Finasteride Vs Propecia

Introduction

Propecia is the branded version of finasteride (the generic form) used to treat androgenetic alopecia in men.

Androgenetic alopecia is a genetic disorder that leads to hair loss from an over-response to certain hormones. This type of hair issue affects both men and women, but it is more common in men and is known as male-pattern baldness. Medications like finasteride and Propecia are prescribed as first-line treatments before other medical or surgical interventions are explored.

About Finasteride Vs. Propecia

What is Finasteride?

Finasteride is an enzyme inhibitor that stops the 5-alpha-reductase, an enzyme responsible for converting the sex hormone testosterone to DHT. It is a slow-working compound that takes time to build, resulting in patients waiting several months before seeing any difference in hair loss. Due to this delay, patients must take finasteride regularly despite the lack of results.

What conditions are finasteride approved to treat?

Finasteride is approved to treat men with hair loss, such as male pattern baldness. It also treats benign prostatic hyperplasia (enlarged prostate gland), excessive hair, prostate cancer, and hormone replacement therapy for transgender women.

How does finasteride work for hair loss?

Finasteride inhibits the action of the enzyme 5-alpha-reductase, which is responsible for converting testosterone into dihydrotestosterone (DHT). In the case of androgenetic alopecia, patients have an overresponse to this hormone which causes hair follicles to shrink to the point where they stop producing hair.

Therefore, finasteride stops hair follicles from shrinking by blocking this conversion and can even help reverse hair fall by stimulating hair growth.

However, finasteride's effects take several months before becoming noticeable. In the meantime, regular intake is crucial to sufficiently inhibit the production of DHT enough to stop hair loss. Patients who discontinue finasteride early see no change.

What is Propecia?

Propecia is the brand name for oral finasteride tablets. Therefore it also inhibits 5-alpha-reductase to stop the production of dihydrotestosterone (DHT).

What conditions is Propecia approved to treat?

Propecia is only approved by the FDA to treat male pattern baldness, such as the gradual thinning of scalp hair that causes balding at the top of the head or receding hairline. It is not approved for treating blandness in women.

How does Propecia work for hair loss?

As Propecia is the brand name for generic finasteride, it works identically, inhibiting 5-alpha-reductase to reduce dihydrotestosterone (DHT) production.

Effectiveness

How effective are finasteride and Propecia for treating hair loss?

Both finasteride and Propecia reduce hair loss and stimulate hair growth. However, there have been several reports showcasing finasteride to be more effective.

In a comparative study, finasteride was slightly more effective than Propecia in promoting hair health for men who have androgenetic alopecia (AGA), with 80% of men in the finasteride group experiencing some hair regrowth compared to 68% in the Propecia group.

Dosage information

How is finasteride administered for hair loss?

Finasteride comes as a tablet administered orally. It can be taken with or without meals but should exceed a dosage of 1 mg per day unless otherwise specified by the physician.

Taking the drug daily for at least three months is recommended to see any visible benefits. Additionally, doctors may recommend long-term use to maintain hair regrowth. It is important to note that the effects of the drug are not permanent, and hair fall may resume within 12 months of stopping treatment.

It is important to note that finasteride is not recommended for women and must be avoided by those who are pregnant or may become pregnant as finasteride as it may lead to birth abnormalities.

How is Propecia administered for hair loss?

Propecia comes as a tablet and is also administered orally. It can be taken before or after meals, but doctors recommend no more than 1 mg daily to avoid unwanted side effects. These tablets have a protective coating because Propecia can be absorbed through the skin.

Patients must be taken Propecia for at least three months to see results, and continued use is recommended to ensure benefits are sustained. Side effects and dosages must be re-evaluated regularly by professionals, and in the case of withdrawing treatment, hair fall may resume within the following 12 months.

Side Effects

What are the most common side effects of finasteride?

Common, mild side effects:

Decreased interest in sexual intercourse
Inability to have or keep an erection
Loss in sexual ability, desire, drive, or performance
Runny or stuffy nose
Sneezing
Back pain
Decreased amount of semen
Diarrhea
Dizziness
Headache
Stomach pain

Less Common, mild side effects:

Bloating or swelling of the face, arms, hands, lower legs, or feet
Breast enlargement and tenderness
Hives or welts, itching, skin rash
Redness of the skin
Tingling of the hands or feet
Sleepiness or unusual drowsiness

Are there any potentially serious side effects of finasteride?

