Balding Blog

Dr. Rassman,

Thank you for continually answering questions on this forum. I am amazed how I routinely learn about hairloss by just reading the answers you post in response to other readers.

My question is about proscar. I’ve decided to switch to proscar over propecia because quite frankly, it is much more affordable to buy and split proscar into fours. I read in the past on this forum how you stated that Merck removed the warning about possibly passing Finasteride to a female through semen. My information leavelet that came with the Proscar had the following on it (women should not) “be exposed to the drug through sexual contact with a man taking Proscar”. It suggests that you should use a latex condom during sex. Does this mean that you should not try to have children while taking Proscar/Propecia? Does the fact that the dosage in split Proscar/Propecia is significantly lower than that of regular Proscar eliminate or reduce the risk for “birth defects” in a baby’s sex organs?

Also what you heard or know about a product advertised on TV by the name of Procede? They claim it is once every three months treatment.

Thank You

What is known about finasteride is that if a baby in the womb is exposed to this drug (dosage is not understood) that the development of their sex organs and possibly the way their brain is wired (female vs male) may be influenced. Genital abnormalities can be created by the influence of this drug in the first trimester of pregnancy. These abnormalities, when associated with finasteride, had been observed when the natural form of finasteride was ingested in very, very large doses (based on the research of a mountain village in the Dominican Republic).

The warning by the drug company reflects that knowledge and that a risk may be present. These are clearly warnings that are meant to protect the drug company, but to my knowledge, even with the widespread use of Propecia in young men (over a million men) there are no reports that I know of that show that there is a link between women who got pregnant with their men on Propecia and the creation of genital abnormalities in any of their children. I have one of my sons on Propecia and when he is ready for a family, I will not recommend that he change his usage of this medication. He likes the hair that is now strong in the frontal area and was thinning before he started to use it.

A little bit of history (though having little to do with your exact question) — One of the untold stories in medicine are about the hermaphrodite whose sex is misdiagnosed at birth. The absence of a penis may cause a baby to be classified as female or the presence of a large clitoris, may cause the baby to be classified as male. These children are then raised according to the original sex designations from the birthing room. These situations lead to great tragedy. For those of you wanting to learn more about hermaphrodites, I suggest that you Google the term hermaphrodite. Also, I have recently read a best selling novel titled Middlesex by Jeffrey Eugenides (a Pulitizer Prize winning epic that follows many generations in a family that had a hermaphrodite inheritance pattern in the family line). It puts a face on this tragedy and is a recommended read.

With regard to Procede, please see past responses here.

Hi Dr. Rassman,

I was wondering if it would be possible for you to write me a prescription for Proscar which I can cut into 4 pieces. If not, do you know a physician who will? Also, is there a good method for cutting it evenly? Thank you.

Yes, I can write a Proscar precription for you, but you will have to come into the office for a check-up and diagnosis. Since you indicated you are in the Orange County area, you’re not too far from my Los Angeles office. You can use a pill cutter to cut the pill into 4 or 5 parts. These are sold in every pharmacy for a dollar or two.

Hi Dr. Rassman,

I’ve been taking finasteride (1 mg tabs of propecia) for 3 years with great success. Recently however I switched to Procar with a pill cutter and am horrified to read from the proscar finasteride package information for users leaflet:

“If you partner is pregnant or planning to become pregnant you should use a condom or other barrier method of contraception when taking proscar. This is because your semen could contain a tiny amount of the drug and may affect the normal development of the baby’s sex organs.”

This is news to me after 3 years of using fin. I know of the dangers of women handling tabs but have never read anything about this. Is it only relavent to the 5mg doses of proscar? Your professional opinion is highly respected. Please advise.

Kind regards

This is news to me, too.

We have known about problems arising from a fetus exposed to finasteride — the US leaflet for Propecia states, “If a woman who is pregnant with a male baby absorbs the active ingredient in Propecia, either by swallowing or through the skin, it may cause abnormalities of a male baby’s sex organs.” — but this is a warning for women that want to take finasteride or handle crushed pills.

As I’ve understood it, finasteride does not have any significant concentration in a man’s ejaculate. In my searching, it appears that this line about a condom is only in the UK Proscar leaflet. This wording is not seen in the US or UK Propecia leaflet, and I’ve not seen this in any of the literature before. Although it is the same drug (finasteride), Proscar is 5 times the dosage of Propecia. Merck’s official word is that Propecia poses no risk to unborn children.

I will have to ponder this one for a while, as it is against what has been revealed to me in the past.

Dr. Rassman,

It says here that Proscar has gone generic. Do you believe it, and what does it mean to american customers of Finasteride? I am particularly confused about the 180 days bit? Does it mean that generics of proscar will only be available for a 180 day window.

Thanks Doc

See Dr. Reddy’s launches generic Proscar in U.S..

Yes, Proscar (brand name of 5mg finasteride) has gone generic. Propecia (brand name of 1mg finasteride) is still not available in the generic form in the US. Some patients take Proscar and break the pill in 1/5 or 1/4 in place of Propecia because it costs less. This does not mean Proscar is available without a prescription in the US, but it now that it is to be available in the generic form, it should cost even less to take finasteride in 1mg doses (as long as you break the pill).

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“.

Hello Dr,
Is it the same Propeshia as Propecia? Here in mexico they only sale Propeshia with a “sh” instead of “c” in between. It’s supposedly run by Merck also.

Thanks!

I’ve never seen any packaging or mention of Propeshia (with that spelling), but I did find a reference to it on Drugs.com that basically just confirms that it is from Mexico.

The only other mentions of it with that spelling that I can find are from Mexican pharmacies selling it online, which isn’t exactly the most trustworthy source of information. I thought Merck was selling it in Mexico as Propecia, not Propeshia… but anyone can print a label that says otherwise. It’s possible that it is the real deal, but I’m not sure.

There are so many names that generic Propecia is sold as internationally that I can’t keep up. Some that come to mind include Finpecia, Finax, Finalo, and Gefina. Plus, I have no way to know if there’s even finasteride in the pills you found.