Balding Blog

I’m 25 years old from Israel and I’m a big fan of your website and very impressed by the elaborate answers you give. As part of my research of treating my own hair loss, I read a lot about dutasteride (Avodart) and ran into this clinical trial.

It looks like GSK is doing the last phase before taking it out to the market as a hair loss product. What is your opinion about this study:

Avodart Phase 4 Protocol Summary

Thank you for bringing this to our attention. I really don’t have anything to add, as this Phase IV study just started in April and isn’t scheduled to end until 2013. There’s not much info available beyond what is listed on that summary page.

The US ClinicalTrials.gov glossary describes the four phases of clinical trials: “Phase I tests a new drug or treatment in a small group; Phase II expands the study to a larger group of people; Phase III expands the study to an even larger group of people; and Phase IV takes place after the drug or treatment has been licensed and marketed.”

The glossary further defines Phase IV as: “Post-marketing studies to delineate additional information including the drug’s risks, benefits, and optimal use.”

So while Phase IV trials are generally done after the drug is already approved by the FDA (at least in the US), perhaps things are different with the phases outlined by the Korea FDA. Searching the Korea FDA site isn’t proving too helpful. I do know that Avodart (dutasteride) isn’t approved for treating hair loss yet in the US, though. Any readers out there with some knowledge about the various clinical trial phases and how they might different by country, please feel free to set me straight in the comments section.

Hey guys. I have been taking proscar (in 1/4’s) for about 10 years but recently I’ve noticed a decline in its effectiveness. So I upped it to 1/3’s. I’ve been under a fair amount of pressure lately and I’m not sure if that is the cause but it seems like I’m always out of breath. I’ve read on various hypochondriac forums that it can be a side effect of the drug. Can you please set the record straight on this?

Thanks so much!

Shortness of breath is a rare, severe side effect of finasteride… so the hypochondriacs are correct. I don’t recall any of my patients reporting respiratory issues from the medication, but it is listed as a known side effect.

I hope you discussed changes in finasteride dosage with your prescribing doctor before you did the increase.

Hi,

Like a lot of other people taking finasteride, I have opted to cut Proscar into my daily amounts to save money. I began by taking 1/4 of a 5mg Proscar pill per day and then moved onto 1/5 per day – Both of which left me with some side effects.

Recently I have attempted to take 0.5mg per day, by way of cutting 5mg into 10 pieces. The pieces I am left with are all reasonably similar in size (for the exception of perhaps one piece, which may end up slightly lesser than the others).

My question is, should there be any problem with going about 0.5mg per day in this fashion? It’s likely of course that some days I may be getting slightly more or slightly less than 0.5mg, but should that slight possible variation effect my attempts at reducing DHT within my body?

Thanks.

Wow, you’re the first person I’m aware of that can cut a Proscar pill into 10 pieces. Not that there is some sort of competition for these things, but the pill just seems too misshapen to be cut into 10 equal parts. I’d think a pill cutter might be too difficult to use for that, so perhaps you’re using a knife.

In any case, to answer your question… there is nothing wrong with what you are doing. If you are doing it to minimize the side effect risks, 0.5mg finasteride should still have some impact on DHT. If you’re doing it just to save costs, you should consider getting the generic 5mg finasteride since it’ll be cheaper than the name brand Proscar.

Dr. Rassman, have any of your patients ever complained of Propecia causing Dry Eyes? I’ve been experiencing severe dry eye for a while and until now I hadn’t really thought that cause might be the Propecia. My eye doctor wasn’t aware of that being a side affect but she was going to research it. I’m thinking about stopping it for a month or so to see if I notice any improvement.

Thank-you

Dry eyes is not an officially reported side effect, but I have heard other doctors in my field report rare occurrences of it. I would speak to your doctor and consider stopping the medication after weighing out the risks and benefits of your treatment (with your doctor).