Common, severe side effects:

Chills
Cold sweats
Confusion
Dizziness, faintness, or lightheadedness

Less Common, severe effects:

Testicular pain

Serious side effects:

Clear or bloody discharge from the nipple
Dimpling of the breast skin
Inverted nipple
Lump in the breast or under the arm
Redness or excessive swelling of the chest area
Any allergies or excessive soreness on chest skin
Excessive hair fall in the chest area.

What are the most common side effects of Propecia?

Common, mild side effects:

Decreased interest in sexual intercourse
Inability to have or keep an erection
Loss in sexual ability, desire, drive, or performance
Runny or stuffy nose
Sleepiness or unusual drowsiness
Sneezing
Back pain
Decreased amount of semen
Diarrhea
Dizziness
Headache
Stomach pain
Testicular pain

Are there any potentially serious side effects of Propecia?

Severe side effects:

Chills
Cold sweats
Confusion
Dizziness, faintness, or lightheadedness
Bloating or swelling of the face, arms, hands, lower legs, or feet
Breast enlargement and tenderness
Hives or welts, itching, skin rash
Rapid weight gain
Redness of the skin
Swelling of the lips and face
Tingling of the hands or feet
Unusual weight gain or loss
Clear or bloody discharge from the nipple
Dimpling of the breast skin
Inverted nipple
Lump in the breast or under the arm
Repeated crusting or scaling of the nipple

Contraindications and interactions

Warnings and general precautions for Finasteride and Propecia

Finasteride and Propecia are not suitable for women or children.

Precaution for pregnant women includes touching crushed or broken tablets because finasteride can be absorbed through the skin to enter the bloodstream and reach the fetus. In case of exposure, the area must be washed immediately with soap and water.

Men allergic to medications such as dutasteride (Avodart) should avoid finasteride and Propecia.
Finasteride and Propecia may increase the risk of developing prostate cancer with long-term use. Therefore patients must have regular prostate screening to ensure growths are not developing.
Finasteride and Propecia may increase the risk of male breast cancer. Therefore, Propecia patients must seek immediate medical attention if they notice any lumps in breasts, associated pain, unintentional nipple discharge, or any other breast changes after starting medication.

Contraindications and important interactions for Finasteride and Propecia

Contraindications

Finasteride/Propecia

Contraindicated in women when they are or may potentially be pregnant.
Contraindicated in patients with hypersensitivity to any component of this medication.

Drug/Medication Interactions

Finasteride/Propecia

Severe and dangerous interactions may occur when finasteride is taken concurrently with Warfarin, such as an increased risk of bleeding.
Taking finasteride with other medications that inhibit cytochrome P450 3A4 enzymes can increase the blood concentration of finasteride, leading to an increased risk of side effects.

Food/Beverage/Supplement Interactions

Finasteride

No interactions between finasteride and any food, beverage, or supplement have been reported.

Propecia

Grapefruit should be avoided unless specified otherwise.

Cost Comparison

How much do finasteride and Propecia cost?

Cost per month is calculated by assuming daily use for 30 days. Note that prices may vary depending on location and pharmacy.

The popularity of Finasteride and Propecia

According to the State Drug Utilization Data by Medicaid for 2022, finasteride and Propecia are among the most commonly used medications in the United States.

Finasteride was the 90th most prescribed medication in the US in 2020, with an estimated 8.2 million prescriptions and 2.2 million patients. Propecia ranked 66th most commonly prescribed medication in the United States, with over 9 million prescriptions filled and a total drug cost of over 38 million dollars.

Despite having a similar formulation, Propecia has been seen to be prescribed more often than its generic counterpart.

Conclusion

Takeaway

Finasteride and Propecia are effective medications for stopping male pattern baldness and improving hair health. However, the effects are temporary and continuous use is needed to prevent hair loss.

Therefore, patients and their doctors must weigh the benefits of long-term use of finasteride and Propecia against their harmful side effects. Both medications can potentially reduce the quality of life and increase the risk of cancer in men.

Given society's acceptance of male baldness and the fact that it is not life-threatening, baldness is more of a superficial concern. In most cases, treatment may not be recommended or even necessary.