Finasteride 5 Mgr vs 1 Mgr in Androgenic Alopecia. !
Finasteride 5 Mgr vs 1 Mgr en Alopecia Androgénica. !
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Hello friends of the DERMAGIC network, back with a very hot topic: FINASTERIDE 5 MG VS FINASTERIDE 1 MG IN ANDROGENIC ALOPECIA.
The first article I found on this drug dates back to 1993, and others from 1994 discussed FINASTERIDE as a promising drug for various conditions such as acne, HIRSUTISM, PROSTATE CANCER and BENIGN PROSTATIC HYPERPLASIA (BPH).
Later, it was discovered that finasteride was and is useful in the treatment of androgenetic alopecia.
But at that time, only the 5 MG version (PROSCAR) was available, and many people began using it twice a week: they would break the original pill into 4 parts, taking 1/4 of a pill daily. This motivated the company to market the 1 mg dosage form for exclusive use in ANDROGENIC ALOPECIA, under the name PROPECIA.
There are studies in which patients were given 5 mg FINASTERIDE daily for 2 years without side effects. Furthermore, the first report from 1993 showed that daily doses of 80 mg FINASTERIDE for 3 months caused no side effects.
However, subsequent studies showed that at doses of 1 mg, FINASTERIDE (PROPECIA), like all medications, has its side effects, mainly erectile dysfunction, mood swings, decreased semen volume, and in some cases, gynecomastia and adenomas.
These reports appeared during the decade from 2010 to 2012, describing the so-called POST-FINASTERIDE SYNDROME (PFS): which is still being discussed today, with symptoms that appear after prolonged treatment with this medication. I describe them as follows:
Symptoms included:
- Decreased libido.
- Erectile dysfunction.
- Changes in penile tissue.
- Loss of enjoyment or desire for sexual intercourse.
- Decreased sperm count.
- Gynecomastia, adenomas.
- Skin changes.
- Cognitive impairment: loss of memory and concentration.
- Fatigue.
- Anxiety, panic attacks.
- Depression.
- Suicidal ideation.
- Loss of muscle mass.
- Metabolic disorders.
MECHANISM PRODUCING THIS SYNDROME:
1.) FINASTERIDE inhibits the enzyme 5-alpha reductase type 2, blocking the conversion of testosterone to dihydrotestosterone (DHT), which is its main effect. This would cause an alteration in the levels of neuroactive steroids that regulate neurotransmitters such as GABA and serotonin in the brain.
2.) Alterations in hippocampal neurogenesis and changes in the gut microbiota that could influence symptoms have been detected.
3.) Genetic susceptibility and changes in androgen receptors and enzymes could be involved in the clinical manifestations.
Although this POST FINASTERIDE SYNDROME is documented and recognized by patients, it remains a topic of debate in the medical community today.
Among cases of female pattern baldness, FINASTERIDE was significantly more common with fetal damage and uterine disorders. Furthermore, drug-gene network analysis indicated that finasteride could profoundly alter pathways related to sex hormone signaling and oocyte maturation.
It was later discovered that FINASTERIDE is not useful in FEMALE pattern baldness, but is useful in HIRSUTISM.
HISTORICAL ACCOUNT:
Since it became known in the scientific world that FINASTERIDE produced hair growth, FINASTERIDE 5 mg (PROSCAR) began to be used, as I mentioned before, because FINASTERIDE 1 mg (PROPECIA) had not yet been marketed. The dosage: 10 mg weekly in 2 doses, Tuesdays and Thursdays, with good results.
Once FINASTERIDE 1 MG (PROPECIA) was released, the company began an AGGRESSIVE CAMPAIGN, stating that the dose had to be 1 MG daily for 7 days a week, which would be 7 MG total, versus the 10 MG twice weekly doses of FINASTERIDE 5 MG (PROSCAR).
The TRUTH is that FINASTERIDE 5 MG twice weekly is as good as or equal to FINASTERIDE 1 MG daily, and it's much cheaper, safer, and has fewer risks. A box of 30 tablets lasts 15 weeks (3 months and 3 weeks).
Perhaps one of the advantages that can be attributed to this regimen is that your body "rests" from the drug because you only take it twice a week, compared to taking FINASTERIDE 1 mg (PROPECIA) daily, from which your body doesn't rest; you always have the medicine "inside."
I went for the scientific route and used FINASTERIDE 5 mg in patients with androgenetic alopecia with the aforementioned regimen: 5 mg twice a week. After the fourth month, I observed significant improvement in the patients. See the attached photos.
CONCLUSIONS:
1.) FINASTERIDE is a wonderful product.
2.) FINASTERIDE5 mg twice a week is better than or equal to finasteride 1 mg daily.
3.) Merck S.D. launched PROPECIA for commercial and marketing purposes.
4.) FINASTERIDE IMPROVES BENIGN PROSTATIC HYPERPLASIA (BPH), AND PRODUCES notable improvement in ANDROGENIC ALOPECIA...!!!
5.) TOPICAL FINASTERIDE, under the name FINASTOPIC, was be marketed by ISDIN in 2024. This has been talked about since 2000; the topical formulation most likely has fewer side effects than the oral formulation. In some presentations it comes combined with the popular MINOXIDIL, which is also useful in hair loss.
Finally, FINASTERIDE has recently been used in the treatment of HIDRADENITIS SUPURATIVA, in both men and women, with good results. Its use as a hormonal agent is also proposed for the treatment of acne.
And its competition also emerged: DUTASTERIDE, which, in addition to being an oral formulation, comes in ampoules for local injection into the scalp. This formulation is the most commonly used, as the oral formulation is not officially approved for the treatment of this condition and is used off-label, given the beneficial clinical effects obtained.
