Hey all,

I've read conflicting information about the effectiveness of finasteride(proscar/propecia) over time. Is there documented research that proves/disproves this? If it is true that finasteride has a limited lifetime, does increasing the dosage work? (and if so, what are the health implications of that?). If its a case of the body building up a tolerance, would cycling the usage help (e.g. use for 5 years, discontinue for 1 year, and restart again, etc).

Thanks!

-k

what is "finasteride tolerence"?. Does it stop inhibiting type II 5alpha-reductase after 5 or 10 years? why? Or does the aging process simply make the folloicles weaker and weaker to the point where little DHT is enough to kill it?
if so, would starting avodart later make any difference, since it supposedly inhibits almost all dht?

Last year I read of a five year published study that did not appear to show any tolerance effect. Moreover, I have been unable to find any research to the contrary. While tolerance builds with some medications, you should not automatically assume tolerance builds with every medication. This is simply not the case. So far, from the data I've seen, that 5 year study is the longest longitudinal research I have been able to find. I assume the research is ongoing, but as yet unpublished (probably in year six or seven). Nothing would indicate that going on and off finasteride would offer any advantage based upon what I have read. You should probably try to do your best to continually block DHT and inhibit MPB by staying on finasteride. "Drug Holidays" as they are called with drugs associated with tolerance, don't seem to be called for with finasteride, as yet. If there is a physician aware of some sound research to the contrary, please speak up.

Tolerance may or may not occur eventually.
I think the key is to try it and if it works, that's great. I figure why worry too much about the future results of this very safe drug. If it loses effectiveness, well, at least you had its effects for a while. That is better than never having it, right?
If your HT result is very, very dependent on the effectiveness of drugs like Propecia, then possibly your HT's design is simply too aggressive.
I believe all HTs, to an extent, depend or are greatly enhanced by the effectiveness of hairloss drugs. Certainly, my result is bolstered and supported by Propecia. If Propecia "stops working", then the result won't look at great but it'll still not look weird or misplaced, I feel.
To sum it up, there aren't any clinical studies supporting the idea of Propecia losing its effectivenss after, let's say, 10 years. And even if it does, would that stop you from taking it now?

vocor1
Knowledge is Power
If the worst question is the one never asked, then the worst answer is the one never shared.

Thanks guys. You pretty much reaffirmed everything I thought. Just covering all my bases.

Thanks again!

-k

Kenyon,

I was using propecia, and paying $55 a month for my prescription, and then recently switched to proscar to save some money (as an aside, it seems like everytime I save money, the cable company takes my savings). Proscar is a slightly higher dosage of propecia (when you quarter it I believe it is a 25% stronger dose). Since I have done that I've definitely noticed a slower fall-out rate. I used to be able to run my hand through my hair and pull out a few hairs, but since I've switched I almost never pull out a hair. I'm not sure if it's just the cycle my hair is currently in, or if the increased dosage is doing the job. I'm thinking it's the increased dosage, but I might be wrong.

Just my experience.

Good luck.

Manko

I don't know if there is any valid research comparing rates of hair loss (or retention or regrowth) comparing varied dosage groups. I've heard much wild speculation, even among physicians about this. But, physicians can be wrong when they are speculating based upon theory and partial evidence. It does appear that there are "diminishing returns" to increasing dosage. For examplye, doubling your dose does not half the level of DHT binding to DHT receptor sites. Yet, increasing dosage, definitely does reduce DHT (blood levels or binding - I'm not sure of the pharmachodynamics). I keep in mind that the fact that if increased dose meant nothing at all, there would be no reason to manufacture Proscar at 5 mg. It's possible then, although not proven, that you might benefit from increasing doses of finasteride. I use 2.5mg and believe it has been more effective than the 1mg dose of propecia.

Just be sure that if your physician measures your PSA during a physical (it's included in some blood panels and it is used as a partial assessment of prostate cancer risk), be sure to tell your physician the actual dose of finasteride that you are taking. He or she will need to know this number in order to properly interpret your PSA number. Higher doses deflate the PSA number and may mask a problem. You don't want to overlook the possibility of prostate cancer because you didn't bother to tell your physician you are taking 5 mg of proscar and he thinks you're taking 1 mg propecia.

On the lower end of the dosage spectrum I found this out:

My case only here (we all differ):

I found .5 to be as effective as 1 mg taken daily. However when I adjusted to only .25 mg daily I began to see some minor fallout after 3 months - so naturally I swithced back to .5 mg daily. As Paul mentions for some men perhaps 1mg daily is not quite enough ? individual characteristics such as body weight, DHT levels etc.. could indicate using a slightly higher dose ? I would agree. I think if you watch and compare you can find an ideal dose.

My study was interesting also because it proved to myself that Propeia is working.

NW

NW

Very good point! I suspect that we all respond idiosyncratically to dosages. It makes sense. It's true with many medications. It suggests that, for every user, a little experimentation could be helpful.

Paul

[This message was edited by paul148 on June 01, 2003 at 10:16 AM.]