Propecia and Dosage

Dear Doc

After years of loyal service I found that 1/4 a pill of proscar a day has stopped working for me & I am shedding hair again.I upped the dose to 1/2 a pill proscar a day & after 4 days of use I can get an erection but am finding that it takes a very long time for me to ejaculate & when I do,the ejaculate is signifcantly reduced.I am also suffering from brain fog & hot flashes. What should I do ?

I don’t want to stop the medication because I don’t want to go bald. Any suggestions ? Would decreasing the dose to 2mg a day make a difference ?

I am really desperate for feedback. Thanks in advance.

The dosage of Propecia was arrived at because when Merck went through the FDA the 1mg dose was found to be lowest effective dose to get the desired result based on the clinical trial program that was done. That may suggest that a higher than 1 mg dose may be more effective, but that was not studied for treating hair loss.

We do know that higher doses of finasteride will increase the known side effects. A decreased ejaculate is one of those side effects. With regard to brain fog, there is nothing that I know of that will support this as a known side effect of finasteride. Be careful that you are not setting yourself up for this and obsessing too much. If you want to play around with the dosage, wait a few weeks between changes as it takes that long to change the tissue levels of the drug.