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Finasteride (Propecia) for Hair Loss


Basic information
  • Generic name: Finasteride
  • Brand/Trade names: Propecia, Proscar
  • Dosages: Tablets 1 mg, 5 mg
  • Pharmacologic category: Enzyme inhibitor
  • FDA approved: December 19, 1997
  • Habit forming? No
  • Pregnancy risk factor: X
Medical uses

Finasteride (Propecia) is a specific type II 5-alpha reductase inhibitor. It inhibits the enzyme responsible for regulating conversion of testosterone to dihydrotestosterone (DHT). By reducing DHT levels in the scalp, the drug decreases DHT effects on the hair follicles, reversing the process of hair loss.

Daily use for three months or more may be necessary before a person will notice increased hair growth.

Finasteride indicated uses include:

  • Male pattern hair loss (androgenic alopecia) in men only
  • Benign prostatic hyperplasia (BPH) in men with enlarged prostate

Decreased libido, impotence, decreased volume of ejaculate are the most common side effects associated with Finasteride.

Pharmacological characteristics
  • Absorption: bioavailability is 65%.
  • Metabolism: Extensively metabolized in the liver, primarily via the CYP-450 3A4 enzyme subfamily. Finasteride has two active metabolites: t-butyl side chain monohydroxylated and monocarboxylic acid. Each metabolite possesses no more than 20% activity.
  • Elimination half-life: 3.3 to 13.4 h
  • Excretion: 32% to 46% is excreted in the urine as metabolites, and 51% to 64% is excreted in the feces.
Benefits
  • Increases hair growth and reduces hair loss
  • No drug interactions of clinical importance
Concerns
  • Improvement takes 6-12 months
  • Any benefits are lost when medication is stopped
  • Sexual side effects
  • Depression. The research suggests that finasteride may induce depressive symptoms 2.
  • Expensive
Unlabeled uses
  • Female hirsutism 3
Mode of action

Male pattern hair loss, or androgenetic alopecia, is an androgen-dependent disorder. In genetically susceptible men, dihydrotestosterone (DHT), a potent metabolite of the male androgen testosterone, contributes to male pattern hair loss. The conversion of testosterone to DHT is regulated by the enzyme 5-alpha reductase, which is found primarily in scalp hair follicles.

Finasteride inhibits conversion of hormone testosterone into 5-alpha-dihydrotestosterone (DHT), a potent androgen. Finasteride decreases DHT concentrations in the serum and the scalp by up to 70 and 60%, respectively.

Propecia (Finasteride) Discussion Boards & Forums
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References
  • 1. U.S. Food and Drug Administration. Finasteride (Propecia) U.S. Prescribing Information. Available at (PDF format): Prescribing Information
  • 2. Rahimi-Ardabili B, Pourandarjani R, Habibollahi P, Mualeki A. Finasteride induced depression: a prospective study. BMC Clin Pharmacol. 2006 Oct 7;6:7. BioMed
  • 3. Beigi A, Sobhi A, Zarrinkoub F. Finasteride versus cyproterone acetate-estrogen regimens in the treatment of hirsutism. Int J Gynaecol Obstet. 2004 Oct;87(1):29-33. PubMed
Interesting Finasteride facts

propecia Finasteride medication

  • At the end of 2004 the World Anti-Doping Agency added finasteride to its list of banned drugs in international sports. The agency calls finasteride a masking agent that hides the use of more nefarious drugs like the steroid nandrolone. (NYTimes)
  • Propecia is a prescription medication approved by the FDA originally as a prostate gland shrinking medication.
  • However in 1998 it was also approved at a lower dosage as an anti-baldness treatment.
  • It is sold as a prescription prostate medication in 5 mg tablet form under the brand name Proscar and for treatment of hair loss it is sold in 1 mg tablets under the brand name Propecia.
  • Propecia is the first and only FDA-approved oral medication for the treatment of male pattern hair loss on the vertex (top of head) and the anterior mid-scalp (middle front of head) in men only.


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