UK FINASTERIDE PRESCRIPTIONS

I get MANY emails from people wanting to start finasteride / Proscar and as I’ve stated on forum posts along with many other forum posters that it’s important you get legitimate products from a trusted source as there are many bogus online drug stores out there in my option so be careful.

The first step for those of you who are open to discussing hair loss with your own GP is to seek his advice and see if he is willing to prescribe medication to help treat your loss. The probelm is that most NHS GP’s are not experienced in prescribing the medication and secondly it is a non NHS medication hence many Doctors and practices have policies either preventing them from prescribing or may charge a private consultation fee.

In the old single handed Gp surgeries, doctors who had experience in the drug were more able and williing to prescribe the medication.  However as you are seeing many small surgeries are disapearing and being replaced by large medical centres with several partners and managers that have strict controls and policies on who and what they treat for.

In any case I have found it rather difficult to find NHS Gp’s and practices that can accommodate prescribing for hair loss.  We also have the other issue in that most of us do not wish for anyone to know we are taking medication to treat hair loss even our own GP’s.

To combat this difficulty in finding reliable and legitimate prescribers of affordable finasteride I have come across a couple of experienced GP’s who have over a decade of experience prescribing all versions of finasteride and are trusted. Feel free to email me and I can put you in touch with them.

Email : support@spexhair.com

I cut 5mg Proscar up and this is another good affordable way to get the daily 1mg requirement. The generic version is very affordable too.

USING PROPECIA

Recently 1mg generic finasteride has become available on prescription in the UK and the price of it is now much more affordable than it was when it first came out. It saves the cutting up of Proscar and 5mg generic finasteride if you find this tricky – so worth considering it if you are a finasteride user, as a similar price for a years supply without cutting. I can gladly help put you in touch with the UK GP i use for my finasteride private prescription if this helps, just let me know.

Propecia should be taken once daily with or without meals. Patients must take Finasteride for one year or longer before its effects in preventing hair loss and re-growing hair can be accurately assessed. Finasteride takes up to a year or more to exert its full effects in both preventing hair loss and in re-growing hair. During the first six months you may note some thinning of your existing hair. This may be due to either progression of your hair loss before finasteride has had a chance to work or some shedding of miniaturized hair that makes way for the new healthy anagen hair to grow. It is important to be patient during this period. You should continue the medication for at least one year before you and your doctor can assess its benefits.

SIDE EFFECTS

Side effects from finasteride at the 1-mg dose are uncommon, but reversible. The one- year drug related side effects were 1.5% greater than in the control group. The data showed that 3.8% of men taking finasteride 1mg experienced some form of sexual dysfunction verses 2.1% in men treated with a placebo. The five-year side effects profile included: decreased libido (0.3%), erectile dysfunction (0.3%), and decreased volume of ejaculate (0.0%).

Most reported cases of sexual dysfunction occurred soon after starting the medication, but there have been reports of sexual dysfunction that have occurred at later points in time. The sexual side effects were reversed in those who discontinued therapy, and in 58% of those who continued treatment. After the medication was stopped, side effects generally disappeared within a few weeks. There have been anecdotal reports where side effects have persisted after discontinuation of therapy.

When finasteride is discontinued, only the hair that had been gained or preserved by the medication is lost. In effect, the patient returns to the level of balding where he would have been had he never used the drug in the first place. No drug interactions of clinical importance have been identified.

EFFECTS ON BODY HAIR

When finasteride is used to re-grow scalp hair, it may also inhibit the growth of body hair. The reason is that DHT stimulates the growth of body hair in adult males and the formation of DHT is blocked by finasteride. However, the genetic variation among people is too great to know how an individual person may respond. For those who may be concerned, finasteride will not increase body hair growth.

ADVERSE REACTIONS

Adverse reactions related to the breast, including breast tenderness or breast enlargement (gynecomastia), occurred in 0.4% of men taking finasteride 1-mg (Propecia), but this was no greater than in the control group. Other side effects that were not statistically significant included hypersensitivity reactions including rash, pruritus, urticaria, swelling of the lips and face, and testicular pain.

EFFECTS ON PSA

Finasteride causes a decrease in serum PSA (prostate specific antigen) by approximately 50% in normal men. Since PSA levels are used to screen for prostate enlargement and prostate cancer, it is important that your personal physician is aware that you are taking Propecia (finasteride) so that he/she may take this into account when interpreting your PSA results.

FINASTERIDE AND PROSTATE DISEASE

A study in The New England Journal of Medicine, in 2003, on finasteride 5-mg PROSCAR (not finasteride 1-mg, Propecia) reported that in the Prostate Cancer Prevention Trial (PCPT), men treated with finasteride 5mg for seven years had a 25 percent relative risk reduction for prostate cancer compared to the men treated with placebo. The authors also reported that high grade prostate cancers were found in 6.4 percent of the men treated with finasteride 5mg, compared to 5.1 percent of the men in the placebo group.

The authors were concerned that finasteride 5mg prevents or delays the appearance of prostate cancer and that this possible benefit and a reduced risk of urinary problems must be weighed against sexual side effects and the increased risk of high-grade prostate cancer. With new information, it is now felt that the increased incidence of a higher grade cancer was due to the fact that the finasteride shrunk the non-cancerous part of the enlarged prostate, making the cancerous part easier to detect on biopsy.