Here is the link to the update on SERENOA REPENS or SAW PALMETTO versus FINASTERIDE for ANDROGENIC ALOPECIA.
In these references, you will learn about FINASTERIDE, its uses, and some of its adverse effects.
Dr, José Lapenta.
A pesar de que este SÍNDROME POST FINASTERIDE esta documentado y reconocido por pacientes, hoy dia sigue siendo un tema de debate en la comunidad medica.
1.) EL FINASTERIDE ES UN producto maravilloso.
2.) EL FINASTERIDE 5 MG 2 veces semanal, es MEJOR o IGUAL que el FINASTERIDE 1 MG DIARIO.
3.) EL LABORATORIO MERCK.S.D LANZO la PROPECIA con fines COMERCIALES Y DE MERCADEO.
4.) EL FINASTERIDE MEJORA LA HIPERPLASIA PROSTÁTICA BENIGNA (HPB), Y PRODUCE mejoría notable en la ALOPECIA ANDROGÉNICA.. !!!
5.) PARA el año 2024, salio al mercado el FINASTERIDE TÓPICO, con el nombre de FINASTOPIC, por el laboratorio ISDIN. De esto se venia hablando desde el año 2000, muy probablemente la presentación tópica tiene menos efectos secundarios que la presentación oral; en algunas presentaciones viene combinado con el popular MINOXIDIL, el cual también es útil en la caída del cabello.
REFERENCIAS BIBLIOGRÁFICAS / BIBLIOGRAPHICAL REFERENCES
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2.) Therapeutic effects of finasteride in benign prostatic hyperplasia: a randomized double-blind controlled trial.
3.) The effect of finasteride on prostate volume, urinary flow rate and symptom score in men with benign prostatic hyperplasia.
4.) [5-alpha-reductase inhibitors].
5.) Benign prostatic hyperplasia.
6.) The potential for hormonal prevention trials.
7.) 5 alpha-reductase inhibition by finasteride (Proscar) in epithelium and stroma of human benign prostatic hyperplasia.
8.) Pharmacological treatment of benign prostatic hyperplasia with finasteride: a clinical review.
9.) Medical therapy for benign prostatic hyperplasia: A review of the literature.
10.) Pretreatment with finasteride decreases perioperative bleeding associated with transurethral resection of the prostate.
11.) Urinary retention in patients with BPH treated with finasteride or placebo over 4 years. Characterization of patients and ultimate outcomes.The PLESS Study Group.
12.) Dihydrotestosterone and the concept of 5alpha-reductase inhibition in human benign prostatic hyperplasia.
13.) Chronic treatment with finasteride daily does not affect spermatogenesis or semen production in young men.
14.) Management of androgenetic alopecia.
15.) Finasteride in the treatment of men with frontal male pattern hair loss.
16.) Androgenetic alopecia in men: the scale of the problem and prospects for treatment.
17.) [Androgenetic alopecia, hirsutism and hypertrichosis].
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19.) Understanding and managing common baldness.
20.) Finasteride: a review of its use in male pattern hair loss.
21.) Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group.
22.) Genetic analysis of male pattern baldness and the 5alpha-reductase genes.
23.) Effect of finasteride on human testicular steroidogenesis.
24.) [Finasteride: a new drug for the treatment of male hirsutism and androgenetic alopecia]?
25.) The 5 alpha-reductase system and its inhibitors. Recent development and its perspective in treating androgen-dependent skin disorders.
26.) Finasteride: a clinical review.
27.) The effect of finasteride, a 5 alpha-reductase inhibitor, on scalp skin testosterone and dihydrotestosterone concentrations in patients with male pattern baldness.
28.) Finasteride: the first 5 alpha-reductase inhibitor.
29.) Cytologic atypia in a 53-year-old man with finasteride-induced gynecomastia.
30.) Reversible painful gynaecomastia induced by low dose finasteride (1 mg/day).
31.) Measuring reversal of hair miniaturization in androgenetic alopecia by follicular counts
in horizontal sections of serial scalp biopsies: results of finasteride 1 mg treatment of men and postmenopausal women.
32.) Improvement in androgenetic alopecia in 53-76-year-old men using oral finasteride.
33.) New topical antiandrogenic formulations can stimulate hair growth in human bald scalp grafted onto mice.
34.) Current management of androgenetic alopecia in men.
35.) Immunohistochemical localization of types 1 and 2 5alpha-reductase in human scalp.
36.) The psychosocial consequences of androgenetic alopecia: a review of the research literature.
37.) Clinical dose ranging studies with finasteride, a type 2 5alpha-reductase inhibitor, in men with male pattern hair loss.
38.) The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia.
40.) Interventions for Female Pattern Hair Loss.
41.) Differences in reproductive toxicology between alopecia drugs: an analysis on adverse events among female and male cases.
42.) Finasteride in Hidradenitis Suppurativa: A "Male" Therapy for a Predominantly "Female" Disease.
43.) Hidradenitis suppurativa treated with finasteride.
44.) The use of hormonal agents in the treatment of acne.
45.) Risk of gynecomastia and breast cancer associated with the use of 5-alpha reductase inhibitors for benign prostatic hyperplasia.
46.) Investigation of the Plausibility of 5-Alpha-Reductase Inhibitor Syndrome.
47.) Post-Finasteride Adverse Effects in Male Androgenic Alopecia: A Case Report of Vitiligo.
48.) Side Effects Related to 5 α-Reductase Inhibitor Treatment of Hair Loss in Women: A Review.
49.) 5 mg/day finasteride treatment for normoandrogenic Asian women with female pattern hair loss.
50.) Adverse effects of 5α-reductase inhibitors: What do we know, don't know, and need to know?
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