The short line
Propecia is the US prescription brand of a finasteride 1 mg tablet for male pattern hair loss in men only. Generic finasteride 1 mg tablets are described as a non-brand option beside Propecia. That comparison does not establish the equivalence, availability, or price of a particular listing. Online, a licensed clinician reviews the request before a pharmacy can be involved, and the review does not guarantee a prescription or a shipment. The 1 mg product is contraindicated in pregnancy and in women who are or may become pregnant.
Generic finasteride versus Propecia
Propecia is the brand name of a finasteride 1 mg film-coated tablet for oral use in the United States. Generic finasteride 1 mg tablets are described as a non-brand option beside it for male pattern hair loss, in that same oral 1 mg setting. Generic Propecia is a common name for those tablets. This general comparison of branded finasteride versus generic finasteride does not establish the equivalence, availability, or price of a particular listing. Topical and compounded products are not this oral 1 mg tablet.
How the 5 mg strength differs
Proscar is finasteride 5 mg. That strength is associated with benign prostatic hyperplasia, a noncancerous enlargement of the prostate, and it is a different strength from the 1 mg hair-loss tablet. The labeled hair-loss regimen in this comparison is the 1 mg tablet. A 5 mg tablet is not that regimen.
Who the 1 mg tablet is for
The 1 mg brand tablet is indicated for male pattern hair loss, also called androgenetic alopecia, in men only. It is not indicated for women. It is not indicated for pediatric patients, and safety and effectiveness in pediatric patients have not been established.
Efficacy in bitemporal recession has not been established. That pattern is a receding hairline on either side of the forehead and above it, the temporal area, and it is not known whether the tablet works there.
The 1 mg product is contraindicated if you are hypersensitive to any of its components. Check the ingredients of the product you were actually dispensed.
Finasteride is metabolized extensively in the liver, which means the liver breaks the drug down. The effect of impaired liver function has not been studied. Abnormal liver function calls for caution.
What pregnancy requires for use and handling
The 1 mg product is contraindicated in pregnancy and in women who are or may become pregnant, because a male fetus can be harmed. Do not take it if you are pregnant or if pregnancy is possible.
A woman who is pregnant or may become pregnant should not handle crushed or broken 1 mg tablets. A crushed or broken tablet can expose her to the medicine. An intact coated tablet prevents contact during normal handling. If skin touches a crushed or broken tablet, wash the area promptly with soap and water. That wash is for contact with a tablet that is already crushed or broken. It is not a method for dividing a dose.
How to get finasteride online
For Finasteride Propecia Online access in the United States, a licensed prescriber still has to decide whether to prescribe the medicine. The US product is a human prescription drug. Its package legend is Rx only, so it is not an over the counter medicine. Pharmacy fulfillment comes after that prescribing decision.
If you want to buy finasteride online or order finasteride online, the pharmacy step still waits on that prescription. It may be prescribed online only if a licensed prescriber issues the prescription. Evaluation does not guarantee a prescription, dispensing, shipment, or availability. The prescriber’s constraints include the men-only labeled use and the pregnancy contraindication.
What the clinician review decides
A licensed clinician reviews an online questionnaire or visit. If a prescription is issued, it may be sent to a pharmacy or a mail-order pharmacy. The pathway depends on the service. The review does not guarantee a prescription or dispensing.
How to check the online pharmacy
Before you trust a pharmacy offer in the United States, use a state-licensed online pharmacy lookup. A low price or a delivery claim does not replace that licensure check.
What side effects and warning signs matter
Sexual effects were measured in the hair-loss trials, and sexual problems also appear in later reports. Other effects reported after approval do not have established frequencies. A prevention trial that used finasteride 5 mg daily raised a high-grade prostate-cancer signal, and the meaning of that signal for men using the 1 mg product is unknown.
