Customized Dosing of Finasteride For Hair Loss

Summary

In Episode 35 of *The Hair Loss Show*, Drs. Russell Knudsen and Vikram Jayaprakash discuss customized dosing of Finasteride for hair loss treatment. They emphasize adjusting the dosage based on factors such as age, balding progression, and sensitivity to side effects. By tailoring the dose, they aim to minimize side effects while maintaining effectiveness. The doctors explain that a lower, intermittent dose can be just as effective as the standard 1 mg daily dose, and offer flexibility in treatment based on individual responses. The goal is to preserve hair and slow loss without unnecessary risks or overmedication.

Takeaways

• 😀 Customized dosing of Finasteride can reduce side effects while maintaining effectiveness, based on individual patient factors.
• 😀 The recommended 1 mg daily dose of Finasteride may not be necessary for all patients; lower doses may be effective for some.
• 😀 Younger patients with aggressive hair loss may require higher doses of Finasteride compared to older patients with minimal loss.
• 😀 The half-life of Finasteride in the blood is 6-8 hours, but in the hair follicle, it lasts for 30 days, meaning daily dosing isn't necessary.
• 😀 Doctors often prescribe Finasteride three times a week, equaling 3 mg weekly, to balance effectiveness and minimize side effects.
• 😀 The dose-response curve for Finasteride shows that effectiveness plateaus around 0.8 mg, so smaller doses can still be effective.
• 😀 Side effects from Finasteride can often be managed by adjusting the dose or spacing out the intervals between doses.
• 😀 Finasteride can build up in the body over time, but it is safe to take breaks (e.g., one month every 5-6 months) to help clear it from the system.
• 😀 Stopping Finasteride for short periods does not result in significant hair loss if the patient is not experiencing aggressive balding.
• 😀 For cost-conscious patients, doctors may prescribe 5 mg tablets and advise cutting them into quarters, providing a cheaper alternative without losing effectiveness.

Q & A

What is customized dosing of Finasteride?

Customized dosing of Finasteride involves adjusting the standard 1 mg daily dose to a lower dose or less frequent schedule based on individual patient needs, aiming to reduce side effects while still effectively slowing hair loss.

Why do the doctors recommend customized dosing instead of the standard 1 mg per day dose?

The doctors believe that the 1 mg per day dose may not be necessary for all patients, as Finasteride has a long half-life in the hair follicles. They aim to reduce side effects while still effectively controlling hair loss by adjusting the dose.

How does the aggressiveness of balding affect the dosage of Finasteride?

Younger patients with more aggressive hair loss may require higher doses of Finasteride, while older patients with slower progression of hair loss may respond well to smaller doses or less frequent dosing.

What is the significance of the half-life of Finasteride in the hair follicle?

The half-life of Finasteride in the hair follicle is 30 days, meaning that a single dose can have effects for up to 30 days. This long duration of action reduces the need for daily dosing, allowing for less frequent administration without losing effectiveness.

What is the dose-response curve for Finasteride, and how does it impact dosing decisions?

The dose-response curve for Finasteride shows that as the dose increases, the effectiveness plateaus. A dose of 0.5 mg is effective, but 1 mg is typically used because it is easy to measure. The doctors aim to find the minimum effective dose that works for each individual.

Why might doctors use a 5 mg tablet of Finasteride for customized dosing?

The 5 mg Finasteride tablet is sometimes prescribed because it is more cost-effective. Patients can cut the tablet into quarters, but the dose may slightly vary (e.g., 1.1 to 1.3 mg per quarter) depending on the accuracy of the pill cutting.

How do the doctors adjust the frequency of Finasteride doses?

The doctors typically start with a dosing schedule of 3 times per week, providing 3 mg per week. They adjust the frequency if side effects occur or if the patient responds well to this regimen.

What should patients do if they experience side effects from Finasteride?

If side effects occur, the doctors suggest adjusting the dose or frequency of Finasteride. The goal is to find the minimal effective dose that prevents further hair loss while avoiding side effects.

Can patients safely stop taking Finasteride for a period of time?

Yes, patients can safely take breaks from Finasteride for up to a month every 5-6 months. The drug clears from the system within 90 days, so short breaks should not result in significant hair loss progression for most patients.

How do the doctors determine the appropriate Finasteride dose for a patient?

The doctors consider factors such as the patient's age, the severity and progression of hair loss, and the patient's response to treatment. They adjust the dose to balance effectiveness in slowing hair loss with minimizing side effects.