Library | Hair Loss Treatments
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You’ve probably noticed that oral finasteride is available as a 1mg or 5mg tablet. The latter hasn’t been approved by the FDA for the treatment of hair loss, but a separate health condition called benign prostatic hyperplasia (enlarged prostate).
At XYON, we currently only offer oral finasteride as a 1mg tablet. In this article we’ll discuss why great hair loss treatment results are possible at this lower dose and why increasing the dose of finasteride doesn’t necessarily lead to better clinical outcomes in hair loss.
What is finasteride 5mg used for?
Finasteride 5mg is used to treat a condition called benign prostatic hyperplasia (BPH). The condition involves enlargement of the prostate gland and is believed to be triggered by changing hormone levels as a man ages. Finasteride works by reducing concentrations of the hormone dihydrotestosterone (DHT) which encourages prostate gland cell growth. Reducing DHT levels also helps halt the progression of pattern hair loss.
In theory, finasteride 5mg could be prescribed off-label to a patient to help manage his pattern hair loss. But this would require the patient to split each tablet into quarters, resulting in four separate doses of 1.25mg finasteride. It’s hard to say whether this modest 0.25mg difference would increase the efficacy of the medication. In the section below, we’ll discuss the reasons why.
Can I use finasteride 5mg for hair loss?
Finasteride 5mg is not approved for the treatment of male pattern hair loss. However, a 5mg tablet could be split into several smaller doses that a patient would take over the course of several days. But there is no strong evidence that this method of administering and dosing finasteride is superior to the approved 1mg dose for androgenetic alopecia.
It’s important to understand that increasing the dose of finasteride does not necessarily result in greater DHT suppression. A study assessing the movement of finasteride through the body and the medication’s effects found no significant benefits to DHT suppression at doses above 5mg (Steiner, 2012). One trial that looked specifically at relative scalp reductions in DHT found that levels decreased by 64% and 69% with 1mg and 5mg doses, respectively (Drake, 1999).
Additionally, a study on the effects of finasteride on hair loss found that 1mg and 5mg doses were similarly efficacious and that the 1mg dose had a similar side effect profile to the placebo and lower doses of finasteride (Roberts et al., 1999). These types of studies have helped establish 1mg finasteride as the optimal dose for androgenetic hair loss because it achieves a balance between therapeutic benefit and safety.
When you take finasteride, the medication remains present in the body for a certain amount of time. Pharmacological studies have found this to be anywhere in the range of 4-7 hours before being fully eliminated (excreted). But do DHT levels immediately return to pre-finasteride levels?
It turns out that DHT levels remain suppressed for several days after the last dose of finasteride. This is a key point to remember, since regular dosing (i.e. taking 1mg of finasteride daily) helps sustain this effect without having to increase an individual dose. This is one major reason why it’s so critical to maintain consistency when taking any hair loss treatment.
What if 1mg finasteride doesn't work for me? Should I switch to 5mg?
If your hair loss isn’t responding to finasteride treatment, one option may be to talk to your doctor about switching from finasteride to dutasteride. Unlike finasteride which only blocks one form of the enzyme that produces DHT, dutasteride blocks multiple forms of it. This typically results in a more dramatic reduction in DHT, without having to increase the dosage of medication itself.
What are the side effects of finasteride 5mg?
The types of side effects reported by patients taking finasteride 5mg vs 1mg are similar. These side effects include reduced libido, erectile dysfunction, ejaculatory changes and gynecomastia (breast swelling and/or tenderness) (Zito et al., 2022). Finasteride may also induce low blood pressure in some patients.
At this point, you may be wondering whether the higher 5mg dose comes with an increased risk of side effects. Currently available data point to this being a possibility, but more research is needed to quantify this risk. A large meta-analysis of finasteride use found that patients being treated for BPH were at a greater risk of developing sexual dysfunction compared to patients being treated for androgenetic hair loss (Liu et al., 2016). This could be attributed to a difference in dosing.
In most cases, adverse effects associated with finasteride are reversible and will go away when patients stop taking the medication. In a small subset of patients, sexual side effects do not resolve on their own, leading to negative effects on patient quality of life. It’s important to mention any concerning side effects to your doctor so they can modify treatment as needed to help manage them.
Finasteride 5mg: Takeaway
Finasteride 5mg is not approved for the treatment of male pattern hair loss. For most patients, the 1mg dose of finasteride is sufficient to produce good treatment results while keeping the risk of developing side effects low. Increasing the dose of finasteride does not guarantee better clinical outcomes. For this reason, if you’re unsatisfied with your hair loss progress, you may want to discuss alternate treatment options with your doctor.
You could consider other delivery methods for finasteride, such as compounded topical formulations that allow doctors to customize drug concentrations for patients. XYON’s proprietary liposomal gel base was designed to reduce possible side effects of finasteride and dutasteride, without compromising treatment efficacy. Depending on the patient, this could be the preferred option to increasing your dose of oral finasteride. Start an online consultation today to be connected to a hair loss specialist who can walk you through your treatment options.
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