I’ve Had Sexual Side Effects Since Switching to Generic Finasteride 2 Years Ago
Hey Dr. Rassman,
Have been taking propecia for approximately 4 years and for the past two switched to finasteride due to it being cheaper. Have had fantastic results with my hair (have more hair now at 30 than I did at 24!)
However, I have slowly been developing sexual side effects over the past 2 years which has come to a breaking point recently. It is now difficult for me to get and maintain an erection and my semen is watery/decreased volume. I am currently taking 1.25 mg of fin a day. I am seeing a doctor today to get my hormone levels checked. I have two questions for you:
1. Do you think these side effects may go away if I lower my dosage to 0.5 mg/day and do you even think that is worth doing? I would love to keep my hair but I am worried I am poisoning my body.
2. If I want a hair transplant in the future, will me being off finasteride significantly limit my options?
Thanks
Lowering the dose of finasteride may lower the side effects, as I have seen this in my practice. Always discuss your medication changes with your prescribing doctor.
While it is advantageous to be on finasteride when considering a hair transplant surgery, it is not an absolute factor. Many patients undergo hair transplantation without taking finasteride.
My brother who is an M.D. student has stated that using generic finasteride does indeed cause him to have sexual dysfunction, whereas brand Propecia does not. I would encourage you to take brand….it is also easier to split the brand pills in half if you want to take 0.5mg per day. I had done that when I was 25 and hair was very thick and I was getting carded all the time for cigarettes and alcohol…so I would say that you should take the brand…….yeah.
the differences between varieties of the same drug can be surprisingly profound. For example adderall….some generics are horrible(and do not work at all) whereas the sandoz form is preferred and actually works. Wellbutrin is another example…(the generic is bad)…brand is good. With some drugs you get lucky and the generic is just as good. I do not believe finasteride is one of those medicines. If you want to treat hairloss with finasteride..I would go with brand based on my brothers (who is an M.D. student who has seen many urologists and hair transplant surgeons) profound experience with both generic & brand finasteride.
There is no chemical difference between generic (off-patient) and brand medications, and the US FDA regulates manufacture of both; the overall quality should be comparable. While the active ingredients are required to be different, the inactive ingredients (fillers, emulsifiers, etc) can be different. It is highly unlikely that the side effects described are related to the inactive ingredients. Outside of the US, I can not comment as regulations differ (which is why online foreign generics are no the best thing to buy). PS. Im a physician and clinical pharmacologist, not a “studentâ€
Writing too fast. I meant “While the active ingredients are required to be THE SAME, the inactive ingredients (fillers, emulsifiers, etc) can be different” in the above comment.
Alex, the two medications you mentioned (Adderall and Wellbutrin) have extended release formulations. The methods in which the medication is slowly dispersed throughout the body are usually patented by the manufacturer. If the patent expires on the medication (that is, the active chemical) it doesn’t necessarily mean this delivery method loses its patent as well.
This means that when a generic manufacturer develops medications, they don’t have access to the time release technology, and their solutions may be inferior to the brandname drugs. This can result in a different reaction between brandname and generic drugs.
However, finasteride (and almost every other drug out there) is a different story. These pills consist of a certain measurement of finasteride powder combined with fillers (thickeners, binders, dyes, etc.). Any manufacturer in north america must follow strict manufacturing practices, meet minimum purity values, and adhere to regulations.
There is a very small chance some people may react to the fillers, but these reactions wouldn’t ever be sexual in nature. Regardless of who manufacturers it, finasteride is finasteride, and it will have the exact same effect on the body.
I think the most dangerous thing here is perception. Many people hold this misconception that generic drugs are less effective and cause more side effects than brandname, even though this myth has been debunked (unless they fall into a special category like I explained at the start of my post). Just like how one night of poor performance in the sack can lead to a period of self-doubt and persistent inability to perform, the self doubt one might experience from a generic medication could do the same.
I’ve taken both brandname and generic Propecia, and could tell absolutely no difference between the two. If one was ordering pills over the internet from India or something, that would be a completely different story…