Q: I heard that Proscar, the 5mg version of finasteride, is now generic. Is that correct and is Propecia going generic as well?
A: Yes, Finasteride 5mg (Proscar) is now available in a generic formulation. It is my understanding that Finasteride 1mg (Propecia) will not be available generically until the year 2012.
Q: I am currently taking Propecia 1mg a day for hair loss and heard that Proscar 5mg now comes in a generic form. If I get that, how should I take it?
A: If you are currently taking Propecia 1mg a day, and want to switch to Proscar (Finasteride 5mg), you can either take Proscar 5mg, 1/4 pill every day or 1/2 pill every other day.
If you break up the pills, be mindful of the potential risk to pregnant women from handling crushed tablets. You can purchase a pill cutter in any pharmacy.
You should be aware that this dosing is not recommended by Merck and that there are no studies showing that either breaking up the pills or taking alternate day dosing is as effective as taking Propecia (Finasteride 1mg) a day.
That said, finasteride lasts in tissues for several days, so these alternate day dosing schedules seem reasonable.
Q I am 35 years old and have been using Propecia for the last 3 years, waiting to save enough money for a hair transplant. I no longer feel comfortable using it due to side effects. Can hair transplantation still be effective even without continuing to take this drug afterwards?
A Many people choose not to take Propecia or choose not to take it due to side effects and the surgical hair restoration is just as effective. The only difference is that medications can prevent further hair loss whereas surgery cannot.
Medications are not needed for the hair transplant to be successful or the transplanted hair to grow and be permanent.
Q: I have read on numerous websites that Propecia and Minoxidil work synergistically, and that a hair loss suffer will see better results using them together than either one alone. Do you believe this is the case, or do you think Propecia is enough treatment by itself for someone who just began to experience slight hair thinning and is too early for hair transplantation?
A: They may act synergistically since their mechanisms of action are different.
Rogaine (Minoxidil) stimulates the hair follicle directly, but Propecia (Finasteride 1 mg) permits hair growth by blocking the negative effects of DHT. Of the two, Propecia is far more effective. It is reasonable to use the two together as long as the medications are used regularly.
For patients contemplating surgical hair restoration, we generally have them continue Propecia only, since applying Minoxidil is too fussy and offers only incremental benefit.
Q: I recently turned 22 and have been on Propecia for about 2.5 years. The amount of hair that de-miniaturized with daily 1 mg peaked about a year ago and I have seen steady thinning since. I feel that I am too young for a hair transplant. My question is whether or not an increase in dosage of Propecia is indicated here or if I should seek other options entirely?
A: At 22 years old, I would increase the dose of Propecia before considering hair restoration surgery. However, it is important to realize that there is no scientific evidence that increasing the dose will have any additional effects. There are published data by Roberts et al in the JAAD in 1999 demonstrating that 5 mg is no better than 1 mg from controlled clinical trials.
I usually increase the dose when someone has been on the same dose of medication for about three years, although there is no good data on how exactly to increase the dose, or that it will actually make a difference.
For this purpose, I generally use finasteride in the form of Proscar 5mg every other day (or Proscar 1/2 pill every day).
If you break up the pills, be mindful of the potential risk to pregnant women from handling crushed tablets.
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Disclaimer: The purpose of the Hair Transplant Blog is to provide the public with general information on hair restoration. Information provided on this site should not be used for medical diagnosis and/or treatment.
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