Please sway my wavering mind ...

[Lead Farmer]

What kind of useless study is that?

One that doesn't suit your distorted view of reality, if the side effects were severe it would have been noted.

Also take note of the following:
"5.9% of patients reported side effects; many of these patients still continued taking Finasteride because of its benefits"
If they were experiencing serious problems they would have discontinued usage.

 

[giant]

I'm not really a pill person, but I've contemplated taking the plunge today. I've had the prescription (5mg finasteride tablets which I'd quarter) since January. I filled it in February and the bag has been lying on my desk ever since. One moment I resolve to not take the drug, the next I'm surveying the sparser areas of my scalp and reconsidering that resolution. I'm fine with my hair now -- it could stand to be thicker and more filled in -- but what drives me to finasteride is that the thinner areas serve as a portent of what is to come.

Can't you get it in 1 mg tabs? that'd save you the trouble of chopping it. Also could you take a 5mg pill every five days and get the same results?

 

[Wuffer]

Habeas: obviously you can't identify a humorous attempt at paraphrasing, which I found to be suitable taking into account the outrageous nature of the majority of your posts.


All of the links you posted are relevant to this discussion, and I thank you for not posting them in obnoxious red bolded font. As you mentioned, the FDA believes that there may be a causal relationship, as was established based solely on case reports submitted to them. The warnings labels currently reflect this fact, and if you look closely at the posts in this thread, you will see that nobody is debating this. I simply don't understand what point you are trying to make anymore, unless you are just arguing for argument's sake. You like to focus on and argue irrelevant details in an attempt to ignore, or shift attention away from the big picture.

The point you repeatedly ignore is that risk is EVERYTHING in life. For example, drinking alcohol is strongly associated with several types of cancers, and dozens of other health conditions. Nobody debates this fact, yet the majority of the population continues to consume it. Driving cars (yes, it is completely relevant) is linked to serious injury and death. Nobody debates this fact, yet the majority of the population engages in this activity on a daily basis.

None of the links you posted are able to establish any sort of risk or incidence rate. The fact that the drug has been on the market for 20 years and we are only hearing about these symptoms recently tells me that there a very low risk. The benefits of taking the drug are clear, and the risks are demonstratively low. People NEED to weigh this out. Some might decide that any risk of these symptoms isn't worth it. More power to them. Others might realize hair loss is already causing loss of self esteem, impotence, depression, and a myriad of other symptoms, then decide that the risk is a no-brainer. More power to them, too.

I encourage you to engage in some constructive, relevant discussion about risk. Enough with the conspiracy theories and copy&pastes from Propeciahelp; no one is reading these anymore. If you think I am wrong and that risk isn't relevant, or that you don't believe my examples illustrate anything useful, then please submit your rebuttal.







- - - Updated - - -

Can't you get it in 1 mg tabs? that'd save you the trouble of chopping it. Also could you take a 5mg pill every five days and get the same results?

5mg generic is actually cheaper than the 1mg brandname Propecia tabs. Every 6 months I crack open a few beers and sit down for a half-hour to cut up my 5mg tabs with an exacto knife. Brandname Propecia is about $800/year, and generic 5mg runs me less than $100 for a year's worth of treatment, so it's well worth the time cutting the pills up!

Finasteride has a relatively low half-life in the system, and I think it's completely gone in about 1.5 days. If you took a 5mg pill every 5 days, you would still be left without an active dose for at least 3.

 

[giant]

5mg generic is actually cheaper than the 1mg brandname Propecia tabs. Every 6 months I crack open a few beers and sit down for a half-hour to cut up my 5mg tabs with an exacto knife. Brandname Propecia is about $800/year, and generic 5mg runs me less than $100 for a year's worth of treatment, so it's well worth the time cutting the pills up!

Finasteride has a relatively low half-life in the system, and I think it's completely gone in about 1.5 days. If you took a 5mg pill every 5 days, you would still be left without an active dose for at least 3.

Good to know, more questions: I thought the pills were not necessarily distributed evenly, this was a concern of the original poster I believe. Meaning you could cut it in half and end up with one piece containing 4 mg while the other only has one.

