Finasteride 5mg for Hair loss treatment?

Question

Hello, I would like to ask whether finasteride 5mg every 5 days can be sufficient alternative option for hair loss treatment equally to 1mg/day. Here in Slovakia we can get only 5mg tablets and I think that splitting them in smaller pieces will cause exposure and damage to active substance in the tablet before is digested. Considering finasterie half-life, what is the best option for me? Splitting 5mg or use 5mg every 5 days? Thanks!!

Anna Chacon, MD, FAAD · Answer

Finasteride is a medication that is commonly used in the treatment of male pattern hair loss (androgenetic alopecia). It works by inhibiting the conversion of testosterone to dihydrotestosterone (DHT), a hormone that contributes to hair loss in men. The typical recommended dose for hair loss is 1mg per day. However, if you only have access to 5mg tablets, it's understandable that you're considering alternative dosing strategies. 
As you've mentioned, finasteride has a half-life of about 5 to 6 hours in men aged 18-60, and 8 hours in men over 70 years. This means that the drug is largely eliminated from your system within a day or so. Therefore, taking 5mg every 5 days might not provide a consistent enough level of the drug to effectively block DHT and could potentially lead to fluctuations in hormone levels.Splitting the 5mg tablet into smaller pieces could be a viable option. While it's true that the tablet's protective coating could be damaged, it's unlikely to significantly affect the medication's efficacy as long as the tablet is stored properly and consumed shortly after being split. 
However, it's important to note that finasteride can be absorbed through the skin, and women who are pregnant or may become pregnant should not handle crushed or broken tablets due to the risk of a specific type of birth defect.

Kulakarn Amonpattana, MD · Answer

Hello I'm Dr. Wipawan Vathananai, a co-worker of Dr. Kulakarn Amonpattana, from BHI Clinic, Bangkok, Thailand. There's no problem breaking the tablet into quarters, however it would be a bit difficult since the tablet is already very small. I would suggest 2 options;
1. Take Finasteride 5 mg/day for 2 days/week or2. Take Finasteride (5 mg) half tablet every other day

Matt Tahsini, MD · Answer

Hello and thank you for your question. Typically the correct dose of Finasteride is 1.25mg daily. I have heard of patients in other countries who split the 5mg tablets into 1.25mg doses and take them daily. Personally, I think that is a better way to go than taking a 5mg tablet every 5 days. I hope this helps.

Dr. T

Dr. T

Jeff Donovan, MD, PhD · Answer

Let me begin by saying the FDA approved dose for male pattern hair loss is 1 mg daily. All other strategies for dosing are therefore off-label. In the present day, taking 1.25 mg daily (one quarter of a pill) would be felt to be superior than “5 mg every 5 days.”  In fact, there is even some evidence that 5 mg daily is better than 1 mg or 1.25 mg daily. (based on network meta-analysis study by Gupta et al 2022). Extremely large numbers of males around the world “split” the 5 mg pills every day and use 1.25 mg with reasonably good effect so you need not be too concerned about that. All in all, if you and your doctors feel finasteride is the right plan for your hair loss, and you are comfortable with how it is used and side effects, then 1.25 mg daily would be felt to be superior to your suggestion of “5 mg every 5 days.”

Finasteride 5mg for Hair loss treatment?

Answers (4)

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