I occasionally take a treatment for erectile dysfunction called CIALIS (tadalafil). The tablets belongs to a group of medicines called phosphodiesterase type 5 inhibitors. The inhibition of phosphodiesterase type 5 (PDE5) enhances erectile function by increasing the amount of cGMP. I was wondering a few things. First and foremost would such a tablet such as CIALIS increase my hairloss, which i do have. I am receding and have slight crown hair loss. Is it possible (if you know anything about this type of medicines) that it could increase DHT. Secondly is it ok to take propeica or avodart if you are taking this drug. I dont really know if taking a drug such as CIALIS which inhibits type 5 inhibitors could cause a reaction with the main chemical in propecia and dutasteride and stop it working or even worse make it dangerous. with the knowledge you may already know, or if not i would like your expertise and suggestions to wether or not its ok to take both or wether it could increases hair loss. Thank you very much

I don’t see why Cialis would increase hair loss, and hair loss is not listed as a side effect (see list). In many cases medications like Cialis, Levitra, and Viagra may be prescribed to counteract any erectile dysfunction side effects from Propecia (finasteride) and Avodart (dutasteride), and I’ve not heard any cases where they negate the benefits of the hair loss medication or make it dangerous. It’s best to talk to your prescribing doctor, of course, and make sure he/she is aware of your other prescription medications in case there is a concern.

Hey Doc Thank you in advance for such an informative sight. I found this excerpt from a web page concerning shedding from propecia. I was wondering what was your take on it as I have experienced a considerbale shed within 4 weeks of starting propecia. The hairs come from not just the balding areas but from the back and sides as well. Just curious as to your assumptions.

Myth: Shedding is an indication that Propecia is working

I have heard that in some patients, there is a period of increased shedding after starting Propecia, but this will stop within a few months in almost every one experiencing the problem. Some doctors believe that Propecia increases the cycling of hair, but I have no way to ascertain if this is the cause or not.

Hi doctor how are you?

This is my question regarding propecia.

Most people think only DHT destroys hair but the follicles are sensitive to testosterone as well. Its interesting to note the first thing that goes on most guys is the hairline mostly the juvenile hairline which is often made up of small vellus like hairs. This is because they are sensitive to testosterone more so than DHT. And we all know finasteride lowers DHT and raises testosterone.

Can that make a persons hairline even worse by trying propecia or can propecia help maintain it? Basically is propecia good for one thing on the scalp and bad for other areas such as the hairline.

I would really appreciate if you could answer my question, because I have searched in your blog and haven’t found a clear answer when regarding testosterone and hairline balding and not DHT.

Propecia has the same impact on the frontal hair and the crown hair, but it appears that it is less effective on the frontal hair, which is often caught later after the hair loss is detectable. The crown seems to have a slower loss rate and that is probably why Propecia (finasteride) works so well in the crown. Finasteride is not bad for frontal hair and I have even seen people reverse frontal hair loss with it in the very young man, although it is rarer in the front than the crown.

Hey Doctor Rassman.

Last night I just tried propecia for the first time, and after a couple of hours I started to get dizzy, and I was dizzy almsot the next day as well. I just decided not to take it anymore and start using rogaine. Im more comfortable with topical than a pill. My question is, by stoping it after the first try, will it have any significant difference on the hair loss (in terms of making it worse) or my over all health just by one trying it once?

What you are describing sound psychosomatic, not physiologic. Stopping it at one day will have no impact on you at all. Rogaine (minoxidil) is just not the answer for a young man losing hair through genetics. I’ve seen Propecia work miracles, and just haven’t seen the same kind of results from minoxidil. Keep in mind that what you experience may be on your mind and not in your body.

hey doc(s) There have been a lot of questions about if propecia will lose it’s effectiveness, but I haven’t seen any on if rogaine will too. Can you shed (pardon the pun) some light on that?

Thanks lots

I am not sure about the loss of effectiveness for Rogaine or Propecia. It is my opinion that these medications continue to work. In other words, they do not stop working as long as you use as directed. The reason I say this is because I have seen patients who have been on Rogaine and/or Propecia for many years and decide to stop the medication for their personal reasons (as they may believe it is not worth it or has lost effectiveness). These patients often come to me expressing regret for their decision to stop the medication, as they notice an increase in their hair loss within a few weeks. The main issue here is that hair loss is a continuing process that can accelerate at times, but the dose of these medications is constant.

There is no single medication that STOPS hair loss forever. At this point there is no cure, however, the medication does slow it down or minimize the loss. It is just that medications do a better job for certain patients and at certain times in their hair loss process.