My doc (Cooley) suggested that I take a Propecia every other day since it doesn't leave the bloodstream that fast to need it every day. This also saves big bucks. Anyone else's doc suggested this?

If you want to save money buy Proscar and cut in 1/4's. The half life of Propecia is 5-6 hours, taking it every other day is below the recommended dosage of Finasteride for hairloss.

There is strong evidence that shows that when a patient first begins taking finasteride (the active ingredient in both Propecia and Proscar) doses as low as .1 mg can be as effective as 1 mg. Of course, as the body becomes acclimated to the medication, the dose must be increased incrementally. Dr. Cooley is right on with his recommendation for new Propecia users.

-Robert

Dr. Cooley has suggested Jake et al, that Popecia stays at high levels in the blood stream for as much as 72 hours.

I don't know where you're getting a 5-6 hour half life from...a term usually used for radioactive isotopes.

The reason dosage recommendations haven't been reduced is that the FDA has already approved the daily dosage, and its unlikely that the drug company will petition to have it lowered.

if you really want to save money, cut Proscar in 1/4's and then take every other day.

I actually take it 3 times a week, so that only one stretch uses the 72 hours, but allows me a stable schedule.

mark

quote:

Originally posted by Mark H:
I don't know where you're getting a 5-6 hour half life from...a term usually used for radioactive isotopes.

Easy, just type in Propecia half life in google. Most of the websites list the half life anywhere between 4-6 hours.

http://www.rxlist.com/cgi/generic3/propecia_cp.htm:

quote:

Mean terminal half-life is approximately 5-6 hours in men 18-60 years of age and 8 hours in men more than 70 years of age.

quote:

Originally posted by Robert - Associate Publisher:
There is strong evidence that shows that when a patient first begins taking finasteride (the active ingredient in both Propecia and Proscar) doses as low as .1 mg can be as effective as 1 mg. Of course, as the body becomes acclimated to the medication, the dose must be increased incrementally. Dr. Cooley is right on with his recommendation for new Propecia users.

-Robert

Robert, it would be good if you could cite your strong evidence. There is a reason why the recommended dosage is what it is, it is based on the results of empirical studies. The end result represents the most optimal dosage for most people given risk/benefit and statistical mean effectiveness amongst the patients in the study. Given that it can be up to 6-12 months to see any results (if any?) I don't think it is wise to suggest a dosage other than the recommended one. IMHO I would only suggest a smaller dosage for men experiencing side effects or only have minor hair loss not patients who are trying to stave off an inevitable NW6/7.

Here is an interesting quote from wikipedia on the issue:

quote:

The UC Berkeley Wellness Letter expressed concern in March 2003 about the unproven long-term safety of Propecia and recommended cutting a standard 1 milligram dose into quarters to reduce the cost without reducing its effectiveness.[2]. This claim appears to be supported by clinical pharmacological data reviewed by the FDA during Propecia's approval process that suggested that the advantage of taking 1 mg per day over 0.2 mg per day is statisticially small. [3] Some people have unsuccessfully petitioned the FDA to re-examine the approved dosage in light of the statistical evidence and unknown long-term risks.[4] The FDA responded and said that just because the level of DHT found in the scalp was not signifigantly different does not mean there is a correlation with hair loss. A study would have to show that the benefits of using 0.2 mg and 1 mg were not statistically different. According to the FDA such a study has been performed and a 1 mg dose has a greater benefit.[4]

There have been studies on different dosages but the conclusion reached is a different one:

quote:

It did, however, include an even lower dose, .Ol mg, in addition to .2 mg and 1 mg doses. The study showed the .Ol mg dose to be ineffective, and the 1 mg dose to be more effective than the .2 mg dose and equally safe

quote:

Originally posted by psychojr:
My doc (Cooley) suggested that I take a Propecia every other day since it doesn't leave the bloodstream that fast to need it every day. This also saves big bucks. Anyone else's doc suggested this?

Dr. Wong suggested the same thing to me which I've been doing and I have seen very mild regrowth along the hairline. The theory from him is that Finasteride actively inhibits DHT for a period of 72 hours so an every other day does works fine. I'm sorry I can't cite any research proving this..............I'm basing my decision on my trust in Dr. Wongs knowledge which I think is a safe bet.

I believe the "half life" of the drug is sometimes confused with the amount of time DHT is effectively blocked. After doing a brief search regarding Finasteride and it's half life, I found this article that I feel is worth a glance. It suggest that multiple doses of Finasteride will actually maintain reduction in serum DHT concentration for at least two weeks....possibly up to 30 days after you stop taking it.

If H&W and Dr. Cooley are on the same page, that's good enough for me.

mark

ooops! Tried to edit my above post but ended up posting a duplicate............sorry!