In fact, in 2009, the American Society of Clinical Oncology and the American Urological Association issued guidelines that recommend that healthy men consider finasteride to lower their level of the hormone dihydrotestosterone (DHT) with the goal of preventing the development of prostate cancer.

CAUTION DURING PREGNANCY

Finasteride use is contraindicated in women when they are, or may be, pregnant. Women should not handle crushed or broken Propecia tablets when they are pregnant, or may potentially be pregnant, because of the possibilities of absorption of finasteride and the subsequent potential risk to a male fetus. Propecia tablets are coated and will prevent contact with the active ingredient during normal handling, provided that the tablets have not been broken or crushed.

Exposure of pregnant women to semen from men treated with Propecia poses no risk to the fetus.

USE IN POST-MENOPAUSAL WOMEN

Merck recently carried out a study to evaluate the efficacy of finasteride in post-menopausal women. After one year there was no significant hair growth and, as a result, the study was terminated. An explanation is that hair loss in women is related more to the action of the enzyme aromatase (which is unaffected by finasteride) rather than DHT. It is also possible that the low DHT levels observed in postmenopausal women are responsible for the lack of significant response to finasteride. (See Causes of Hair Loss in Women).

LONG-TERM BENEFITS AND RISKS

The effects of finasteride are confined to areas of the scalp that are thinning, but where there is still some hair present. It does not grow hair in areas that are completely bald. Although it can regrow hair in thin areas, the major benefit of finasteride seems to be in its ability to slow down or halt hair loss. Results generally peak around one year and then are stable in the second year or decrease very slightly. Although the long-term ability of finasteride to maintain one’s hair is unknown, the majority of men find that after 5 years the medication is still working.

The benefits of finasteride will stop if the medication is discontinued. Over the 2-6 months following discontinuation, the hair loss pattern will generally return to the state that it would have been if the medication had never been used.

PROPECIA AND HAIR TRANSPLANTATION

Propecia (finasteride) has shown to be useful in complementing a hair transplant for several reasons:

1. Propecia works best in the younger patient who may not yet be a candidate for hair transplantation.
2. Propecia is less effective in the front part of the scalp, the area where surgical hair restoration can offer the greatest cosmetic improvement.
3. Propecia can re-grow hair, or stabilize hair loss, in the back part of the scalp where hair transplantation may not always be indicated.

For those who choose not to take Propecia, or who cannot take it due to its side effects, the surgical hair restoration is just as effective. The only difference is that medications can prevent further hair loss whereas surgery cannot. Medications are not needed for a hair transplant to be successful or the transplanted hair to grow and be permanent.

GENERIC FINASTERIDE

Finasteride 5mg (Proscar) is available in a generic formulation. (Propecia) will not be available generically until the year 2012. For those wanting to take generic finasteride, we recommend buying a pill cutter at the pharmacy and taking ¼ of a 5mg tablet every day. Please be advised that there is no scientific data insuring that this will be as effective as Propecia 1mg a day. Also, remember that there is a potential risk to pregnant women from handling broken or crushed tablets.

INCREASING THE DOSE

We are often asked if one should increase the dose of Propecia. Although we do increase the dose under certain circumstances, there is no scientific evidence that increasing the dose will have any additional effects. There are published data demonstrating that 5 mg is no better than 1 mg from controlled clinical trials. In practice, I often increase the dose when someone has been on the same dose of medication for about three years and then stops responding (begins to lose hair after being stable). When increasing the dose, I generally use generic finasteride 5mg, ½ pill a day.

PROSTATE CANCER SCREENING

The American Cancer Society and the American Urological Association recommend the following screening ages:

• Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
• Age 45 for men at high risk of developing prostate cancer: African American men and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer younger than age 65.
• Age 40 for men at even higher risk (those with several first-degree relatives who had prostate cancer at an early age).
• Regardless of age, yearly screening for PSA level if 2.5ng/ml or higher, and every 2 years for less than 2.5ng/ml.

An evaluation should include a rectal examination, a PSA, and other tests that your examining physician feels are appropriate. The above are general guidelines recommended men regardless of whether they use finasteride or not. Specific recommendations for each patient should be based upon the judgment of his own physician.

COMMON MISCONCEPTIONS ABOUT FINASTERIDE

Myth: Women can’t touch the medication.
Fact: Pregnant women should not handle crushed or broken tablets.

Myth: It only works in the crown.
Fact: It potentially works any where on the scalp where there is some hair, even in the front of the scalp.

Myth: Once you start it you must take it for ever.
Fact: You can stop the medication any time you want – you just lose its benefits when one stops.

Myth: Finasteride lowers testosterone
Fact: The medication, on average, causes a rise in serum testosterone levels by 9%.

Myth: The sexual side effects are frequent.
Fact: The sexual side effects occur in approximately 4% of patients taking the medication.

Myth: Finasteride causes birth defects if a man takes it when his wife is pregnant.
Fact: Exposure of pregnant women to semen from men treated with Propecia poses no risk to the fetus.

Myth: Propecia was originally a prostate medication that was found to prevent hair loss.
Fact: Propecia is not a prostate medication that was by chance noted to have a side effect of hair growth, it is a medication that was known since its discovery that it could grow hair.