I use this blog to share important dermatologic information. Because I have a number of patients who take Propecia, I wanted to share this here.
For general information on Propecia, how it works, and if it might be right for you, independent of the warnings below, see our prior article. https://wvderm.com/should-you-take-propecia-for-hair-loss/
In brief, Propecia, Generic Name Finasteride, is a testosterone antagonist called a Type 2 – 5 Alpha Reductase Inhibitor. It works to prevent the conversion of testosterone into dihydrotestosterone (DHT). It is also prescribed for benign prostatic hypertrophy (BPH) in men in a 5mg dose. Dihydrotestosterone is the hormone that plays a major role in androgenetic alopecia, male pattern loss in men and women. Propecia is available as a 1 mg pill taken daily.
Propecia received its initial FDA approval in 1997. It appears that there have been concerns for Suicidal thoughts and related deaths since at least 2011, when a warning was considered for the drug. Newly unsealed court documents have shown that…
“Since the 2011 decision on the warning, the FDA has received more than 700 reports of suicide and suicidal thoughts among people taking Propecia or generic versions of the drug. Those included at least 100 deaths. Before that, in the first 14 years the drug was on the market, the agency received 34 such reports, including 10 deaths.”-Reuters
Merck, the maker of finasteride, argues that that risk is not greater than in the general population. It is of interest to me, that there are no similar problems for men taking the higher (5mg) dose for BPH.
Nonetheless, patients with a history of depression or suicidal ideation seem best to avoid Propecia. If you are taking Propecia and develop depression and/or suicidal thoughts, stop the drug immediately and seek help.
For those with male pattern baldness, Rogaine might be a better option. For tips on Rogaine use, see below.
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