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Must
I take 1 milligram of propecia every day to successfully treat pattern
baldness
Perhaps not. Some scientists and clinicians have questioned the
daily dosage recommended by Merck, the manufacturers of propecia
and proscar.
Finasteride is the generic name for the drug used in the products
propecia and proscar made by Merck. Propecia is a 1mg tablet taken
once per day to treat androgenetic aloepcia. Proscar is a 5mg tablet
taken once per day to treat androgen dependent prostate problems.
Merck studies reported to the Federal Drug Administration (FDA)
to gain approval for Proscar, showed that in measurements of prostate
shrinkage a 1mg finasteride dose could not be distinguished from
a 5mg dose. It has been questioned why 5mg doses were recommended
by Merck when 1mg doses had the same effect.
In the Propecia studies, the effects of a several were reported
to the FDA. These studies examined how the drug inhibited the conversion
of testosterone to dihydrotestosterone (DHT). One experiment examined
the reduction of total DHT measured in the scalp skin in relation
to the finasteride dose taken. 0.01-mg of propecia each day did
not have a significant effect. However DHT levels dropped by 60%
for a 0.05-mg dose and DHT levels were similar for all doses up
to 5 mg. A similar dose dependence was seen for the serum DHT level
and the effect was no different with doses above 0.2 mg per day.
In other experiments the efficacy parameters of hair growth compared
the 0.2mg with a 1.0mg dose and looked at hair count changes, estimates
of hair density, and global photographic assessment. None of the
results showed a statistically significant difference between those
using a 0.2mg dose and those using a 1mg dose.
An extract from the leading article cited below (Frankel) says:
"Typically for a 1-month supply, the price of 5mg of Proscar
is $76 for 30 pills, and for 1mg of Propecia, $54. Therefore, a
Propecia user would pay only $15 if he were to cut up the 5mg Proscar
pills. However, the above depletion studies suggest that a dosage
of 0.2mg would be as effective as the 1mg dose, bringing the price
down to $3 for a 1-month supply. For the user willing to dissolve
the Proscar pill (it is soluble in ethanol), or divide it up by
other means, the monthly cost would be $0.76."
However, articles issued by Merck on dosage rates suggest that
1mg of finasteride is the optimum dose to use in treating patern
baldness.
Must
I take 1 milligram of propecia every day to successfully treat pattern
baldness references
- Frankel S. Study of the Food and Drug Administration
files on Propecia: dosages, side effects, and recommendations.
Arch Dermatol. 1999 Mar;135(3):257-8.
- Frankel S. Prostate size dependence of
proscar efficacy. Urology. 1998 Nov;52(5):933.
- Frankel S. Analyzing finasteride data.
Neurourol Urodyn. 1995;14(6):619-24.
- Roberts
JL, Fiedler V, Imperato-McGinley J, Whiting D, Olsen E, Shupack
J, Stough D, DeVillez R, Rietschel R, Savin R, Bergfeld W, Swinehart
J, Funicella T, Hordinsky M, Lowe N, Katz I, Lucky A, Drake
L, Price VH, Weiss D, Whitmore E, Millikan L, Muller S, Gencheff
C, et al. Clinical dose ranging studies with finasteride, a
type 2 5alpha-reductase inhibitor, in men with male pattern
hair loss. J Am Acad Dermatol. 1999 Oct;41(4):555-63.
- Drake
L, Hordinsky M, Fiedler V, Swinehart J, Unger WP, Cotterill
PC, Thiboutot DM, Lowe N, Jacobson C, Whiting D, Stieglitz S,
Kraus SJ, Griffin EI, Weiss D, Carrington P, Gencheff C, Cole
GW, Pariser DM, Epstein ES, Tanaka W, Dallob A, Vandormael K,
Geissler L, Waldstreicher J. The effects of finasteride on scalp
skin and serum androgen levels in men with androgenetic alopecia.
J Am Acad Dermatol. 1999 Oct;41(4):550-4.
- Kaufman KD. Finasteride, 1 mg (Propecia),
is the optimal dose for the treatment of men with male pattern
hair loss. Arch Dermatol. 1999 Aug;135(8):989-90.
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