Propecia®

Propecia is the first medication for the treatment of hereditary hair loss (androgenetic alopecia) in men. It was developed by MSD (Merck Sharp & Dohme) and approved in 1998.

The active ingredient it contains, finasteride, inhibits the enzyme that converts testosterone into DHT, which damages the hair. As a result, hair loss is stopped, and in many men more hair grows back.

Propecia is the original product – since the patent expired, finasteride has also been available as a generic. Many men prefer the original for reasons of trust.

Important: Propecia is approved exclusively for men. Women, especially pregnant women, must not take the medication and should also not touch broken tablets.

The mechanism of hair loss: In men with a genetic predisposition, the enzyme 5-alpha reductase converts testosterone into dihydrotestosterone (DHT). DHT causes the hair follicles on the top of the head to shrink – the hairs become thinner and eventually fall out.

How Propecia works: Finasteride inhibits the enzyme 5-alpha reductase (type II) and thereby lowers the DHT level in the blood and in the scalp by about 70%.

The result:

• The hair follicles are protected
• Hair loss is stopped in about 90% of men
• In about 65% of men, more hair grows back
• Existing hair becomes stronger

Time course: The effect does not set in immediately. First visible results after 3-6 months, optimal effect after 12-24 months of continuous use.

Propecia is suitable for:

Men with androgenetic alopecia:

• Typical pattern: thinning area on the top of the head
• Mild to moderate hair loss
• Also possible with advanced hair loss

Particularly effective with:

• Early intervention – the earlier, the better
• Hair loss at the crown and the back of the head
• Hair that is still present but thinned

Less suitable for:

• Completely bald areas
• Receding hairline at the temples (effectiveness not proven)
• Women (contraindicated)
• Scarring or disease-related hair loss

For hair loss:

• 1 mg daily – The only approved dosage

Important: The 5 mg tablets (for prostate enlargement) are not suitable for hair loss and should not be split.

Duration of use:

• Long-term therapy required
• When treatment is stopped, hair loss returns
• Continuous intake for a lasting effect

How to take:

• One tablet (1 mg) daily
• Regardless of meals
• Preferably at the same time of day
• With a glass of water

Duration of treatment:

• At least 3-6 months for first visible results
• 12 months to assess the full effect
• Permanent intake for a lasting effect

If you forget a dose: Simply continue as normal the next day; do not take a double dose.

Absolute contraindications:

• Women: Propecia is only approved for men
• Pregnancy: Can cause severe malformations in male fetuses
• Children and adolescents: Not for persons under 18 years of age
• Hypersensitivity: Allergy to finasteride

Caution with:

• Impaired liver function
• History of depression
• Mental illness

Pregnant women: Should not touch broken or crushed tablets (absorption through the skin is possible).

Uncommon (0.1-1%):

• Decreased libido
• Erectile dysfunction
• Ejaculation disorders (including reduced ejaculate volume)
• Depression

Frequency not known:

• Hypersensitivity reactions such as skin rash, itching, hives and angioedema (swelling of the lips, tongue, throat and face)
• Anxiety, suicidal thoughts
• Palpitations
• Elevated liver enzymes
• Breast tenderness and enlargement
• Testicular pain, blood in the semen, infertility
• Male breast cancer

Note: Most sexual side effects disappear with continued therapy or after stopping treatment. In rare cases, persistent symptoms have been reported.

Propecia has few known interactions:

PSA test: Finasteride lowers the PSA level by about 50%. This must be taken into account in prostate cancer screening.

Blood donation: Do not donate blood while taking it and until one month after stopping.