Finasteride (Hair Loss)

Finasteride 1 mg is a type II 5-alpha reductase inhibitor prescribed for the treatment of male pattern hair loss (androgenetic alopecia) in men aged 18 to 41 years.

It is marketed under various brand names for this indication and works by reducing the conversion of testosterone to dihydrotestosterone (DHT), the androgen principally responsible for miniaturisation of hair follicles in genetically susceptible men.

DHT binds to androgen receptors in hair follicles on the scalp, progressively shortening the growth phase of the hair cycle and causing the follicles to produce thinner, shorter hairs until they eventually cease producing visible hair altogether.

By lowering scalp and serum DHT levels by approximately 60% to 70%, finasteride 1 mg slows or halts this process and, in many patients, promotes partial regrowth of hair.

Clinical trials have demonstrated that finasteride 1 mg increases hair count and improves the appearance of hair over a treatment period of 6 to 12 months.

Continued use is necessary to maintain the benefit; discontinuation leads to reversal of the effect within approximately 12 months.

Take one 1 mg tablet by mouth once daily, with or without food. Swallow whole with a glass of water. Finasteride may be taken at any time of day, but try to take it at a consistent time.

Treatment must be continued for at least 3 to 6 months before improvement can be assessed, as hair regrowth is a gradual process.

If treatment is stopped, any hair gained will typically be lost within 12 months.

The recommended dose is 1 mg once daily. There is no evidence that higher doses produce greater benefit for hair loss. No dose adjustment is required for renal impairment.

Finasteride 1 mg is intended for use in men only and must not be taken by women or children.

Common (1 in 10 to 1 in 100): decreased libido. Uncommon (1 in 100 to 1 in 1,000): erectile dysfunction, ejaculation disorders, breast tenderness or enlargement.

Rare (1 in 1,000 to 1 in 10,000): allergic reactions including rash, pruritus, urticaria, and lip swelling.

Post-marketing reports include depression, anxiety, and persistent sexual dysfunction after discontinuation in a small number of men.

These reports remain under investigation and a causal link has not been fully established.

Women who are or may become pregnant must not handle crushed or broken finasteride tablets, as the drug can be absorbed through the skin and may cause abnormalities of the external genitalia of a male foetus.

Intact tablets are film-coated, preventing contact with the active ingredient during normal handling.

Patients should inform their doctor if they develop mood changes, depression, or persistent sexual side effects.

Finasteride may lower PSA levels; urologists should be informed of its use when interpreting prostate screening results.

Finasteride 1 mg is contraindicated in women, children, and patients with known hypersensitivity to finasteride or any of the excipients.

It must not be used in women of childbearing potential due to the risk of foetal harm. It should not be used by patients already taking finasteride 5 mg for benign prostatic hyperplasia.