Side Effects of Finasteride | The Hair Loss Show
Summary
TLDRDans cet épisode du 'Hair Loss Show', les docteurs Russell et Vickram discutent des traitements médicaux et chirurgicaux de la perte de cheveux, se concentrant sur le rôle de la finastéride. Ils expliquent comment cette molécule, utilisée pour stabiliser la perte de cheveux masculine, fonctionne et abordent les contre-indications et les effets secondaires, soulignant que la dose et la fréquence d'administration peuvent être ajustées pour minimiser ces risques tout en maximisant l'efficacité. Ils encouragent les patients à discuter avec des professionnels de la santé pour obtenir des conseils adaptés à leur situation.
Takeaways
- 👨⚕️ Les docteurs Russell et Vickram discutent des traitements médicaux et chirurgicaux pour la perte de cheveux chez les hommes et les femmes.
- 🧬 Finesse Ride (Finasteride) est un médicament utilisé pour stabiliser la perte de cheveux chez les hommes, en bloquant l'enzyme qui convertit la testostérone en DHT.
- ⏳ Finesse Ride a été introduit en Australie en 1998 et a plus de 20 ans d'utilisation, permettant d'avoir une grande expérience sur son utilisation et ses effets.
- 🌐 Beaucoup de mythes entourent Finesse Ride sur Internet, ce qui effraie certains patients potentiels.
- 💊 La dose recommandée pour traiter la perte de cheveux est de 1 mg par jour, bien que des études suggèrent que moins pourrait être suffisant.
- 🔍 Les effets secondaires de Finesse Ride sont rares et peuvent être réduits en ajustant la dose ou la fréquence d'administration.
- 🔄 La durée d'action de Finesse Ride dans le système corporel est de plus de 30 jours, ce qui permet des régimes de prise plus souples.
- 🚫 Les effets secondaires les plus courants sont des problèmes sexuels, mais ils sont très rares et complètement réversibles en arrêtant le traitement.
- 🤔 Les effets secondaires peuvent être psychologiques, où l'anticipation d'un problème peut conduire à l'expérience de celui-ci.
- 🌟 La prise de Finesse Ride à une dose ajustée et à une fréquence réduite est efficace pour stabiliser la perte de cheveux avec un risque d'effets secondaires très faible.
Q & A
Quel est le sujet principal de l'épisode 4 du podcast 'The Hair Loss Show'?
-Le sujet principal de l'épisode 4 est la discussion autour du traitement médicamenteux de la perte de cheveux, en se concentrant sur le médicament Finesse Ride (Finasteride) et ses implications, avantages et inconvénients.
Pourquoi les patients pourraient-ils être réticents à prendre Finesse Ride?
-Les patients peuvent être réticents à prendre Finesse Ride à cause des mythes et des craintes liés à ses effets secondaires, souvent amplifiés par Internet, qui les effraient et les dissuadent de commencer ou de continuer le traitement.
Quel est le rôle de Finesse Ride dans le traitement de la perte de cheveux?
-Finesse Ride est un inhibiteur enzymatique qui bloque la conversion de la testostérone en DHT (dihydrotestostérone), réduisant ainsi les niveaux de DHT et contribuant à stabiliser la perte de cheveux.
Combien de temps le médicament Finesse Ride est-il recommandé de prendre?
-Selon le Dr. Russell, bien que la dose recommandée soit un milligramme par jour, il n'est pas nécessaire de prendre le médicament tous les jours car il reste actif dans le système pendant au moins 30 jours.
Quels sont les effets secondaires les plus courants associés à Finesse Ride?
-Les effets secondaires les plus courants de Finesse Ride comprennent une réduction de la libido et des difficultés à maintenir une érection. Cependant, ces effets sont rares et peuvent être gérés en ajustant la dose ou la fréquence de prise.
Quelle est la différence de fréquence des effets secondaires entre le groupe traité avec Finesse Ride et le groupe placebo lors des études initiales?
