Why Time of Day Taking Finasteride Makes No Difference, but a Daily Habit is Important


Thank you for your question. You’re asking an interesting question which
actually has been asked of me in my practice. You’re asking what is the best time of the
day to take finasteride? And you’re concerned that if you take it in the beginning of the
day and since you work out, you may sweat the drug out and you follow that up asking
if that is even possible. Well, I can certainly share with you how I
guide my patients who I prescribe finasteride for. A little bit of background, I’m a Board-certified
cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have
been in practice in Manhattan and Long Island for over 20 years. I’m also the founder
of TrichoStem™ Hair Regeneration Centers, a system I developed in my practice starting
about 7 years ago as an alternative drug or I should say, an alternative treatment for
men and women with thinning hair using regenerative medicine which became a significant benefit
for patients who are uncomfortable with taking finasteride. So that being said, I do prescribe this drug
and I have been prescribing it since it was introduced in the market back in 1997. Hair
transplant was a big part of my practice. But just going back to the question that you
have about taking the drug, essentially the drug is a once a day drug. And when I talk
to my patients about taking this drug, essentially, it’s more about establishing a habit more
than it is about the best time of day. The reason is that interestingly, studies done
on compliance with this drug with men continuously taking the drug daily has shown a precipitous
drop in the second year after taking the drug daily. For a variety of reasons, close to
50% of men will stop taking the drug in year number two. And when we do our medical histories
on our patients, very often, people will say that “I took the drug for a while and then
I’m not sure if it was working or not or I was not sure if I was feeling right about
it, how the drug might be affecting me. I thought I might have some side-effects.” And so essentially, physiologically speaking,
you don’t have to be concerned about what the drug would do in terms of sweating. It
may give you some peace of mind than to rather take it once a day, take it once before you
go to sleep. And that way, you have no issues about working on sweating. But really, it’s
more about taking the drug at a regular consistent basis. A lot of times, right now, there are a lot
of concerns about long-term sexual side-effects. Practically speaking, in my own practice and
in the general community, hair loss treating community, sexual side-effects long-term is
not really has been something that we generally have experienced with our patients. Patients
have mentioned side-effects and have stopped taking the drug. Less than 2% in my own practice
and it’s consistent with the original studies about finasteride where the active drug group
as well as the placebo group both had less than 2% having sexual side-effects which makes
you also at least inquire as to the perception. A lot of times, what I find is that patients
won’t factor in lack of sleep, exercise, diet and other physiologic issues and will
often see a cause-effect relationship between a drug and how they feel. Now that being said, we have certainly plenty
of patients who have been on the drug for over 15 plus years. And we treat our patients
with Hair Regeneration. Many come because they don’t want to take finasteride or they
can’t take finasteride. And we have been able to establish with Hair Regeneration the
ability to stimulate growth of hair that isn’t growing, stopping progression, thickening
of thinning hairs. Essentially, prolong the existing growth cycles but instead of hair
thinning, hair gets thicker and that’s without finasteride. For 99% of our male and female
patients, this is without other pharmaceutical benefit. There are some patients who I feel do benefit
from the drug especially those who are younger, who appear to have very rapid progression.
I present to them the possibility of using a DHT blocker to diminish the toxic effect
of DHT on their hair while benefiting from the stimulatory effect of Hair Regeneration,
but that’s a separate topic. Again, the drug itself is absorbed by your
body, goes into your circulation and goes to where the DHT would be blocked and is blocking
specifically an enzyme called 5-alpha reductase. It’s not likely that you would be sweating
it out. As far as I’m concerned, I try to help my patients learn about ways to make
something into a habit and to stick with it. I always tell my patients that if you take
the drug every day for 3 months regardless of what time of day, it becomes a habit and
you’re less inclined to connect a cause and effect between the drug and a particular
perception of your feeling. It’s a controversial topic and right now, for years now, the internet
has been exploding with fears about the long-term sexual side-effects so certainly, with Hair
Regeneration, we’ve been able to help a lot of patients who are unable to take finasteride. Nonetheless, as far as the drug is concerned,
I wouldn’t worry about sweating it out. I would probably suggest to you that you just
to take it at night. It’s a once a day drug. So I hope that was helpful, I wish you the
best of luck and thank you for your question.

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