Finasteride is a 5-alpha reductase inhibitor, mostly used in the management of male pattern hair loss and stimulation of re-growth of hair in men. It is also indicated for the treatment of symptomatic benign prostatic hyperplasia (BPH) in men with an enlarged prostate. Finasteride is commonly sold under brand names as “Proscar” (for benign prostatic hyperplasia) and “Propecia” (for male pattern hair loss).

It is believed that women with hyperandrogenism might be more likely to benefit from finasteride treatment. Finasteride 1.25 mg or 2.5 mg daily, effectively promotes scalp hair growth.

There are no significant any drug interactions with clinically important which have been demonstrated with finasteride.

It is classified in the FDA pregnancy category. Women should not even touch this medicine in pregnancy

Finasteride is indicated for androgenetic alopecia in males. It stabilizes the male pattern hair loss in the males aged from 18-41 year old.

Finasteride is used to treat

Oral Finasteride has been known to associate with side effects such as erectile dysfunction, low libido due to decreased levels of DHT in blood. A topical formulation of finasteride has been formulated along with minoxidil. Minoxidil helps finasteride in better absorption due to its vasodilator property. A clinical trial has shown that 1mg of topical finasteride controls more DHT levels in scalp than oral finasteride. Meanwhile, both topical and oral administrations decrease almost similar DHT level in serum. But study also suggests that if you get a side effect from oral finasteride, most likely you will get a side effect from topical finasteride also.

Finasteride is a white crystalline powder and freely soluble in chloroform, alcoholic solvents but is insoluble in water. Many scientific research or clinical studies have been conducted on Finasteride and various physical or chemical data have been collected which is as follows:

Finasteride is a synthetically derived 4-azasteroid reductase. It is a specific inhibitor of steroid type II DHT, testosterone to 5 carboxamide. Its structural formula is;

1. Men are at risk of developing obstructive uropathy. So consult with your doctor before taking. 2. Do not use finasteride if you are allergic to finasteride or any other inactive ingredient present in finasteride tablet . 3. Finasteride can be absorbed through the skin. Women who are pregnant should avoid contact with crushed or broken tablets. 4. Avoid contact with semen from a male partner who is exposed to finasteride as it can retard fetal growth.

The most common side effects of Finasteride are: • Genitourinary: • Erectile dysfunction • Loss of libido • Impotence • Low Blood pressure or hypertension • Depression, drowsiness • Difficulty in breathing • Fatigue, weakness, headache

In a clinical study, 249 men with androgenetic alopecia underwent for scalp biopsies for the determination the effect of different doses of finasteride administered daily up to 42 days, on scalp skin and serum androgens.

If you missed a dose just skip the dose missed and use only the prescribed next dose. Do not use a double dose to make up for the missed doses.

Recommended dosage of finasteride (1mg) is one tablet once a day . With daily use for one year or longer, hair loss can be prevented and re-growth of hair can be assessed. During first months, shedding or thinning of hair may still exist but new healthy hair will grow after it. Continuation of finasteride is recommended.

Finasteride pills are available which can be taken orally with or without meal.

FDA approved finasteride as oral pill of 1mg to be taken once a day. A topical formulation of finasteride including minoxidil has been approved and has been found to be as effective as oral finasteride.

Few studies have been reported which showed that approximately 39% of patients were improved. However, results were not as dramatic as the patients of aged 18-41 years old, but still were quite effective.

5AR is 5 alpha reducatse and DHT is produced by it in two isoenzymes known as Type 1 and Type 2. Type 1 is more prominent in scalp than Type 2. Finasteride inhibits Type 2 5AR and approximately reduces 2/3rd of DHT levels.

Propecia and Proscar are the brand names while finasteride is the active ingredient in both.

No, Proscar is indicated for the treatment of benign prostatic hyperplasia (a condition in which prostate gland surrounding urethra gets bigger) in men. Recommended dosage is 5mg orally once a day.

No, Finasteride is not a steroid. It is a 5 alpha reductase inhibitor which inhibits DHT (dihydrotestosterone) which causes hair fall.

About Author & Bibliography

Bibliography

1. Rossi A, Cantisani C, Melis L, Iorio A, Scali E, Calvieri S. Minoxidil use in dermatology, side effects and recent patents. Recent patents on inflammation & allergy drug discovery [Internet]. 2012 [cited 6 May 2002]; 2012(22409453):130-6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22409453.

2. Mysore V. Finasteride and sexual side effects. Indian Dermatol Online J [serial online] 2012 [cited 2017 Aug 10]; 3:62-5. Available from: http://www.idoj.in/text.asp?2012/3/1/62/93496

3. Angela B Smith and Culley C Carson. Finasteride in the treatment of patients with benign prostatic hyperplasia: a review. Therapeutics and clinical risk management. 2009; 5(e.g. 2): 535–545. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2710385/

4. Izabela Urysiak-Czubatka .Assessment of the usefulness of dihydrotestosterone in the diagnostics of patients with androgenetic alopecia. Postepy Dermatol Alergol. 2014 Aug; 31(4): 207–215. [Internet]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171668/

5. Rossi A (2012). Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study. Int J Immunopathol Pharmacol. Oct-Dec; 25(4):1167-73.

6. Mysore V, Dua Kapil (2016). Hair transplantation. A text book. 4: 71-74

7. Drake L (1999). The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia. J Am Acad Dermatol. Oct; 41(4):550-4.

8. Anita K. Gupta (2016). Atypical post-finasteride syndrome: A pharmacological riddle. Indian J Pharmacol. May-Jun; 48(3): 316–317.

9. B. S. Chandrashekar (2015). Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride. Indian Dermatol Online J. Jan-Feb; 6(1): 17–20.

10. Maurizio Caserini (2014). A novel finasteride 0.25% topical solution for androgenetic alopecia: pharmacokinetics and effects on plasma androgen levels in healthy male volunteers. International Journal of Clinical Pharmacology and Therapeutics, (1-8).

11. http://www.aafp.org/news/health-of-the-public/20130823finasteride.html

12. https://en.wikipedia.org/wiki/Finasteride

13. https://pubchem.ncbi.nlm.nih.gov/compound/finasteride#section=Top

14. https://www.steroidal.com/anti-estrogens-pct/finasteride-proscar/

15. https://www.medicines.org.uk/emc/medicine/25803

16. https://perfecthairhealth.com/natural-dht-blockers-vs-finasteride-they-all-cause-sexual-side-effects/

17. https://www.mims.com/india/drug/info/finasteride

18. https://medlineplus.gov/druginfo/meds/a698016.html

19. http://www.rxlist.com/propecia-drug.htm

20. https://www.bernsteinmedical.com/medical-treatment/propecia-finasteride/

NOTE: This content of this post is written by the experienced dermotologist based on formal medical studies. It is reliable and scientifically verified and reviewed and edited by concerned doctors and health professionals to provide objective information on the diagnosis and treatment of diseases. If you are a doctor or health scientist and find inaccuracies, errors or omissions, please contact us at info@akclinics.com

About Author: This post is written by Dr. Aman Dua, MBBS, MD, FISHRS having 14 year of experience in the fields of Dermatology and Hair Transplant. She is the Chief Dermatologist, Co-Founder & Managing Director At AK Clinics.

Reviewed by: This post is reviewed by Dr Kapil Dua, MBBS, MS, Dipl. American Board of Hair Restoration Surgery (ABHRS), Member, FUE Advancement Committee, ISHRS, USA to improve readability and authority of the written content.