-Lors des études initiales, 1.8% des hommes qui prenaient Finesse Ride ont signalé des effets secondaires sexuels, tandis que 1.3% des hommes du groupe placebo en ont signalé, montrant une différence de 0.5%.
Quel est le conseil des docteurs pour les patients qui expérimentent des effets secondaires avec Finesse Ride?
-Si un patient expérimente des effets secondaires, les docteurs conseillent de cesser le traitement et d'attendre la résorption du médicament dans le corps, ce qui permet de récupérer normalement sans conséquences à long terme.
Pourquoi les effets secondaires de Finesse Ride pourraient-ils être liés à la dose ou à la fréquence de prise?
-Les effets secondaires pourraient être liés à une dose ou une fréquence de prise excessive, car le médicament a une durée d'action longue dans le corps, et une suraccumulation pourrait causer des réactions indésirables.
Quels sont les autres effets secondaires moins courants associés à Finesse Ride mentionnés dans le script?
-D'autres effets secondaires moins courants incluent la 'brume cérébrale' (trouble de la pensée), une sensibilité du sein et des tendinites du scrotum.
Quel sera le sujet du prochain épisode du podcast 'The Hair Loss Show'?
-Le prochain épisode du podcast traitera du sujet de la croissance des cheveux, en explorant les options pour aider les patients à augmenter la quantité de cheveux et à récupérer ceux qu'ils ont perdu.
Quel est le message final des docteurs à propos de Finesse Ride et de la perte de cheveux?
-Le message final est que Finesse Ride est un médicament efficace pour stabiliser la perte de cheveux, et que les effets secondaires, bien que possibles, sont rares et peuvent être évités ou gérés par une utilisation appropriée et un ajustement de la dose ou de la fréquence de prise.
Outlines
💬 Introduction to Hair Loss Treatments
Dans le premier paragraphe, les docteurs Russell et Vickram abordent l'épisode 4 de leur émission sur la chute de cheveux. Ils discutent de la thérapie de la calvitie, en se concentrant sur le rôle du médicament Finesse Ride (finastéride) dans le traitement de la calvitie masculine. Ils mentionnent les réticences des patients à commencer la thérapie en raison de rumeurs et de craintes liées aux effets secondaires, et ils proposent de clarifier ces questions.
🔍 Finesse Ride: Effets et Posologie
Le deuxième paragraphe se concentre sur le finastéride, un médicament introduit en Australie en 1998 pour traiter la calvitie. Les docteurs expliquent que le finastéride est un inhibiteur d'enzyme, non un bloqueur de DHT, et qu'il agit en réduisant la conversion de la testostérone en DHT. Ils discutent de la posologie quotidienne recommandée et soulignent que, selon eux, il n'est pas nécessaire de prendre le médicament tous les jours, car il reste actif dans le système corporel pendant 30 jours minimum. Ils suggèrent un dosage réduit pour réduire les risques d'effets secondaires.
🚫 Gestion des Effets Secondaires du Finastéride
Dans le troisième paragraphe, les docteurs discutent des effets secondaires du finastéride, tels que la diminution de la libido et des difficultés à maintenir une érection. Ils mentionnent que ces effets sont rares et qu'ils sont souvent liés à une prise excessive de médicament. Les docteurs encouragent à ajuster la dose ou la fréquence de prise pour minimiser ces risques. Ils soulignent que même si des effets secondaires apparaissent, ils sont généralement réversibles en arrêtant le traitement.
🌟 Conclusion et Perspectives
Le quatrième paragraphe conclut l'épisode en résumant les points clés sur le finastéride comme traitement de la calvitie. Les docteurs soulignent que, bien que le médicament puisse avoir des effets secondaires, ils sont rares et peuvent être gérés en ajustant la dose ou la fréquence de prise. Ils encouragent les patients à discuter avec un professionnel de la santé pour obtenir des conseils appropriés. Ils annoncent également le prochain épisode qui traitera de la croissance des cheveux.
