hi all

[Mo7a]

hey guys...

i asked my friend for information about Propecia he's an pharmacist this is what he replied me ... tell me your opinion

 

 

 

<span class="ev_code_RED">What are the harms and risks of taking this drug?[/b</span>] In the randomized controlled trials 4.2% of the finasteride group reported one or more adverse sexual experiences (decreased libido, erectile dysfunction, or ejaculation disorder) as compared to 2.2% of the placebo group, ARI* = 2.0%, NNH* = 50 for 1 year (p < 0.05).5 Long-term adverse effects are unknown at this time.

 

<span class="ev_code_RED">How long will I have to prescribe it?</span> Continued treatment is needed to maintain benefit; if treatment is stopped, any benefit will be lost within 6 to 12 months.3, 5

 

<span class="ev_code_RED">How will I know that it is working?</span> It is difficult to be certain in any individual case whether the drug is working. If the patient is not achieving the desired cosmetic effect in 6 to 12 months there is no reason to continue.

 

<span class="ev_code_RED">What other facts should I know about this drug?</span> Finasteride is also prescribed at a higher dose under the trade name Proscar?® for the treatment of symptoms of benign prostatic hypertrophy, because of its effect to decrease prostate volume (see Therapeutics Letter #19).

The dose for male baldness (1 mg/day) and doses as low as 0.2 mg/day reduce dihydrotestosterone serum concentrations by approximately 70%, increase testosterone serum concentrations by about 20%, and variably decrease concentrations of prostatic specific antigen. 3, 5, 6, 8 The clinical significance and long-term consequences of these effects is unknown at this time.

Any contact with the drug is contraindicated in women who are pregnant or may become pregnant as the drug can cause abnormalities of the genitalia in male fetuses.

 

<span class="ev_code_RED">What are my legal liabilities if I give in to patient pressure and prescribe it?</span> No different than for any other drug you prescribe.

 

What is it going to cost?<span class="ev_code_RED">What is it going to cost?</span> Finasteride, 1 mg tablets, for male pattern baldness, average daily cost $1.60. Finasteride, 5 mg tablets, for symptoms of prostatic hypertrophy, average daily cost $1.70.

 

What happens to a company when the DTCA is deemed to be misleading?<span class="ev_code_GREEN">What happens to a company when the DTCA is deemed to be misleading?</span>

Two ads for Propecia?® in Time Magazine were found to be misleading by the Division of Drug Marketing, Advertising and Communications at the US FDA. These ads stated "One day science will create a pill for hair loss: That day is today." And "Starting today, you need not face the fear of more hair loss". In both cases the FDA found the ads claimed a broader benefit than had been demonstrated and advised the company to immediately discontinue the ads. No other action was taken.

 

<span class="ev_code_GREEN">Conclusions</span>

DTCA appears to increase drug sales and adds to the pressure on busy clinicians.

 

Before yielding to this pressure, physicians must be able to convey to the patient in a meaningful way:

 

the known benefits (e.g. 6 men have to be treated for one year with finasteride for 1 to be satisfied with the appearance of his hair).

 

the known harms (e.g. 1 in 50 men treated with finasteride for l year will have an adverse sexual experience).

 

the unknown risks (e.g. long-term finasteride therapy is necessary to maintain benefit and long-term effects are unknown at this time).

 

 

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[Mo7a]

hey guys...

i asked my friend for information about Propecia he's an pharmacist this is what he replied me ... tell me your opinion

 

 

 

<span class="ev_code_RED">What are the harms and risks of taking this drug?[/b</span>] In the randomized controlled trials 4.2% of the finasteride group reported one or more adverse sexual experiences (decreased libido, erectile dysfunction, or ejaculation disorder) as compared to 2.2% of the placebo group, ARI* = 2.0%, NNH* = 50 for 1 year (p < 0.05).5 Long-term adverse effects are unknown at this time.

 

<span class="ev_code_RED">How long will I have to prescribe it?</span> Continued treatment is needed to maintain benefit; if treatment is stopped, any benefit will be lost within 6 to 12 months.3, 5

 

<span class="ev_code_RED">How will I know that it is working?</span> It is difficult to be certain in any individual case whether the drug is working. If the patient is not achieving the desired cosmetic effect in 6 to 12 months there is no reason to continue.

 

<span class="ev_code_RED">What other facts should I know about this drug?</span> Finasteride is also prescribed at a higher dose under the trade name Proscar?® for the treatment of symptoms of benign prostatic hypertrophy, because of its effect to decrease prostate volume (see Therapeutics Letter #19).

The dose for male baldness (1 mg/day) and doses as low as 0.2 mg/day reduce dihydrotestosterone serum concentrations by approximately 70%, increase testosterone serum concentrations by about 20%, and variably decrease concentrations of prostatic specific antigen. 3, 5, 6, 8 The clinical significance and long-term consequences of these effects is unknown at this time.

Any contact with the drug is contraindicated in women who are pregnant or may become pregnant as the drug can cause abnormalities of the genitalia in male fetuses.

 

<span class="ev_code_RED">What are my legal liabilities if I give in to patient pressure and prescribe it?</span> No different than for any other drug you prescribe.

 

What is it going to cost?<span class="ev_code_RED">What is it going to cost?</span> Finasteride, 1 mg tablets, for male pattern baldness, average daily cost $1.60. Finasteride, 5 mg tablets, for symptoms of prostatic hypertrophy, average daily cost $1.70.

 

What happens to a company when the DTCA is deemed to be misleading?<span class="ev_code_GREEN">What happens to a company when the DTCA is deemed to be misleading?</span>

Two ads for Propecia?® in Time Magazine were found to be misleading by the Division of Drug Marketing, Advertising and Communications at the US FDA. These ads stated "One day science will create a pill for hair loss: That day is today." And "Starting today, you need not face the fear of more hair loss". In both cases the FDA found the ads claimed a broader benefit than had been demonstrated and advised the company to immediately discontinue the ads. No other action was taken.

 

<span class="ev_code_GREEN">Conclusions</span>

DTCA appears to increase drug sales and adds to the pressure on busy clinicians.

 

Before yielding to this pressure, physicians must be able to convey to the patient in a meaningful way:

 

the known benefits (e.g. 6 men have to be treated for one year with finasteride for 1 to be satisfied with the appearance of his hair).

 

the known harms (e.g. 1 in 50 men treated with finasteride for l year will have an adverse sexual experience).

 

the unknown risks (e.g. long-term finasteride therapy is necessary to maintain benefit and long-term effects are unknown at this time).

 

 

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[hairbank]

I don't know that I disagree with any of it. Do you have a specific question about experiences regarding Finasteride?

[Mo7a]

thanx Hairbank for reply

the only one thing i want to know is what the real side effect of long-term Finastride ??

[calvinmd]

Everyone on this site would probably like to have a definitive answer to that question. Nobody knows. Merck didn't do long-term studies on it. (And if they'd even tried to wait for long-term evidence before releasing the stuff, we'd all be screaming at them to stop being so cautious and just release it already.)

 

 

When you take into account the prostate-oriented users and those who started using it before it had been okayed for MPB, there are a fair number of users who have logged well over a decade with the stuff. So if everyone was gonna have some catastrophic effect at year 9 or something, it would have probably come up by now.

 

I don't think anybody expects that the long-term effects are gonna turn out to be anything very good. But it's a question of HOW bad, how reversible, and is there a correlation between severity & long-term issues?

 

 

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