Posts Tagged: Hair Loss Medication

Is Finpecia a Viable Hair Loss Medication?

September 14th, 2006

Q: A friend of mine is taking Finpecia, is this the same as Propecia?

A: Both Propecia and Finpecia contain the active ingredient Finasteride 1mg. Finpecia is manufactured in India by the company Cipla. It comes in packets of 10. Finpecia contains the same chemical ingredient as Propecia, i.e. 1mg of Finasteride, but it is manufactured differently and it is less expensive.

Indian patent law allows companies in India to make medications that are patented by drug companies in other countries, since Indian law protects only the processes by which drugs are made and not medication itself. Therefore, if an Indian company finds another way to make a drug, it can legally do so.

Cipla has not published any studies showing that their generic Finasteride is identical or as effective as Merck’s original product in treating hair loss.

These alternative processes and drugs are not regulated by the FDA, so there is no assurance that the medication manufactured in India has the same biologic activity or potency as the FDA approved counterpart made in the United States.

Topic: Drugs & Medications

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Posted by Robert M. Bernstein M.D. at 12:15 pm

Is Hair Loss Treatment with Avodart Safe?

September 1st, 2006

Q: My friend is taking Avodart, he bought it over the internet. Is it safe to take?

A: Avodart (dutasteride 0.5mg) was approved by the FDA for the treatment of prostate enlargement in men in 2002. Avodart has not been approved for the treatment of androgenetic hair loss, although physicians can use an approved medication in ways other than for which it was specifically approved. That said, the use of dutasteride certainly requires a doctor’s supervision.

Like finasteride (the active ingredient in Proscar and Propecia), dutasteride blocks the enzyme 5-alpha reductase that converts testosterone to DHT (DHT is a key hormone that causes hair loss). However, unlike finasteride, which only inhibits the Type I form of the enzyme, dutasteride inhibits both the Type I and Type II forms. This combined effect lowers circulating DHT more with dutasteride than with finasteride, but also increases the incidence of its side effects.

The Type II form of the enzyme (blocked by finasteride) is found predominantly in the hair follicle. The Type I form of the enzyme has been found in the scalp and sebaceous glands, and many other parts of the body, but its exact role in hair growth has not been determined. It is felt that dutasteride’s ability to dramatically lower serum levels of DHT is what makes it a more potent medication in hair loss.

When considering the safety of dutasteride, one should consider the following:

  • It acts on other parts of the body besides the hair follicle.
  • Unlike finasteride, where families that had a deficiency of the Type II 5-alpha reductase enzyme were followed for years without any adverse effects, there is no natural biologic model to show the safety of dutasteride.
  • Dutasteride has been approved for prostate enlargement in an older male population. It is not approved for hair loss and, in fact, the clinical trials for hair loss were discontinued, so there is no safety data for its use in younger patients. There is a greater incidence of sexual side effects with dutasteride compared to finasteride.
  • The 1/2 life of dutasteride is 5 weeks compared to 6-8 hours for finasteride. Serum concentrations of dutasteride are detectable up to 4-6 months after discontinuation of treatment.

Topic: Drugs & Medications

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Posted by Robert M. Bernstein M.D. at 5:30 am

What are Long-Term Effects of Hair Loss Treatment with Propecia?

August 28th, 2006

Q: I have a 19-year-old son who is suffering from hair loss. I wonder if that will affect him in years to come if he starts taking it?

A: Finasteride was approved in 1992 as Proscar and as Propecia in 1997, so there is a lot of clinical data so far. Remember that over time, additional long-term data and clinical experience will be available. For example, we have 14 years of experience with the medication. By the time your son has been on it for 10 years, there will be 24 years of clinical experience with the medication, so judgments with more long-term information can be made at that time.

The one question that has come up is that a study showed that finasteride 5mg (Proscar) decreased the incidence of prostate cancer by 25%, but some of those in the study who developed prostate cancer had a higher grade of tumor. It is now felt that since finasteride shrinks the enlarged, but benign, tissue surrounding the prostate cancer, the malignant part in the center of the tumor was more easily reached with the needle biopsy, giving a false positive reading in the study. Supporting this explanation is the fact that those on Proscar did not have a more severe course from their cancer than those not taking the medication.

Topic: Drugs & Medications

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Posted by Robert M. Bernstein M.D. at 5:59 am

Was Propecia Hair Loss Medication Originally for Treatment of Prostate Enlargement?

August 21st, 2006

Q: I heard that Propecia was being used originally for shrinking the prostate, is this true?

A: Propecia (finasteride 1mg) is not a prostate medication that was serendipitously noted to have a side effect of re-growing hair, it is a medication that was known all along that it might be able to slow hair loss and/or to grow hair.

Although finasteride was first approved for the treatment of prostate enlargement, the researchers at Merck knew, at the outset, that there were families whose members were deficient in the 5-alpha reductase, Type II enzyme and that the men in these families neither developed prostate disease nor went bald. In addition they had no long-term problems from the lack of this enzyme.

Merck used this natural model to develop a medication that could block the 5-alpha reductase, Type II enzyme – the result was finasteride. Because the only approved treatment for symptoms related to prostate enlargement at the time was surgery, Merck developed finasteride as a medical treatment for this condition prior to developing finasteride as a potential treatment for men with male pattern hair loss.

This also meant that Merck would understand the safety profile of finasteride, and have it approved for a medical disease (symptomatic prostate enlargement), before developing it for a cosmetic condition.

The drug was first submitted to the FDA for the treatment of prostate enlargement as Proscar (finasteride 5mg) in 1991 and it was approved for this use in 1992. The drug was submitted for the treatment of men with male pattern hair loss as Propecia (finasteride 1mg) in 1996 and was approved for this use in 1997.

Topic: Drugs & Medications

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Posted by Robert M. Bernstein M.D. at 7:12 am

How is Rogaine for Women Different from Rogaine for Men?

August 11th, 2006

Q:What is the difference between Rogaine for men and Rogaine for women?

A: Rogaine for men is 5% minoxidil and Rogaine for women is 2%. Another difference is that the 5% solution has propylene glycol in it whereas the 2% is alcohol based. The propylene glycol helps the minoxidil penetrate the skin better and makes the medication more effective. Although both the alcohol and propylene glycol based preparations can irritate the scalp, propylene glycol can cause actual allergic reactions in those who are sensitive.

Propylene glycol is greasier to have on the scalp than the alcohol based formulation. For patients who complain of the greasiness, we advise Minoxidil 5% at bedtime and 2% in the AM.

A side effect of minoxidil specific to women is increased facial hair and this is seen predominately with the 5% propylene based formulation. Women are also more likely to experience lightheadedness or dizziness from the medication.

Topic: Drugs & Medications

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Posted by Robert M. Bernstein M.D. at 6:55 am



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