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While topical solutions such as Rogaine® brand monoxidil have been used to treat hair loss, Propecia® brand Finasteride by Merck & Company, Inc. is the only FDA approved pill approved for the prevention of hair loss and possible hair re-growth. Like Rogaine®, Propecia® was discovered when its generic equivalent being used for another purpose was found to have beneficial side effects. 

Finasteride is the generic name for the drug, which was already in existence for quite some time and had been produced under the name Proscar® by Merck & Company and used for treatment of enlarged prostates, a syndrome medically called benign prostatic hyperplasia (BPH). BPH is caused by an overproduction of DHT, which causes the prostate to grow. Many BHP patients were also suffering with MPB, and when patients began taking Proscar®, they noticed the re-growth of hair also. This sparked new testing and the birth of Propecia® as a hair restoration drug. The approval of Propecia® by the FDA was easy to achieve, since it was merely marketing already approved Finasteride as a hair restoration drug, with a much smaller dosage than that required for BPH.

Propecia® is being prescribed by doctors to some patients as an oral treatment to internally block the production of DHT. Propecia is an androgen hormone inhibitor only approved for men, and has been clinically proven to grow hair on a significant percentage of men who suffer with Male Pattern Baldness (MPB) or more properly androgenetic alopecia. Unfortunately, the drug has not been approved for use by women at this time. This is especially true for women who are pregnant or can become pregnant, because the process of inhibiting testosterone from being converted to DHT can affect secondary sex characteristics of unborn fetuses. 

Propecia® works by reversing the shrinkage of hair follicles that are in the telogen phase, or last phase of the normal hair cycle. Propecia® works best in combination with topical treatments of Monoxidil such as Rogaine®. Participants in studies have seen hair grow in as little as six months, whereas those who have seen no results in a year’s time are reported not likely to see any results from the drug. One round of testing of over 2,000 men with androgenetic alopecia over a four-year period showed half with reported new hair growth.

Side effects of Propecia® in a few persons studied include diminished sex drive, difficulty in achieving an erection, and a decreased sperm production. Side effects were found in less than three percent of participants in clinical studies. Fortunately when the drug’s use was discontinued, the side effects went away and normal functions resumed.  Of course there are some who say that the growth of new hair is worth the cost of a drop in libido. Only you can decide whether this side effect is worth the personal cost to you. Finasteride is metabolized primarily by the liver, and therefore anyone suffering with liver disease may not be able to take the drug, and should consult a physician. Additionally, as with Monoxidil, it can mask PSA levels, thus caution should be used if used by patients with elevated PSA levels, as it may be difficult to read levels properly when diagnosing potential prostate cancer. Of course proper consultation with your physician will help determine if taking Finasteride treatments such as Propecia® is right for you. 

An interesting phenomena concerning Propecia® is the dramatic rise in price it caused for Finasteride when it entered the market as a hair restoration drug. Propecia® is simply a 1mg version of Finasteride, a drug that was already being marketed as Proscar® for BPH by the same company that markets Propecia®, Merck & Company, Inc. Therefore there should not be an increase of any kind in the cost of production of Finasteride, since it was simply being marketed under a new name at a much smaller dosage. Merck & Company therefore was prepared to introduce Propecia at the price of $1.25 per pill or $37.50 for a 30-day supply in 1998. However, after reconsiderations it was decided that Propecia would be introduced at $50 for a one-month supply. 

This is compared to a 30-day supply of Proscar® which is 5mg Finasteride being marketed at $55-60.00 for a 30-day supply. The price was adjusted to be in the range of Rogaine® Extra Strength. The price of Propecia® today in 2004 is in the range of $130 for a 30-day supply, while Proscar® prices have risen at a much slower pace, and is now less expensive than the same Finasteride drug that is 1/5th the dosage. Doctors of course are discouraged by pharmaceutical companies to prescribe Proscar for cosmetic treatment of androgenetic alopecia. Of course there are always going to be those who find ways to circumvent this. Therefore, many have been driven to find ways to purchase Proscar® and divide the pill into fourths or fifths instead of paying the exorbitant prices for the very same Finasteride.