Finasteride

What is Finasteride?

Finasteride is a type of medication called a 5-alpha reductase inhibitor which is used to treat male pattern baldness, otherwise known as androgenetic alopecia.

How does it work?

The treatment works by preventing testosterone from converting into dihydrotestosterone (DHT). DHT is a hormone that causes the hair follicles to shrink and the hair to fall out. Finasteride reduces the production of this hormone to prevent hair loss. 

How long does it take to work?

Finasteride can take 3–6 months to achieve noticeable effects. It needs to be taken regularly and continuously for it to have and maintain its effects.

How effective is Finasteride?

Finasteride is 90% effective at slowing hair loss over a period of 5 years in clinical studies. When taken regularly over a long period of time, it can be very effective. Once you start taking it, you'll need to take it for life if you want to prevent hair loss as your hair will start to thin again after you stop taking it.

What is the difference between finasteride and Aindeem?

Aindeem was a brand name version of generic finasteride which has been discontinued. They both contain the active ingredient; 1mg finasteride.

Active ingredients

Finasteride is the active ingredient within the medication. 

Inactive ingredients

The other ingredients are lactose monohydrate, microcrystalline cellulose, pregelatinized starch, sodium starch glycolate, hydroxypropyl methylcellulose, hydroxypropyl cellulose, titanium dioxide, magnesium stearate, talc, docusate sodium, yellow ferric oxide, and red ferric oxide.

Please note: Different generic brands of finasteride could contain different inactive ingredients

How to take Finasteride

Finasteride should be taken once a day at the same time each day. You should always take the medication as directed by your doctor and never take too much. It can be taken with or without food and is only effective if it is taken long term. 

Finasteride dosage

1mg is the dose given to treat male pattern baldness.

Can Finasteride be crushed/split?

Finasteride should not be crushed or split and should be swallowed whole. Pregnant women and women who could become pregnant should not come into contact with any crushed or split tablets as it can cause harm to an unborn fetus. If this happens, ensure that she washes her hands thoroughly right away and she receives medical attention.

Finasteride side effects

There are possible side effects associated with taking Finasteride including: 

• Hypersensitivity reactions including rash, pruritus, urticaria, and angioedema (including swelling of the lips, tongue, throat and face)
• Decreased libido 
• Depression
• Anxiety
• Palpitations
• Erectile dysfunction 
• Ejaculation disorders including reduced volume of ejaculate
• Enlargement or tenderness of the breast tissue, gynecomastia (enlarged breasts in men)
• Haematospermia (blood in the semen)
• Infertility 

Contraindications

Finasteride should not be taken by women and pregnant women should avoid coming into contact with it as the medicine can be absorbed through the skin. Inform your doctor if you:

• Are allergic to any of the ingredients 
• Have a history of liver problems 
• Have a history of prostate cancer 
• Have a history of prostate infections
• Have urinary problems

Drug interactions

You should inform your doctor of any other medications you take prior to starting finasteride. Particularly if you take any other 5α-reductase inhibitors.

Are Finasteride side effects permanent?

Finasteride side effects are uncommon but if you do experience any they will likely disappear after you stop taking the medication.

Is Finasteride linked to erectile dysfunction?

Erectile dysfunction is one of the possible side effects associated with finasteride. However, side effects are relatively uncommon and it's estimated that side effects will only affect 3–4% of men using this treatment.

Finasteride vs Minoxidil

Both finasteride and minoxidil are effective for treating hair loss but they work in different ways. While finasteride is a tablet taken orally to target the hormones, minoxidil is applied directly to the hair and works by relaxing the blood vessels to allow blood to flow more freely towards the hair follicles. This promotes hair growth rather than preventing hair loss like finasteride. Minoxidil is suitable for both men and women, whereas finasteride is only suitable for men.

Finasteride vs Propecia

Finasteride is the generic name for Propecia. They are essentially the same thing, Propecia being a brand name of the finasteride drug.