Mindmap
Keywords
💡Chute de cheveux
💡Finastéride
💡DHT
💡Traitement à long terme
💡Effets secondaires
💡Dosage
💡Stabilisation
💡Prostate
💡Énzyme
💡Régime de prise de médicament
💡Psychologie
Highlights
Dr. Russell and Dr. Vickram discuss medical and surgical treatments for hair loss.
Finasteride is used to stabilize male pattern hair loss, and its mechanism is explained.
Common misconceptions about finasteride and its side effects are addressed.
The drug's introduction in Australia in 1998 and its extensive use over 20 years.
Finasteride's action as an enzyme blocker, not a DHT blocker, is clarified.
The accidental discovery of finasteride's hair loss treatment potential.
Different dosing recommendations for hair loss versus prostate enlargement.
The importance of finasteride's long-lasting effect in the skin tissue.
Dr. Russell's controversial opinion on the non-necessity of daily finasteride intake.
The potential for reduced side effects with a lower and less frequent dosage.
The psychological impact on patients expecting side effects from finasteride.
The low incidence of sexual side effects and the importance of dosage adjustment.
The recovery from side effects after stopping finasteride and its time frame.
The lesser-known side effects of finasteride, such as brain fog and breast tenderness.
The effectiveness of finasteride in a low-dose schedule for most patients.
The upcoming discussion in the next podcast about increasing hair growth.
Advice on consulting with a registered medical professional for personalized treatment.
Transcripts
[Music] welcome to the hair loss show Dr Russell nudson and Dr vickram J aash discuss
issues relating to hair loss and the medical and surgical treatment of hair loss in both men and
women hi everyone and welcome to the ha Show episode number four my name is Dr vicam J aash
and I am Dr Russell nson welcome all right so last episode we went through uh so previously
we've gone through mail patent hair loss we've covered um the start covering therapy and and
how we use finess ride finess ride to stabilize male patent hairloss we've talked through the
mechanism of how that works and again if you're unclear of that please go back through to episode
two and three and and and hopefully you'll get a a recap uh through there but uh I thought today
we'd uh drill down a little bit more on uh finesse ride because again as as I said in the last show
it's one of the things it's one of the biggest push backs that I get when we see patients on a
on a day-to-day basis one in terms of people not wanting to start therapy because they've heard
and read too much about it and they're scared of uh um of starting uh secondly people start it and
then stop because they don't know it needs to be longterm um so why don't we sort of unpacked that
a little bit and and and go through what the implications of taking fessa and what you know
what are the pros and cons from that perspective right okay so finast was introduced in Australia
in 1998 so we've had over 20 years of experience with it so that's something that's important to
consider we had a lot of experience with this drug millions and millions of men around the world have
taken it we have very very good information about what's possible with the medicine and what's not
possible with the medicine unfortunately the internet perpetuates a lot of myths about
finasterid uh that scare people and so many as Dr vikam said many people come into our surgeries
and say I'm not prepared to take it because I've heard you get side effects and I'm able to say to
them that if you're getting side effects you're not going to be taking it so there aren't people
in my practice who are taking it that are having side effects otherwise they wouldn't be on it so
let's talk a little bit about finasteride again as we mentioned in the last podcast this the action
of finasteride is to block the enzyme so it's an enzyme blocker not a DHT blocker and what
that means is that we block some of the enzyme activity which blocks some of the conversion
of testosterone to DHT in that scenario the DHT level goes down and the T level goes up okay so
why would people get side effects if you're not actually altering the hormones our suspicion is
it's because the DHT is a slightly stronger version of testosterone than testosterone so
there's more testosterone in the body less DHT but DHT pound forp pound is a slightly stronger
hormone so how did finasterid happen well the drug was actually developed for people with
enlargement of men with the enlargement of the pro prate gland not a cancerous enlargement a
non-cancerous enlargement of the prostate gland that they had worked out was also a function of
overactivity of the enzyme and too much DHT in the prostate so they started treating the
prostate in these men with finasteride and found to their amazement that some of these balding men
with enlarged prostates started to stabilize and reverse their balding so it was was an accidental
finding it wasn't a targeted finding that they were expecting so the drug has been around for
longer than just for treating people with hair loss it's been around longer because we used
