Finasteride For Male Pattern Baldness

Photo by Ron Lach on Pexels.com

Finasteride is used to treat men with benign prostatic hyperplasia (BPH) and male pattern hair loss, also called androgenetic alopecia. BPH is caused by an enlarged prostate. Men with BPH usually have difficulty urinating, a decreased flow of urination, hesitation at the beginning of urination, and a need to get up at night to urinate. Finasteride will make these symptoms less severe and reduce the chance that prostate surgery will be needed. It may be used alone or in combination with other medicines such as an alpha-blocker (doxazosin, Cardura®) to treat BPH. For men with hair loss, finasteride will increase the number of scalp hairs but will not increase the amount of body hair.

Finasteride blocks the action of an enzyme called 5-alpha-reductase. This enzyme changes testosterone to another hormone that causes the prostate to grow or hair loss in males. It will increase testosterone levels in the body, which decreases prostate size and increases hair growth on the scalp. The effect of finasteride on the prostate and scalp will only last as long as the medicine is taken. When it is stopped, the prostate begins to grow again and the hair will be lost.

This medicine is available only with your doctor’s prescription.

This product is available in the following dosage forms:

Tablet

Finasteride side effects

Finasteride oral tablet doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects that can occur with finasteride include:

  • decreased sex drive
  • trouble getting or keeping an erection
  • ejaculation disorder
  • increase in breast size and tenderness
  • skin rash

If these effects are mild, they may disappear within a few days or a couple of weeks. If they’re more severe or don’t disappear, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • swelling of your lips, tongue, throat, or face
  • depression
  • lumps or pain in your breasts
  • nipple discharge

Finasteride may interact with other medications

An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. To help prevent interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking.

To find out how finasteride oral tablet might interact with something else you’re taking, talk to your doctor or pharmacist.

Finasteride warnings

This drug comes with several warnings.

Allergy warning

Finasteride can cause a severe allergic reaction, causing symptoms such as:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

If you develop these symptoms, call 911 or go to the nearest emergency room.

Do not take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Contact with drug warning

Finasteride may be passed through the skin. Pregnant women and women who plan to become pregnant in the near future should not handle this drug. Doing so could cause birth defects.

Warnings for people with certain health conditions

For people with liver disease: This drug is processed in your liver. If you have liver disease, your body might process this drug more slowly. This could lead to a buildup of this drug in your body, which could increase your risk for side effects. Your doctor might reduce your dosage of finasteride.

For people with prostate cancer: Finasteride can increase the chance of a faster growing or irregular form of prostate cancer. If you have or have had prostate cancer, this drug can make it worse.

Warnings for other groups

For pregnant women: This drug is not prescribed for use in women, and should never be used during pregnancy.

For women who are breastfeeding: Finasteride should never be used in breastfeeding women. It is not known if finasteride passes through breast milk.

This drug is not prescribed for use in women.

For children: The safety and effectiveness of finasteride in children have not been established. This drug is not prescribed for use in children.

How to take finasteride

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Dosage for male pattern hair loss

Generic: Finasteride

  • Form: oral tablet
  • Strengths: 1 mg

Brand: Propecia

  • Form: oral tablet
  • Strengths: 1 mg

Adult dosage (ages 18 years and older)

  • Typical dosage: 1 mg per day.

Child dosage (ages 0-17 years)

Dosage for people younger than 18 years has not been established. This drug is not prescribed for use in children.

Dosage for benign prostatic hyperplasia

Generic: Finasteride

  • Form: oral tablet
  • Strengths: 5 mg

Brand: Proscar

  • Form: oral tablet
  • Strengths: 5 mg

Adult dosage (ages 18 years and older)

  • Typical dosage: 5 mg per day.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years has not been established. This drug is not prescribed for use in children.

Post Finasteride Syndrome

Men in the U.S. and Canada concerned about persistent sexual side effects “coined the phrase ‘post-finasteride syndrome’, which they say is characterized by sexual, neurological, hormonal and psychological side effects that can persist in men who have taken finasteride for hair loss or an enlarged prostate”. As of 2016, Merck was a defendant in approximately 1,370 product liability lawsuits which had been filed by customers alleging they have experienced persistent sexual side effects following cessation of treatment with finasteride.

A 2019 editorial in The BMJ called post finasteride syndrome “ill defined and controversial”. It has common features with other self-diagnosed “mystery syndromes such as morgellons syndrome or multiple chemical sensitivity. There is no known underlying biological mechanism for the proposed syndrome, and its incidence is also unclear. A lack of clear diagnostic criteria and the variable reporting fraction in different health-care settings make the problem challenging to evaluate.

Self-reported symptoms of post-finasteride syndrome include penile atrophy and tissue changes, decreased ejaculate volume and quality, libido loss, erectile dysfunction, loss of penile sensitivity, decreased orgasm sensation, dry skin, metabolic changes, muscle and strength loss, gynecomastia, depression, anxiety, panic attacks, insomnia, anhedonia, concentration problems, memory impairment and suicidal ideation. A meta-analysis found significant association between finasteride use and post-discontinuation depression, suicide ideation, and sexual dysfunction.

Plaintiffs have filed over one thousand court cases against Merck over the effects of finasteride. Most were settled by 2018 when Merck paid a lump sum of US$4.3 million to be distributed. As of September 2019, 25 cases remained outstanding in the United States.[59]

In 2019 Reuters reported that faulty redactions in court documents revealed allegations from plaintiffs that Merck had known of persistent side effects in their original clinical trials but chose not to disclose them in warning labels.

Photo by Ron Lach on Pexels.com

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