One Propecia in the Morning, One Propecia at Night?

Dear Dr. Rassman,

I know there is no standardized evidence to say one way or another, but in your opinion is 2 mg of Propecia (1 mg taken in the morning, 1 mg taken at night) more effective at preventing hairloss than 1 mg Propecia?

The reason I ask is I have been taking 2 mg Propecia daily for almost 3 years now, and have started to experience “clumpy” semen and painful ejaculation. I am thinking this is due to a side effect of Propecia. I am kind of in a dilemma now because I don’t know if my fight against hairloss will be affected by cutting down the Propecia to 1 mg or altogether. I am 26 yrs old and single so hair is very important to me.

Thanks Dr. Rassman!

I would reduce the dose of Propecia to 1mg taken in the mornings. The higher the dose, the more side effects you are likely to see. The 1mg dose has been shown to be just as effective as higher doses in the formal studies of drug dosing done by the manufacturer. I recently saw a patient with a similar complaint, and he halved the dose and the side effects went away. He was taking 1mg and reduced it to half a pill of Propecia, which has been reported to be about 80% as effective (0.5mg vs 1mg). In your case, you’re taking too much of the medication to begin with. 1mg a day is fine.