to also use it and we still do for people with enlarg prostates so basically we discovered when
we were doing it for hair that you didn't have to use the same dose so for example for men that are
using the prostate there is a 5 Mig that they take every day but for the hair the recommended dose is
a milligram and the reason it's recommended at a milligram is because if you track the response
curve versus the dose curve I know that's a bit technical it kind of flattens off at about one
and what that really means that more isn't better okay more is not better a milligram is enough now
where I'm going to be a little controversial with you today is talking about what the correct dosing
is because because the recommended dose on the packet says a milligram per day right in other
words you're supposed to take a tablet every day now I certainly think that's acceptable to do but
it is not necessary in many people for you to take a milligram every day why because the drug
lasts a lot longer than a day in the system if we go back to the idea that this is happening in the
hair follicle it's not about the amount that you have in the blood that is most important
it's the amount you have in the skin tissue that's important and a dose of finasterid lasts 30 days
minimum 30 days inside the skin so we really in my opinion and I'm saying it's my opinion don't
need to take this any every day so basically what I ask my patients to do um is take it probably on
average about three times a week now you'd say well why not just take it once a month well the
body is continually creating new enzyme every day so all we're doing is mopping it up and in
my experience over 20 years using this toasting schedule my results are the same in terms of being
able to achieve stability as people who take it every day so that is for me an important finding
because the other side of that argument is that the number of patients in my practice that get any
side effects on faside is correspondingly reduced because I'm asking them to take less of it so key
Point here is that most people in my opinion they get side effects it's because they're taking too
much of it and that's a critical thing because if we can adjust the dose and down to a lower
dose and still get the same effect without the side effects then this most important medication
we have could be used by many more men without fear of side effects or fear of the ability of
it to harm their health or their partner's Health that's great and so just to again to to go through
that again the end point is we want to stabilize hair loss so the key is What is the least amount
of drug that we can put in our system that's going to give us that 5 milligrams is too much and this
is the and this is sometimes the problem because people are taking ferid and don't know if it's
one or five and they're getting their you know their tablets from wherever they're going to get
problems when they're on on five again taking a small dose of the medication and you don't like
like Russell was saying because it lasts longer than 36 hours in the sorry it lasts longer than
a day in the system you don't need to take it on a daily basis you just need enough to lower the
DHT level to a threshold level that it doesn't cause progression of of the hair loss so the
lowest dose that we can get away that will give us the outcome is inevitably going to give us the
least amount of side effects as well and here's a funny thing because the medicine had been around
before it was used for hair it was being used for the prostate as I as I said we knew what the side
effect profile was and that uh in a percentage of between maybe five to 8% of men using finter at
the 5 mgram dose we're getting sexual side effects and by that I mean they had reduced libido which
is another word for sex drive or difficulty maintaining erections so this is something we
looked for and tested for in the original trials and this is a very interesting point in the
original trial they used 2,000 men two groups of a thousand neither the doctor nor the patient knew
whether they were taking finasteride or they were taking sugar something we call a placebo meaning
it has no active ingredient so we have a th men take fin aside we have a thousand men taking sugar
they don't know which the doctors don't know which they tracked them over year that they knew to ask
for sexual side effects so at the end of the year when they analyzed the results and opened up the
study to see who was taking what they discovered that for the people that were taking finro 1.8% of
men had complained of sexual side effects and that was probably a good figure because as I said it
was a high figure if you're taking 5 mg but very interestingly and perhaps surprisingly when they
looked at the sugar group 1.3% complain of sexual side effects 20.5% difference correct so basically
the the message here is that if you think you're going to get the side effect you probably are
going to get the side effect so the reality is the way the psychology works in the brain if you know
it's possible and you really expect it you could probably convince yourself that it happens but it