Also, does this mean it is not available in 1mg, or it is just more expensive? I've been trying to decide what reg to start and since I used propecia in the past (i think i stopped due to $$$) without side effects I may as well start with this (its progressed in the last five years).

You cut up 6 months supply at a time? Sounds like a lot of work... is there not an expiry date? do the contents get lost with all that cutting and handling?

 

[Wuffer]

How is the fact that men weren't previously adequately warned by Merck and the FDA at all relevant to the OP's situation? The package inserts now contain said warnings, and he is now well apprised of them. He is now attempting to gauge the level of risk so that he can make a more informed decision.

You are picking out an extremely specific example. I could also say ten years ago if you went to the doctor presenting with an infection, you would be prescribed antibiotics and that would be the end of it. It is irrelevant and of no consequence to this discussion. Using Vioxx as an example doesn't prove anything except the fact that it was dangerous, and it clearly was. If you are simply suggesting that Propecia is dangerous by association, then you are using unsubstantiated conspiracy theories as your argument, which don't hold any weight.

Merck released Vioxx and it killed many people. They also released dozens if not hundreds of other treatments that are safe and effective. Data strongly suggests that finasteride is safe; unlike Vioxx, where questions of its safety arose shortly after it's FDA approval. Subsequent withdraw from the market soon followed.

I am honestly looking forward to seeing these studies, because more information about this condition is certainly a good thing. However, this still doesn't change the fact that these symptoms are extremely rare. Just because we learn more about it doesn't suddenly make the drug more dangerous than it has already been established to be. Will the side effect percentages suddenly jump from 2% to 50% after these studies are released?

SSRI's have been more or less conclusively established to cause persistent sexual dysfunction, and it's believed to occur in a significant number of people, I recall as high as 1%. However, the FDA hasn't pulled them from the market, have they? Are people now convinced to never take them? Same thing will happen with finasteride. Just because we know more about a rare condition, doesn't make it any more dangerous or any more common.

 

[Hairless Goat]

Before seeking a longterm treatment, I like to weigh the benefits against the risk so I appreciate it, Habeas Corpus, that you have brought those studies and websites to my attention (which I had already seen). However, it's another thing to make such assertions with no personal evidence to base it off. The other posters here are merely recounting their experiences with the drug, so this mission to repudiate all they say is greatly unjustified. Furthermore, some of the side effects listed on these sites are ridiculous and could be attributed to anything. Before I took Accutane, I heard all the horror stories of depression and being predisposed to it myself, I was a little ambivalent about the drug. Well, I can honestly say I felt great over the course of the treatment. Whenever someone tries to draw suicide/depression to a drug that treats a cosmetic condition, they fail to account for all the people that commit suicide because that cosmetic condition is left untreated. Few may write in their suicide letters that going bald caused that to kill themselves, yet it most certainly could have contributed to a lower self-esteem.

- - - Updated - - -

Good to know, more questions: I thought the pills were not necessarily distributed evenly, this was a concern of the original poster I believe. Meaning you could cut it in half and end up with one piece containing 4 mg while the other only has one.

Also, does this mean it is not available in 1mg, or it is just more expensive? I've been trying to decide what reg to start and since I used propecia in the past (i think i stopped due to $$$) without side effects I may as well start with this (its progressed in the last five years).

You cut up 6 months supply at a time? Sounds like a lot of work... is there not an expiry date? do the contents get lost with all that cutting and handling?

I called the manufacturer of my 5mg finasteride tablets and they advised against cutting anything that was not scored because the drug was not evenly distributed throughout. I know it's a more expensive option, but I've begun to wonder whether I should get brand name Propecia then take a pill every other day (which would cut the cost in half). In the not so distance future, I would imagine Merck's contract for Propecia to expire and cheap generic versions, 1mg tablets, to sprout up.

 

[Benjamin36]

I called the manufacturer of my 5mg finasteride tablets and they advised against cutting anything that was not scored because the drug was not evenly distributed throughout. I know it's a more expensive option, but I've begun to wonder whether I should get brand name Propecia then take a pill every other day (which would cut the cost in half). In the not so distance future, I would imagine Merck's contract for Propecia to expire and cheap generic versions, 1mg tablets, to sprout up.

I buy Finasteride in 1mg dose, it's cheaper than Propecia.