Can I use Finasteride with other hair loss treatments?

Finasteride is generally safe to use alongside other hair loss treatments. It's recommended to ask the advice of a pharmacist before doing so.

Does Finasteride affect hair growth on other parts of the body?

Finasteride does not affect hair growth on other parts of the body. If you experience changes in body hair while taking finasteride, speak to your doctor.

Can women use Finasteride?

No. Clinical trials have shown that Propecia is not effective in reversing hair loss in women and taking it can harm a pregnancy.

What is the hair growth cycle?

Normal hair growth happens in a cycle of 3 phases: anagen, catagen and telogen. Every single hair goes through these phases, each relating to different states of activity. 

1. Anagen – The anagen phase is the growing phase or the “on” phase. In humans, this lasts for approximately 1,000 days but can range from 2 to 6 years. During the anagen phase, hair cells grow rapidly, producing the hair shaft from the follicle, which itself grows deeper into the scalp. The length of your anagen phase determines the maximum length of your hair. So, the longer your anagen phase, the longer your hair will grow.
2. Catagen – The catagen phase only lasts for one to two weeks. It is the transitional or regressive phase. Essentially, it is when the hair stops growing. During this period, the hair follicle shrinks and part of it starts to die.
3. Telogen – The telogen phase is the final resting stage or “off” phase. When the old hair is in this phase, the hair follicle becomes active again and a new hair in the anagen phase develops, forcing the old telogen hair out. This is when you might notice hairs in the bath or in your brush or comb.

In the case of common baldness, male pattern baldness, or what is commonly called hereditary hair loss; genes and hormones cause the miniaturisation or “shrinking” of the hair follicles. This results in a shorter anagen phase and a particularly long telogen phase so the hairs then become short and thin. They are soon barely visible to the naked eye and eventually, the hair follicles shut down completely.

At any one time, around 90% of most people’s hair follicles are in the anagen phase and approximately 10% are in the telogen phase.

What is the role of 5-alpha reductase in the body?

5-alpha reductase is an enzyme that regulates production of DHT. An enzyme is a protein that acts as a catalyst to speed up a chemical reaction. 5-alpha reductase can be inhibited by specially synthesised drugs (see below).

What role does heredity/genetics play in the male pattern hair loss?

Male pattern hair loss occurs in men who are genetically predisposed to be more sensitive to the effects of DHT. Researchers now believe that the condition can be inherited from either side of the family.

Where is DHT found in the body?

DHT (dihydrotestosterone) is found in several tissues in the body including the scalp.

What is the role of 5-alpha reductase in the body?

5-alpha reductase is an enzyme that regulates the production of dihydrotestosterone (DHT). An enzyme is a protein that acts as a catalyst to speed up a chemical reaction. 5-alpha reductase can be inhibited by drugs such as finasteride. DHT is a form of testosterone which can promote hair loss on the scalp.

How common is male pattern hair loss?

Male pattern hair loss affects at least 50% of men at some point in their lives, and possibly as many as 80% by the age of 70 years. It affects different populations at different rates, probably because of genetics. Up to half of male Caucasians will experience some degree of hair loss by age 50, while other population groups such as Japanese and Chinese men are far less affected.

Can Finasteride help an area of complete baldness?

There are studies showing that finasteride can in fact regrow hair in more than 60% of men using the drug. However, it's unlikely that it will completely restore an area of complete baldness. Finasteride works better as a preventative measure rather than a cure for baldness.

Is Finasteride safe?

Finasteride is safe to use long term. 

Do you need to take Finasteride after a hair transplant?

Finasteride is not needed after having a hair transplant. The donated hair follicles will not react to the DHT in the same way as your natural follicles that are prone to male pattern baldness.

Can Finasteride be used for enlarged prostate?

Finasteride is also used to treat an enlarged prostate. In this case, the drug will be prescribed at a higher dose.