Finasteride 1mg Oral for Male Pattern Hair Loss
Recommended Dosage
Take finasteride 1mg once daily for male pattern hair loss, with treatment continuing long-term (5+ years) to maintain benefits, as hair loss resumes upon discontinuation. 1, 2
Treatment Protocol
Dosing Specifics
- Standard dose: 1mg once daily for men aged 18-60 years with male pattern hair loss 1, 2
- The 1mg dose produces similar DHT suppression (approximately 50%) as the 5mg dose used for benign prostatic hyperplasia 3, 2
- No dose adjustment needed based on age within the approved range 1
Timeline for Results
- Visible improvement typically begins by 12 weeks of treatment 1
- Maximal benefit occurs at 1-2 years of continuous use 1
- Efficacy is maintained over 5+ years with continued treatment 1, 4
- In long-term studies, 58% of men showed improvement at 48 weeks, and 66% showed improvement at 2 years 5, 6
Duration of Treatment
- Plan for lifelong treatment if you want to maintain hair growth benefits 1
- Hair loss resumes if treatment is discontinued 1
- Treatment continuation beyond 5 years can provide additional improvements in 21% of cases 7
Important Clinical Considerations
PSA Monitoring (Critical Pitfall)
- Finasteride 1mg reduces PSA levels by approximately 50% after 12 months, identical to the 5mg dose 3, 2
- Double the PSA value when screening for prostate cancer in men taking finasteride after 12 months of therapy 3, 2
- Consider obtaining baseline PSA before starting treatment in men approaching prostate cancer screening age (>40-45 years) 1
Sexual Side Effects
- Sexual dysfunction occurs in approximately 2-4% more patients taking finasteride compared to placebo 1, 8
- Specific effects include decreased libido, ejaculation disorders, and erectile dysfunction 1, 6
- The magnitude is relatively small: mean difference of 3.21 points on sexual function scales versus 1.26 points for each year of aging 1, 8
- All sexual adverse events reverse upon discontinuation, and many resolve even with continued therapy 6, 9
- Overall discontinuation rates due to adverse events are similar between finasteride (6-7%) and placebo groups 8
Fertility Considerations
- Evidence regarding direct fertility impact is inconclusive for the 1mg dose 1, 8
- Sexual side effects may indirectly affect fertility by impacting sexual function 8
- The 5mg dose is associated with reduced semen volume, but data for 1mg is less clear 8
Patient Counseling Points
Setting Realistic Expectations
- Counsel patients that improvement takes 12 weeks minimum to become visible 1
- Explain that maximal benefit requires 1-2 years of treatment 1
- Better results are observed in patients older than 30 years; 42.8% of men aged 20-30 years showed no improvement even after 10 years 7
- Patients with higher AGA grades (IV-V) may take longer to show initial improvement 7
Safety Profile
- Finasteride is generally well tolerated with no new safety concerns identified during long-term use up to 10 years 4, 7
- Treatment-related adverse events occur in 7.7% of finasteride recipients versus 7.0% of placebo recipients 6
- Most adverse events are mild to moderate in severity 6