Finasteride and the Swedish Medical Products Agency

This is continued from my response an hour ago about finasteride and the Swedish Medical Products Agency (MPA). The question was:

What is your opinion about the Swedish Medical Products Agency 2008 study that supports permanent side effects from the use of finasteride?

As I said in my earlier response, “If you believe in the study, do not use Propecia. Many of the reports that I read are on bulletin boards which are suspicious.”

What that boils down to is that I’m not going to try to convince people to use a medication if they’re already so convinced it’ll do them harm. I’m not a sales rep and it isn’t my job to make guarantees about medications or provide incentives for you to take it. It’s an elective medication. You don’t have to take it if you don’t want to. If you’d rather believe message boards than published reports in medical journals, then by all means that is your choice to make.

But I’ll elaborate more with some interesting tidbits from the Swedish Medical Products Agency (sources: here and here). Some key points I found:

1. In clinical studies, single doses of finasteride up to 400 mg and multiple doses of finasteride up to 80 mg/day for three months (n=71) did not result in dose-related undesirable effects.
2. Drug-related sexual undesirable effects were more common in the finasteride-treated men than the placebo-treated men, with frequencies during the first 12 months of 3.8% vs 2.1%, respectively. This means 3.8% of men taking Propecia had undesirable sexual effects and 2.1% men taking a fake sugar pill had undesirable sexual effects. The incidence of these effects decreased to 0.6% in finasteride-treated men over the following four years. Approximately 1% of men in each treatment group discontinued due to drug related sexual adverse experiences in the first 12 months, and the incidence declined thereafter.
3. People that are up in arms about the Agency listing “persistent difficulty having an erection after discontinuation of treatment” as a possible side effect should also realize this is listed under the “frequency unknown” section. In other words, they received complaints about it (how many hasn’t been established), but it is not a proven effect.