is a low incidence in real terms of side effect so in my practice I would say that it's less than
that 1.8 because we're using a smaller dose like vicam and I do and so I think it's around about
the 1% Mark now two things about this number one is I think that there's two categories of people
that respond uh by getting side effects there are the people that respond immediately meaning
it happens in the first two weeks okay they are very sensitive to the medicine the good news is
if they get these side effects which is the commonest side effect in the first two weeks
stopping the medicine means they recover in about two weeks that's just they always recover in 20
years I've never had anybody that didn't recover from their side effects the second group are the
people that don't get it immediately they get it later and this is a delayed response so these are
people that get it say between four and eight or maybe even longer months into therapy and
my reading of that is that because they've been taking it every day and it lasts every tablets
lasting 30 days in your system it's building up and building up and building up in your system so
if this happens later on it's because you got too much in your body and so the simple thing is stop
again and wait for it to recover now these people recover very quickly these people take a little
bit longer again because because of the length of time that's in the system so don't be surprised
in that scenario whether it took 2 3 months for people to recover and that's normal again I've
never had a single patient in 20 years that did not recover after they stopped their medication so
if you're the person that gets it later on it's a medicine you still could use just more customized
dose so there's two ways you either lower the dose that you're giving to the patient or you
lower the frequency and the third thing you can do is you can let them take a month off whenever they
want because you know it's going to hang around for month and that's going to do you no harm so
stopping for one or two months is not going to harm you in the long run and that's something
we get asked a lot isn't it you know if I'm going to stop the medication am I going to am I suddenly
going to lose my hair ER in that you know for a couple of months if I stop the medication for a
couple of months am I going to lose all that ground that I you know was holding on to and
the answer is probably absolutely not you know if if you're only stopping for a short period of time
letting it wash out of the system you're going to be fine now just to finish off the conversation
about side effects and finasterid the Lesser common side effects that people get are they
sometimes complain of thing called brain fog which means they just don't feel like they're thinking
as clearly as they do they can have tenderness of the breast they can have tendons of the scrotum
but these are really uncommon really uncommon side effects so it's it's fair to say that I
have thousands of men and vicam has thousands of men in our practices that take this uh you
know on a lowd dose schedule mostly round about three times a week with no problems whatsoever and
highly highly effective at stopping further hair loss to summarize to so to summarize look finest
is a great drug and it's it certainly forms for us the main stay of uh treatment modality and trying
to stabilize uh male pattern uh hair loss but we know that it's not without its problems part of
the problem and there are side effects but part of it is from taking too much so you're either taking
a higher dose or you're take even taking it too frequently so I think this the summary is again
you should if you if you're having is shoes make sure you have that conversation we see people all
the time that come back to us and say been on the medication I'm not liking it because of X Y and Z
and then we modulate how they're taking we might change the dose we might change the frequency we
may you know slowly gradually uh you know you do this as well gradually in um uh take a bit of a
break and then gradually uh sequentially increase the dose over a period of few months because we
want some of the blockade happening to give us some of that stability there but the reality is
the side effects the incidence of side effects are very very low it is a very safe drug we've been
using it for many many years and without any sort of problems and there is a lot of there's a lot
of information on the internet which will scare a lot of people but again make sure you have a chat
with the U registered Medical Professional and seek appropriate advice would you say that's good
that's good so the next episode of the podcast we're going to discuss what patients really are
interested in which isn't so much stability it's about whether we can increase their hair and grow
their hair back so that'll be the subject of the next podcast I hope you've enjoyed tonight and
I hope you've found that this is somewhat helpful so uh I'd like to thank you for listening tonight
and uh we look forward to talking to you next time see you next time thank [Music]
you
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