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I’m about to start taking Propecia, but I’m currently taking fat burners called Clenbuterol

Will it be ok to take both at the same time?

Many thanks

I have not found anything that suggests a problem mixing these two drugs, but I know very little about clenbuterol other than its use in breathing disorders (chronic asthma) and as an enhancement drug for athletic competitors. You need to do your research and possibly speak with the doctor who is prescribing your Propecia.

My husband has been taking Propecia for about 3 years or so. He is a relatively moody person in general, but nothing out of the ordinary. In the past few years it has been pretty bad to the point where he has tried antidepressants, tried seeing psychologists, etc. Then, this past summer, we went on a vacation and he forgot his Propecia. That was the best week I can remember him having. He felt good and it showed to those around him. I didn’t think much about it except that when he began using Propecia again, he went back to how he felt before and I noticed changes in him right away (within a day or so). When I made the connection that the main difference was that he was off of the Propecia when he felt and acted better, he acknowledged it, but was pretty adament that he would rather be in a bad mood all of the time then lose the rest of his hair. Just this week, I had noticed a difference in his mood and demeanor. I didn’t say anything though…hoping it would last. He then mentioned that he hadn’t taken his Propecia for 4 days. He said he felt really good and it shows. I guess what I am asking, as have others on your site, could there be a connection with Propecia and Mood Swings/Depression? At least with certain people’s chemistry? I would love to know more about this.

Although rare, there have been concerns that finasteride (Propecia) or dutasteride (Avodart) may have some impact on personality or emotions. That would not surprise me as we have seen changes in brain function with testosterone and women have seen hormone cyclical changes that affect mood. The good news is that very few patients out of my large practice have seen significant changes and reported them to me. The literature does have mention of occasional depression which may have been caused or influenced by these medications. I would suggest that if any person has mood alterations with these drugs, they should consult with the doctor who has prescribed it.

NOTE: The following comes to us from a longtime reader that wishes to remain anonymous. He’s gifted us with some insightful posts in the past about the FDA, LLLT, and clinical trial regulations. His email is as follows:

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The Journal of Sexual Medicine recently published an article that has been the source of several Balding Blog posts, including one that answered a reader who wondered if, “the study suggests up to 15% of men taking the drug might experience some form of sexual dysfunction” in context of “the warning label on Propecia (that) … only 2 percent of men might experience erectile dysfunction while using the drug…”.

As a fan of the Balding Blog and a clinical trialist (someone who interprets clinical trial data), and one who has no relationship to Merck or financial interest in finasteride use, I have reviewed the article:

• Dr. Rassman has correctly pointed out that this article is not a study per se, but a review of data in the literature from completed and published finasteride studies that included placebo groups.
• The review included 3 studies of men using finasteride (1 mg daily) for alopecia, 15 studies of men using finasteride (mainly 5 mg daily) for benign prostatic hyperplasia, and 2 for “none” listed as the condition.
• The 3 studies of men using finasteride for alopecia included a combined total of 1196 men receiving finasteride, and 1035 men receiving placebo.
• As Dr Rassman has nicely emphasized before, the “true” incidence of an adverse event (attributable to a drug) is the percentage of men who experience a side effect receiving an active drug minus the percentage of men who experience a side effect via placebo. It is important to emphasize that this equation implies no causality (i.e., if a man receiving a drug gets a side effect, it is attributable to his active drug or placebo regardless of other factors – such as diabetes – that may be causally involved).
• The largest incidence of sexual side effects among the 3 studies involving men with androgenic alopecia is from the smallest study involving only 286 men who received finasteride and were a considerably higher age (41-60 years) than men in the 2 other studies (ages 18-40 years). In older men, factors that contribute to sexual side effects (diabetes, coronary artery disease, and aging) are considerably more frequent. In this small study of 286 men, changes in sex drive were observed (over a period of 1 year of treatment and 1-year of follow-up) in 4.9% receiving finasteride and 4.4% receiving placebo (treatment effect of 0.5%). In the same study, erectile dysfunction was observed in 3.8% of men receiving finasteride and 0.7% of men receiving placebo (treatment effect of 3.1%). In the two larger studies – involving younger men – the incidence of erectile dysfunction was 0.5% (1.4 minus 0.9) in one study, and 0.75% (0.75% minus 0) in the other study.
• Taken together, these results are consistent with the incidence of sexual side effects noted in the finasteride (Propecia) US product label: decreased sex drive (1.8% finasteride vs. 1.3% placebo) and erectile dysfunction (1.3% vs. 0.7%).
• The “15%” figure contained in the Balding Blog post by a reader was based in part on the cited (and misleading) newspaper commentary from a business reporter that stated ”…up to 15% of men taking (Propecia) might experience some sort of sexual dysfunction.” Indeed, The Journal of Sexual Medicine article cites a study of 613 men aged 45-80 taking 5 mg finasteride daily for benign prostatic hypertrophy for 2 years. In this study, 15.8% of men receiving finasteride (compared with 6.3% of men receiving placebo) reported erectile dysfunction. This is 5 times the recommended dose for treating hair loss, though. The largest study, involving 2315 men aged 45 years or older (with prostate hypertrophy), showed the next largest effect on erectile dysfunction: 8.1% (finasteride) vs. 3.8% placebo. This latter figure is almost identical to the incidence of erectile dysfunction noted in the finasteride (Proscar) US label.

In summary, one can’t properly mix “apples and oranges” involving clinical trial data involving different doses of drugs with different patient populations and for different indications. The journal article offered no major insights to me but is a nice review of currently published work. To me, a significant issue of side effects is reversibility. Even a minor headache is devastating if due to an active drug and is not reversible.

Despite anecdotes from blogs, I have seen no case histories published in the medical literature of men using finasteride for androgenic alopecia who have developed irreversible erectile dysfunction that has been attributed to use of finasteride. I am not saying that such a phenomenon does not exist; I just have not read any well-documented case history. A newspaper commentary from a business writer that references a blog where a 32-year old man developed erectile dysfunction (“had pretty lousy quality erections otherwise”) of unknown duration 12 years after starting finasteride and who cites “(recent) experiences with a new sexual partner” is not compelling (to me).