What you're saying Hairbank makes a lot of sense. Dr's Wong, and Cooley wouldn't be recommending a lesser dose willy nilly. These are sober professionals, and in fact Dr. Cooley put it to me just as Dr. Wong put it to you. It keeps DHT levels down for 72 hours.

I take it Tues, Fri, Sun, so I only have one three day stretch, but it allows me to have specific days I take it...easier to remember.

mark

I actually just emailed Jotronic some of these questions as to what Dr. Hasson says about this as I'm considering switching to Proscar to save money. But if Robert is correct and your body becomes acclamated, I've already been taking 1 mg per day for 2 years+...would my body react strangely if I went down to 1 mg every other day? I don't want to lose the hair that I've been successful at saving!

Falc

I'd be interested too on exploring Robert's notion that the body acclimates and the dose needs to be increased. that's new information to me.

mark

We all could probably second-guess ourselves to death on this subject. Until I see solid proof that the body acclimates to finasteride and dosages need to be changed, I'm sticking with the 1mg/1.25mg dosage per day that was used in the actual finasteride studies.

When I said that the body becomes acclimated to Propecia, I meant that the lower initial dose (3x per week) may not be as effective after a certain amount of time. I'm not advocating anyone going above the recommended dose of 1 mg per day (or 1.25 mg/day if you quarter Proscar).

-Robert

Hi Robert,

That was good to point out. I'm inquiring because I would like to take Propecia every other day or take 1/4 a proscar every other day...not only would it save money, but if it's just as effective as taking it every day, why not lower the dosage? It would also save money. But I know that some of my hair, mostly below the crown is being saved probably because of the Propecia and I dont' want to risk losing it...so I'm not sure if I'll do this or not.

Falc

I wouldn't risk it personally. If you want to save some cash just get a script for Proscar. I used to pay around $32 for 10 Proscar pills at CVS. That came out to 40 days at $.80 a day. Not too shabby.

-Robert

I've been taking .5 mg of Propecia every other day. I've been doing this for close to a year now and feel I've retained as much hair as I had with a full dose...which I had been taking for two years.

Falc-

You have a valid point..........I'm not sure what would happen if you go from having consistently taking Fin for 2 years daily to a EOD dosage?? If I were you I'd call Joe or Doc Hasson and get their advice.

Personally, having never taken Fin for any length of time before 9 months ago, I can tell you that my EOD regimen has been fruitful and shown DEFINITE mild regrowth in my hairline. I don't know about the crown since that's where the majority of my HT # 2 grafts were placed. So, for me, I know the EOD regimen is having a positive effect.

Hey guys!

I don't usually post much any more but I thought I would try to give some insight to this question.

The "half Life" of a medicine refers to how long it takes to significantly clear the blood stream. With finasteride this is approximately 7 hours.

What happens when you take finasteride is that it binds to the 5 alpha reductase enzyme and keeps it from binding with testoserone and converting to DHT. This binding is at it's peak at about 72 hours. It is completely out of the body in about 7 days. The binding ratio is approximately 77% of the enzymes are inactive.

So the lesser dose makes logical sense. Is it safe at a daily 1mg dose? Absolutely. That is the dose the studies were done on but is it overkill? Interesting theory.

We always pass along this information to patients. It potentially cuts down any negative side effect along with the price reduction! It is how Dr. Cooley takes the medication himself so you know he believes that it works at this dose. We have been giving this information for probably the last 4-5 years.

Merck is definitely not interested in a study to tell patients they can take less meds. But in our practice it makes a lot of men more interested in trying the drug. I hope this helps????

Regards,
Ailene

All of this information has been very informative.

I have also talked with Christina from Hasson and Wong and both doctors give prescriptions to Proscar stating there is no difference. Ironically though, Dr. Hasson typically prescribed at 1/4 a pill per day whereas Dr. Wong typically prescribes at 1/4 a pill every other day...interesting. There have been times that Dr. Wong has prescribed 1/4 a pill a day, but not mostly. Very interesting.

Here was a direct quote from Christina:

"Dr. Hasson follows the recommended dosage from Merck which is 1mg of Finasteride a day. Dr. Wong is of the thought that the medication stays in the body for 48 hours and thus you only need to take it every other day. There have been some cases when Dr. Wong has had to increase the dosage for some patients but for the most part both doctors have seen great success with the Proscar."

So...I don't know...I think I am going to switch to Proscar to save money...but I'm not sure whether to switch to every other day or not. I MIGHT consider it but be taking weekly pictures of the area below the crown to make sure nothihng is being lost. If nothing is lost for 6 months to a year, I think I will continue down that path.

Falc