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The methods
Different preparations - Proscar
Maj littel särtsh-båx
In Sweden two pharmaceutical preparations (medicaments) are registered for male pattern baldness: Minoxidil (Rogaine/Rogaine Forte/Recrea/Revexan) and finasteride (Propecia). Besides there is a third preparation, with a function similar to finasterid: Dutasteride (Avodart). So far the indication for dutasterid does not include thinning of hair. Like the drug Proscar (finasterid 5 mg), it is ment for men with benigne prostatic hyperplasia, a common disorder in the upper middle aged.
Propecia (finasterid 1 mg) was developed as a conequence of clinical observations on patients taking Proscar. They reported in many cases, that they stopped loosing hair. The studies indicated that this effect could be reached by approhximately 1 mg. In Sweden, MSD has fixed the price of 98 Propecia to 1278 SEK, while the price of Proscar for a package of the same size is around 920 SEK. Or, put in an other way: Finasteride in Propecia is more than 4 times the price. On a free market you can make Your choice. (See below).
Proscar
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 As mentioned previously, this medicament is used by men with prostate disorders, and officially not to treat male pattern baldness. Since the active (and sole) ingredient of the tablet is finasteride, which has a proven effect in male pattern baldness, fractions of Proscar can be used as an economically more favourable alternative to Propecia. In Sweden a prescription from a physican is needed for both drugs. It is not against the law to prescribe Proscar to balding men. The daily dosage should be 1/4 of one tablet.
The ideal would be 1/5, but it is more convenient to split tablets into quaters. A special tool is needed, since the tablet is not meant to be split. In Swedish pharmacies (drugstores), the device is called "Tablettdelaren", and it costs less than 100 SEK. With a razor blade and a bit of imagination, one can probably build one´s own device. Anyhow, on a yearly basis, the clear saving for the Proscar-user is more than 4000 SEK.
When I prescribe Proscar (and I do!), I advise my patient to store the quaters in a dark box. It cannot be ruled out that finasteride is sensitive to light, although it can be presumed that the motive for the coating is economic. Proscar and Propecia are manufactured by the same company, MSD.
Lately, a Swedish researcher has warned against a possible risk with finasteride. There are (at least) to receptors for testosterone in prostate tissue. DHT stimulates the growth by acting on one of them, but has a slight opposite effect on the other. To block out the production of DHT (which is the effect of finasteride) could mean a slightly increased risk for the formation of tumor cells in the prostate gland. The resarcher has made experiments on genetically manipulated mice to support his thesis. Mice and men is not the same, as the representitives for MSD have stated. My opinion is, that the short term risk for younger men on approximarely 1 mg of finasteride a day is negligable. Maybe, if thre are cases of prostate cancer among close relatives, I would advise the patient to give up his medication until more knowledge has been gained. Until know, around 25000 people have been taking Proscar over the last 13 years without any known sideffect of this kind.
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We are members of International Society of Hair Restoration Surgery (ISHRS).
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