 

[Hairless Goat]

Really, where do you get? Online? Walmart doesn't have it.

 

[Relax Im hilarious]

I know it's not a scientific study and only a sample size of 2 but i've been on 1mg branded propecia for almost a year and my brother has been on for 4 years (i'm late almost 27 and he is almost 30) and neither of us have had any side-effects to report. I do believe sides effects from finasteride exist but the scientific evidence (not just from merck, but independent studies) have suggested finasteride is safe in the majority of people who take it, unfortunately for some it is not, like all meds, they are not one size fits all.
Also the list of side effects is not a good thing to quote, take a look at these lists:

1) Common adverse drugs reactions associated with use of the ******** include diarrhoea, hypersensitivity, nausea, rash, neurotoxicity, urticaria, superinfection (including candidiasis), fever, vomiting, erythema, dermatitis, angioedema, seizures and pseudomembranous colitis

or how about this one?

2) Insomnia, Headache, Nausea, Diarrhoea, Fatigue, Dry mouth, Anxiety, nervousness and restlessness, Feeling jittery, Decreased sex drive, Problems with getting an erection or ejaculation, Abnormal dreams, Dizziness, Change in taste, Feeling sleepy or lethargic, Blurred vision, palpitations, Flushing, Yawning, Indigestion, Vomiting, Increased sweating, Rash or itching, Frequent urination, Aching joints, Decreased appetite and weight loss, Problems with co-ordination or balance, Tremor or twitching, Dilated pupils, Low blood pressure, Hair loss, Increased tendency to bruise, Feeling hot, cold or generally unwell, Problems with orgasm, Convulsions, Mania, Hallucinations, Panic attacks, Abnormal reaction of the skin to light (photosensitivity), Milky secretion from the breasts (galactorrhoea), Difficulty passing urine, akathisia.

The first one is paracetamol and the second is fluoxetine, better known as prozac. I've prescribed both these medications (i'm a doctor) and would not hesitate to do so again if needed, it doesn't mean that they can be given out like sweets and some people can't tolerate them, but for the vast majority they work, with zero or few sides and help so much that they are life-changing. Finasteride is just like those drugs, it really does change peoples lives, especially for those who can become clinically depressed by baldness, and it doesn't just work for baldness but also for BPH, those patients have been taking 5mg for almost two decades now with few side effects (if any). Everyone has to be vigilant when taking finasteride and to the OP, do your research before starting but also trust your own body, if you feel something is wrong don't keep taking the drug but the statistics would suggest you are far more likely to experience no (or few) sides.

OP, if your interested (and don't get to bored!), i started my own thread in the tell your story section and i did a lot of research into finasteride and have quoted numerous scientific studies on everything from the neurological effect of DHT to the effect of DHT on sperm production. I've tried to be as impartial as possible and have posted not just the positive studies but also the negative ones so you get a clear picture, if you have the time check it out and maybe it will answer a few questions you have.

 

[Benjamin36]

Really, where do you get? Online? Walmart doesn't have it.

I get mine at the pharmacy in Shoppers Drug Mart in Canada.

 

[Wuffer]

Well said with your last post, Hairless Goat. One thing to note is almost all of the symptoms that Habeas listed are mental in nature, meaning that the mind is capable of creating them under the right circumstances. The others (such as testicular shrinking) are open to interpretation, may be exaggerated or people are simply convincing themselves that the symptoms might be occurring. The drug itself may very well be responsible as well, but nobody has any way of knowing for sure since these reports are all self submitted.

I found out about an extremely interesting condition called Somatization Disorder a while back. Here is a link that describes it:

http://www.merckmanuals.com/profess...ctitious_disorders/somatization_disorder.html

Before Habeas jumps all over this, it's not a Merck made-up condition, but their website contained one of the better explanations of the condition. If you take a look, you will notice the symptoms are extremely similar to those of this persistent finasteride disorder. It includes sexual symptoms, neurological issues and depression and/or anxiety which often exist co-morbidly (which in of themselves can produce dozens of symptoms, almost all of which exist in Habeas' symptom list). The incidence rate for this condition is estimated at around 1/500 to 1/200people, but it may be more common. It's unknown what causes this condition, but it's believed to be linked to acute stress, and can continue indefinitely without proper targeted cognitive treatment.

