hormone levels.

Read the full abstract — Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss

This is new to me. We always try to follow publications, but remember that just because an article is published does not mean it is FACT and everyone needs to understand how the results were compiled. This was a paper based only on interviews of 71 men with sexual side effects only. I’m unsure about what lengths they went to find any underlying health issues or even conducting physical exams.

If this is true, then those men who develop sexual side effects will have a difficult decision. This has not been my experience in using and prescribing this drug for over 14 years. We have to make our decisions not just based on what we read, but also the methods of how the conclusions were based.

More info can be found at Time.com.

Does anyone think the new drug called astressin-B has any possible benefits to regrow hair? I am surprised no one has asked any question about the new finding made last month. Researchers claim that mice grew hair when injected with the drug astressin-B, how far is this true and how long would it take for the treatment to be available.

Thanks

Actually, we did write about this last month.

Quick recap — researchers discovered that a compound (astressin-B) that blocks the action of a stress hormone called corticotrophin-releasing factor (CRF) was able to regrow hair in genetically altered mice. There isn’t enough information available to discuss anything beyond what was published. It is all hopeful, but the FDA process will take years before safety and effectiveness is proven in humans.

Dear Doctor,

Really Love the website. I wanted to know, I have read up on HGH and some of the positive side effects which were listed, are hair growth and thickness on the scalp. I was wondering these method hasn’t been used to treat hair loss.
Thank u.

Human growth hormone (HGH) is not something that should be taken lightly. I have met many men who have elected to take it and it is definitely effective at making the person who takes it feel more energy, younger, and have more vitality. While HGH may have many benefits (including some reported hair regrowth), there are also patients that suffer heart attacks. The final conclusions on safety are not out as far as I am concerned.

I am not religious so take what I’m about to say as my logical mind in action, but I believe that if we were intended to have the energy of a 20 year old when we are 60, then our bodies would continue to secrete growth hormone late into life. Since I believe in Darwin’s laws, older men with vigor would probably compete better for women, and survive in the bush better as they would be more stealth, but alas, that is not how we are built so I suspect that there are plenty of down sides. I am not an expert on the subject, so read on the various sites for HGH and interpret what you want.

A recent article I read in the LA Times a few weeks back discussed negative side effects of HGH, which can promote cancer. With the hype of Propecia and its side effects, HGH would not be recommended. Remember, there is always a risks and benefits of any drug use. My point is HGH is not a bad drug. It has its purpose and use. I just wouldn’t recommend it for treating balding.