Sexual effects in treatment and after stopping
In three 12-month hair-loss trials, drug-related sexual effects were counted among men in the Propecia studies: 945 on finasteride and 934 on placebo. The rates overlap, so they are not added into a new total. Figures in parentheses are the decreased-volume portion of the ejaculation-disorder rate.
| Drug-related experience | Finasteride | Placebo |
|---|---|---|
| Decreased libido | 1.8% | 1.3% |
| Erectile dysfunction | 1.3% | 0.7% |
| Ejaculation disorder (decreased volume) | 1.2% (0.8%) | 0.7% (0.4%) |
| Stopped for a drug-related sexual adverse experience | 1.2% | 0.9% |
A separate count recorded men with one or more of those experiences: 3.8% (36 of 945) on finasteride and 2.1% (20 of 934) on placebo. Resolution occurred in the men who stopped because of these sexual effects and in most who continued. By the fifth year of treatment, the incidence of each of those experiences had fallen to 0.3% or less. That course in the trials does not remove later reports.
After approval, the 1 mg product has reports of sexual dysfunction that continued after stopping: erectile dysfunction, libido disorders, ejaculation disorders, and orgasm disorders. Frequency cannot be estimated from voluntary reports, and no duration is stated.
Other effects reported after approval
Other postmarketing reports, with no established frequency, include:
- male infertility, poor seminal quality, or both, with reports of improvement after stopping
- testicular pain
- blood in semen
- depression
- suicidal ideation and behavior
- breast tenderness and enlargement
- male breast cancer
- hypersensitivity, including rash, itching, hives, and swelling of the lips, tongue, throat, and face
The relationship between long-term finasteride and male breast neoplasia is currently unknown. Male breast cancer has been reported in rare cases. Report a lump, pain, enlargement, tenderness, or nipple discharge.
High-grade prostate cancer and 1 mg use
In the 7-year Prostate Cancer Prevention Trial, men 55 and older with a normal rectal exam and a PSA at or below 3.0 ng/mL took finasteride 5 mg daily. PSA is a prostate blood test, and that result was part of how men entered the trial. Gleason scores of 8–10 are a high-grade range. Gleason 8–10 cancers were 1.8% on finasteride and 1.1% on placebo.
5-alpha-reductase inhibitors may increase the risk of high-grade prostate cancer. Finasteride inhibits that enzyme. The clinical significance of these findings for men using the 1 mg product is unknown. The 5 mg product is not approved to reduce the risk of developing prostate cancer.
What to tell a clinician before starting
Before you start the 1 mg regimen, tell the clinician about prostate problems and liver problems. Also tell the clinician about every medicine, vitamin, and herbal product you use.
How to take the 1 mg tablet
The 1 mg hair-loss regimen is one 1 mg tablet once a day. Taking it more than once a day will not make it work faster or better. You can take the tablet with or without meals. If you miss a dose, do not take an extra tablet. Take the next tablet at the usual time.
Brand tablets, as supplied, are kept at room temperature, 15–30°C (59–86°F). Keep the container closed and protect the tablets from moisture.
How long results take and what stopping does
Finasteride inhibits Type II 5-alpha-reductase, the enzyme that converts testosterone to DHT. DHT is a hormone made from testosterone. Lowering DHT in the scalp and in the blood is the proposed way finasteride interrupts the process associated with miniaturized follicles, hair follicles that have shrunk. How much of that lowering comes from the scalp, and how much from the bloodstream, is not defined.
In general, daily use for three months or more is needed before a benefit is observed. Continued use is recommended to sustain the benefit, and the benefit should be re-evaluated periodically. Stopping leads to reversal of the effect within 12 months. These timing statements apply to the 1 mg regimen.
What the two-year hair counts and photos showed
Both endpoints below come from men ages 18 to 41 with mild to moderate hair loss at the vertex, the crown. No further hair-count loss is a different endpoint from increased hair growth on blinded photos, where the photo reviewers did not know who was on treatment. The no-further-loss shares are derived from further loss in 17% of treated men and 72% of men on placebo. Neither endpoint describes bitemporal recession.
| Endpoint at 2 years | Treatment | Placebo |
|---|---|---|
| No further hair-count loss | 83% | 28% |
| Increased hair growth on blinded photos | 66% | 7% |