Is It Legal for Physicians to Prescribe Proscar to Cut Up?

First of all, I just wanted to let you know that I have found your blog very useful.

I am a 24 male and for the last couple of years I have noticed my hairline receding and then my hair getting much thinner. I look back at pictures from 3 or 4 years ago and I am in awe at how much my hair looks different. Anyway, I have tried rogaine for about 4 months and have not seen much of a difference, plus it is kind of a pain to use. In fact my hair seems to just continue getting thinner.

I would like to try Propecia, however, I am in medical school and I really cannot justify using that much loan money for propecia, if you know what I mean. I have noticed that you and others suggest using 5mg generic Finasteride normally used for BPH as an economic alternative. I would like to ask my doctor about this option. My question is whether this is considered ethical/legal and how physicians usually respond to this.

Thank you for your time

There are no ethical or legal issues associated with prescribing finasteride for androgenic alopecia. There is however a financial issue, as finasteride 5mg is about $30-$60 for 90 pills and finasteride 1mg is about $150 to $200 for 90 pills. If you cut the 5mg finasteride in four parts, the 90 pills should last you 360 days! This drastic difference is based on U.S. Patent laws that give protection to Merck, as they have the rights to manufacture the 1mg dose of finasteride up until mid-2013. The 5mg finasteride is available as a generic because the 5mg patent expired already, so the prices are way, way lower.

As far as doctors are concerned in prescribing medications, as a medical student, I hope you will soon find that there are hundreds of medications with generic versions that are exactly the same and just as effective as their branded counterpart. Consider this when you prescribe branded medications to patients after the drug companies wine and dine you.

On a final note, there is an ethical issue to the patient if they decide to cheat the system by getting the generic finasteride 5mg using their insurance card. The insurance companies may approve finasteride 5mg thinking you are treating a prostate problem. Finasteride used for androgenic alopecia is not covered by insurance.