I'm not saying ALL cases of persistent symptoms are from this condition, but I am willing to bet a number of them are related. It's also possible that finasteride could cause this condition through an unknown mechanism. The similarities of this condition are so strikingly similar to the descriptions of people with finasteride symptoms that it really shouldn't be ignored.

 

[Relax Im hilarious]

I actually am in agreement with habeas corpse on this one, this is definitely not somatization disorder. I've seen psych patients with somatization disorder and they almost always tend to be women and they present more like this; persistent headache (over a number of years), dyspareunia, chronic diarrhoea/constipation and food intolerances. They have usually had a battery of all medical tests as this is a diagnosis of exclusion, people that get serious problems with finasteride do tend to have irregularities in their blood work, you can see in some peoples posts when they say they have PFS and they have deranged bloods.

 

[Wuffer]

I actually am in agreement with habeas corpse on this one, this is definitely not somatization disorder. I've seen psych patients with somatization disorder and they almost always tend to be women and they present more like this; persistent headache (over a number of years), dyspareunia, chronic diarrhoea/constipation and food intolerances. They have usually had a battery of all medical tests as this is a diagnosis of exclusion, people that get serious problems with finasteride do tend to have irregularities in their blood work, you can see in some peoples posts when they say they have PFS and they have deranged bloods.

Thanks for your posts BTW, it's good to have an experienced medical opinion on this matter.

I personally haven't seen any evidence that individuals with persistent symptoms have irregularities in their hormone levels, other than what is reported on forums. Often the post-finasteride blood levels don't have baseline tests to compare to, and I haven't seen any similarities between people that complain of these persistent symptoms. T, DHT and E levels are usually within range, and as I mentioned, if they 'seem' off, I haven't seen baseline levels that indicate they were any different before starting the drug.

Have you seen any studies that indicate this, or have you otherwise encountered this in your practice? You can understand how it is difficult to take what is posted on forums at face value or as any kind of significant proof.

 

[Relax Im hilarious]

Thanks for your posts BTW, it's good to have an experienced medical opinion on this matter.

I personally haven't seen any evidence that individuals with persistent symptoms have irregularities in their hormone levels, other than what is reported on forums. Often the post-finasteride blood levels don't have baseline tests to compare to, and I haven't seen any similarities between people that complain of these persistent symptoms. T, DHT and E levels are usually within range, and as I mentioned, if they 'seem' off, I haven't seen baseline levels that indicate they were any different before starting the drug.

Have you seen any studies that indicate this, or have you otherwise encountered this in your practice? You can understand how it is difficult to take what is posted on forums at face value or as any kind of significant proof.

I completely agree with you, i haven't seen anything other than anecdotal evidence posted by people on forums in regards to blood work run on people who suspect they have 'PFS'. What i said in my last post is simply a reflection of what i have read on these forums and therefore is not verifiable data. You are absolutely right that the value of a blood test without a baseline level to compare to leads to a questionable link between conditions as references ranges (especially for hormones) can vary widely. In terms of clinical practice, i am not a urologist but i did do a urological surgery rotation and a renal medicine rotation in med school and saw many patients (probably 40-50), all above the age of about 50, with BPH on 5mg finasteride and never once saw any of them have side effects, and i remember some of these men had been taking it for over a decade. People were more likely to get sides from their alpha-blockers when treated for BPH than their finasteride. To be honest the only time i've ever heard of a side effect from finasteride is since i started doing research into propecia.
I have nothing but good things to say about propecia, it has helped me regrow hair, thickened it up, made me worry about my hair less and i've had no sides, but i understand this is of little consolation to someone who has a negative experience. I do believe it can cause sides i just think the selection on the internet has a strong sampling bias and is skewed towards the negative, and even with this taken into account, sides are still rare.
The nocebo effect is massive in finasteride use, i posted about this paper before, it makes a great read and explains how many finasteride sides effects can be psychological:
http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2007.00563.x/abstract

I must admit, habeas corpse, i am very intrigued as to why you are so negative to finasteride, given that you have not tried it yourself, have you had friends who have had bad experiences? Is there a reason for being so vehemently opposed to this drug?