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fred11

Finasteride Advice Needed

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Hi,

 

I’m in my mid 30’s and for the last few years my hair has started to gradually recede. I’m now at the point where I need to take some sort of action, because it’s affecting the way I look and feel.

 

My lifestyle means topical solution Minoxidil/Rogaine wouldn’t be practical. I am considering FUE, but this wouldn’t be realistic at this stage as I am only just starting to recede, so it’s something I may consider at a later stage.

 

I am interested in trying Finasteride/Propecia to keep what I have, however I have a few questions that I would be grateful if you could answer or give me your opinion.

 

If I started taking Finasteride for 2 years and then stopped, would I then lose the hair I would have lost in that period if I wasn’t taking it? Or would the hair loss be greater or increase at a higher rate after I stop using? i.e. would it create more hair loss in the end than if I hadn’t used it?

 

Can you stop and restart the use of Finasteride?

 

Can you reduce the amount you take? For example, only taking half the dosage each day?

 

Is it safe to use continuously for the rest of your life? If I wanted to have kids, should I come off it before trying, and how long should it take to completely come out of my system.

 

Where is the cheapest place to buy Finasteride from? Is their a generic version that is cheaper than Propecia? If so, is it as safe and is it exactly the same (i.e. ingredients etc, are we just paying for the brand?), do you have any recommendations where I should buy from?

 

Thanks in advance for any replies and advice.

 

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If I started taking Finasteride for 2 years and then stopped, would I then lose the hair I would have lost in that period if I wasn’t taking it? Or would the hair loss be greater or increase at a higher rate after I stop using? i.e. would it create more hair loss in the end than if I hadn’t used it?

 

From Keratin.com: "In six months after stopping Propecia you will lose about half to two thirds of the hair that regrew due to Propecia. By 12 months you would lose it all."

 

Can you stop and restart the use of Finasteride?

 

Also from Keratin.com: "How much hair you would gain back again after restarting Propecia use would depend on how long the time interval was between stopping use and starting again. Probably after stopping for just 3-4 months you would be able to use Propecia again and regain pretty much all the hair that was lost. After stopping Propecia use for over a year you may not gain back all of your previous hair regrowth."

 

Can you reduce the amount you take? For example, only taking half the dosage each day?

 

Doses smaller than 1mg/day can also stop hair loss and regrow some hair, but the studies I've seen suggest that 1mg will promote a faster response.

 

Is it safe to use continuously for the rest of your life?

 

Yes, there are men with a condition called 5 alpha reductase deficiency who have a similar hormonal profile to finasteride users. These men are otherwise normal, healthy men who have small prostates throughout life and do not experience male pattern hair loss, benign prostatic hyperplasia or prostate cancer.

 

If I wanted to have kids, should I come off it before trying, and how long should it take to completely come out of my system.

 

Two studies of the effect of finasteride on sperm have been conducted. One tested a 1mg dose for a year and concluded that "treatment with 1 mg. finasteride daily for 48 weeks did not affect spermatogenesis or semen production in young men." Another study examined the effect of the larger dose of 5mg per day, concluding "the decrease in DHT induced by 5ARIs is associated with mild decreases in semen parameters that appear reversible after discontinuation."

 

If a pregnant woman has sex with a man taking 1mg finasteride, it poses no risk to a foetus. This is from the Electronic Medicines Compendium: "A small amount of finasteride, less than 0.001% of the 1 mg dose per ejaculation, has been detected in the seminal fluid of men taking 'Propecia'. Studies in Rhesus monkeys have indicated that this amount is unlikely to constitute a risk to the developing male foetus (see Section 5.3). [However]... Crushed or broken tablets of 'Propecia' should not be handled by women when they are or may potentially be pregnant because of the possibility of absorption of finasteride and the subsequent potential risk to a male foetus. 'Propecia' tablets are coated to prevent contact with the active ingredient during normal handling, provided that the tablets are not broken or crushed."

 

Where is the cheapest place to buy Finasteride from? Is their a generic version that is cheaper than Propecia? If so, is it as safe and is it exactly the same (i.e. ingredients etc, are we just paying for the brand?), do you have any recommendations where I should buy from?

 

Finasteride is marketed as a 5mg dose for BPH (brand name 'Proscar') and a 1mg dose for male pattern hair loss (brand name 'Propecia'). Proscar's patent recently expired and cheaper generic versions, which you can cut into fifths, are now available. Propecia will not lose patent protection until 2013.

 

However, Indian patent law allows domestic pharmaceutical manufacturers to copy foreign drugs. These drugs are not intended for resale outside India but unregulated internet pharmacies do sell them on to Western customers. It's not always clear whether these meds are actually genuine.

 

In the UK you can obtain Propecia or Proscar from Boots Hair Retention Programme or by private prescription from a GP.

http://www.hairhelp.myzen.co.uk/?q=node/7

 

Hope this all helps!

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are there studies that show the effectiveness of finasteride wears off after a few years of taking it?

 

The longest study of Propecia was the 5-year trial. This is a summary from hairlosstalk.com:

 

At the start of the studies, baseline hair counts averaged 876 hairs in a one-inch diameter area of scalp. By the end of the first year, men taking Propecia had an average of 126 more hairs than men taking placebo. This difference continued to grow, and, by the end of the fifth year, the net difference between the groups increased to 277 hairs in favor of the men taking Propecia. At the end of the fifth year, 65 percent of men taking Propecia (n=219) maintained or improved their hair count compared to their hair count at the start of the studies, while all of the men on placebo (n=15) lost hair count.

 

The basic story is that Propecia gets better and better compared to placebo, but peaks compared to baseline at 2 yrs. Here's the graph:

IPB Image

 

 

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so after it peaks at 2 years, the hairloss continues but at a slower rate than it would without Finasteride? Is that when you could consider going on dutasteride?

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so after it peaks at 2 years, the hairloss continues but at a slower rate than it would without Finasteride? Is that when you could consider going on dutasteride?

 

Well, the numbers are just averages - some men will continue to lose hair from day 1 on Propecia. It's possible that the hair counts are pulled down by non-responders, so some men may experience a period of regrowth followed by a long plateau.

 

Someone explained it to me like this: imagine we have a hypothetical drug that gives 9 out of 10 men all their hair back over 12 months - but after those 12 months those guys simply maintain that full head of hair for life. One unlucky remaining patient gets no benefit at all and continues to lose his hair over the first 12 months and beyond.

 

In this case, the average hair count for all 10 guys will shoot up in the first year, because hair growth for the nine good responders is much greater than the hair loss of the one unfortunate non-responder. Once the first year is up, the good responders have got all their hair back so the average hair count cannot increase anymore. However, the non-responder is still losing his hair, which will drag the average hair count down again. Make sense?

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yeah I see. Are they conducting any longer trials? As more and more men become aware of Finasteride, I expect use of the drug will increase.

 

I haven't heard of any plans for longer trials. These things are HUGELY expensive so it's hard to see an incentive. The drug has been out for more than a decade in the US, and sales have been described as disappointing.

 

http://www.pharmalot.com/2007/10/mercks-pr...s-thinning-out/

 

Marketing the drug seems to have been a particular problem in the US (and direct advertising of prescription meds is actually banned in Europe).

 

http://hbswk.hbs.edu/item/4503.html

 

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