1mg of finasteride is an arbitrary dosage

evildude

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these have probably been posted before, but i finally came across some good data to show how pointless the 1mg dosage really is.

http://www.physics.upenn.edu/facultyinf ... index.html

serum dht levels are almost identical from 0,2mg to 5mg of finasteride. so if you want to save money, cut your proscar/propecia into plenty of pieces. pretty much same effect for far less money.
 

nydheart

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Right on brother! I actually considered quitting finasteride at the 0.5 mg dose because my dick lost so much sensation in it. I am currently cutting my finpecia's into 4th's and at this point in time I am not having near the side effects as I had at 0.5. Anyways, good information for those having issues with sides even at the 0.5mg range.
 

Pondle

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Yeah we've discussed this one before.

Here's the FDA response to Sherman Frankel -
You also state that the efficacy data upon which approval was based lacked the “statistical accuracy to prefer 1 mg over .2 mgs and no studies were shown down to .05 mgâ€￾ (Petition at 1). You cIaim that clinical trials should have studied Propecia at low dosages because Propecia must be taken throughout the patient’s Iifetime to ensure continued and retained hair growth- You conclude that Propecia should not be approved at the 1 mg dosage until “data are provided to the FDA showing efficacy studies at the lower dosages of sufficient statistical accuracy and ‘with clear presentations of the effects of systematic errors in the studiesâ€￾ (Petition at 1).

We interpret your statement “[t]hat the efficacy data submitted to FDA did not possess the statistica accuracy to prefer 1 mg over .2 mgs. . . .- (Petition at 1) to mean that there was not a statistically significant difference between these doses. FDA does not require that a dose-ranging study demonstrate statistical significance between doses; showing a positive slope in the doseresponse curve, as did the Propecia study, is sufficient. You also object that there were no studies “down to .05 mgâ€￾ (Petition at 1). It is true that the dose-ranging study did not include a .05 mg dose. It did, however, include an even lower dose, .O1 mg, in addition to .2 mg and 1 mg doses. The study showed the .01 mg dose to be ineffective, and the 1 mg dose to be more effective than the .2 mg dose and equally safe.


BTW 5mg does seem to be more effective than 1mg over 6 months, but you end up at the same point after a year. I pooled that data from the various Merck and Glaxo trials to draw this graph.
ProscarhasafasterresponsethanPropec.jpg
 

evildude

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the reason i mention this, is that claims without any real substance are constantly thrown here. such as this notion that you shouldn't take 0,5mg or even 0,25mg of finasteride a day. "stick to the proven dosage" or similar nonsensical statements. if you want to reduce dht, it doesn't really matter that much whether you take 0,2mg or 5mg a day. i would assume most side effects would be similar on both dosages as well...

another gem, is the one that you need to take the "exact" same dose each day to avoid fluctuations of the dht levels. first of all, as the data shows, there is very little difference in supressed dht between 0,2mg and 5mg, so to then think that 0,2mg one day and then 0,4mg the next day would be harmfull is plain wrong. secondly, regeneration of 5-ar and, consequently, dht takes a long time. based on the numbers, i'd think taking as little as 0,2mg every other day would almost inhibit as much dht as 5mg of finasteride every day...

btw, this is also why i don't get why those using finasteride think lowering the dosages will give them significantly different results in terms of side effects. i would assume most side effects occur as a result of lowered dht levels. if that is the case, then the difference in side effects would be, as the dht levels, negligeble.
 

Pondle

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Looking at the Merck dose-ranging study, I would prefer 1mg/day to 0.2mg/day in order to maximise regrowth over the short term. I don't know whether you would eventually end up at the same point in hair counts, as per 1mg vs. 5mg.

Propeciadoserangingstudy.gif


Hair counts on 0.5mg/day do not seem to have been studied. Interpolating from the dose response curve would suggest that this dose would be nearly as effective as 1mg/day. However, remember that 5mg/day is more than 20% 'better' than 1mg/day over 6 months, despite the minimal difference in DHT inhibition.

Fincurve.jpg


Some men report a reduction in side effects by taking a lower dose, but it could be a largely psychological benefit.
 

ginner

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I'm not 'anti-pharmaceutical companies' and I don't want to sound cynical but I think it's fair to say that MSD is motivated by profit. Obviously they want people to use 1mg daily because they make 2-5 times more money compared to the lower doses. We know that 0.2mg is effective - in fact MSD's own data demonstrates this. They want to scare people into spending more money.

Almost every drug out there can have its dose titrated to the individual patient. Doctors do this all the time. I fail to see what makes Propecia so special that it should only be taken in the exact way set out by its manufacturer, especially when the manufacturer's own research shows that lower doses will work.
 

evildude

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why? the evidence is clear as day. the so called recommended dose is arbitrary. if money is an issue, cut the pills. simple as that. pretty much the same effect, for a fraction of the money...
 

bubka

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the data shows that there is around a 10% difference from .2mg to 1mg, plus if you look at the hair count, the data is even more clear that 1mg is optimal for regrowth... which they forget to leave out
 

evildude

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what are you on about? the difference in serum dht levels, which as far as i know gives the best indication, between 0,2mg and 1mg is negligeable.

larger dose could maybe give you results quicker, but, as pondle's graph show, in the long term, the results seem to be almost identical. which is as expected, as the dht levels are almost identical as well. or are you claiming that finasteride works by some other mechanisms other than lowering dht levels?
 

Pondle

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Well we only have 12 month data for 1mg and 5mg. Whether 0.2mg gives you a comparable hair count over the long term (and how long it might take to get there) is a matter of speculation.
 

bubka

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exactly, and for all we know, it will not, given that at m6 you will have 26% less hair

i believe hair transplant surgeons have said that even a 10% gain is noticeable
 

evildude

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did you not see the graph supplied by pondle? it showed that there was quite a bit larger haircount at 6 months on 5mg than on 1mg. however, after a year, the results were similar. a larger dose will then, probably, give quicker results, but in the long term, the difference will be insignificant.
 

bubka

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you are making an assumption based on a dosage that is 25 times greater, i don't see how you can scientifically draw that conclusion
 

RaginDemon

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10% gain in the thinning area is actually a lot.
 
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