Finasteride 0.5mg + Oral Minoxidil 1mg 100s

What is Finasteride + Minoxidil combination oral tablet used for​​​?

Finasteride and Minoxidil are complementary therapies for hair loss. Finasteride tackles the underlying hormonal hair loss trigger, while Minoxidil allows more blood to flow to the scalp, providing follicles with more nutrients and oxygen. This can help them progress into the growth phase of the hair growth cycle.

​How does oral Finasteride work?

Finasteride works to improve hair growth and prevent hair loss by inhibiting the activity of the 5-alpha reductase enzyme. This means that it stops the conversion of testosterone to dihydrotestosterone (DHT).

DHT has been shown to shrink hair follicles and cause them to lose their ability to produce new hair strands (miniaturization), eventually causing hair loss. By reducing levels of DHT in the scalp, hair becomes thicker and grows longer in the anagen phase of its growth cycle.

A study involving 1879 men has shown that Finasteride 1mg/day promotes hair growth and prevents further hair loss in a significant proportion of men with male pattern hair loss.

In men with vertex hair loss, global photographs showed improvement in hair growth in 48% of Finasteride recipients at 1 year and in 66% at 2 years compared with 7% of placebo recipients at each time point. Furthermore, hair counts in these men showed that 83% of Finasteride versus 28% of placebo recipients had no further hair loss compared with baseline after 2 years.

Over the long term, Finasteride works well as a treatment for hair loss. A 10-year study found that more than 99% of men who take Finasteride 1mg/day experience no further progression of their hair loss over the long term.

​How does oral Minoxidil work?

Unlike Finasteride, which suppresses the conversion of testosterone into the DHT that can harm the follicles, Minoxidil works directly on the hair follicles to stimulate local hair growth.

Research-based findings have shown that Minoxidil can shorten the telogen or resting cycle of the hair, thereby preventing hair shedding.

In addition, Minoxidil increases blood flow to the scalp, providing follicles with more nutrients and oxygen. As a result, taking Minoxidil can result in a healthier hair growth.

Oral Minoxidil is considered off-label for the treatment of hair loss but its favourable use for hair loss treatment has been documented in multiple small clinical studies:

1. In a clinical study involving 18 subjects, 33% of patients reported decreased hair shedding and 28% reported increased scalp hair after 6 months of consuming 1.25mg/day oral MInoxidil.
2. Among 30 male subjects, there was a significant increase in total hair counts from baseline at weeks 12 and 24. Photographic assessment of the vertex area by an expert panel revealed 100% improvement, of which 43% of patients showed excellent/ remarkable improvement.

​How effective is this medication for hair loss?

While there are no head-on comparison studies between mono-therapy (Finasteride or Minoxidil only) vs combination therapy (Finasteride + Minoxidil), if you’re a man with male pattern baldness, it’s usually safe to mix Finasteride with Minoxidil.

Since Minoxidil and Finasteride tackle hair loss through two different mechanisms, mixing these treatments may lead to better, longer-lasting results. 

However, results from Finasteride/ Minoxidil typically aren’t immediate. It usually takes 3 to 4 months before any results are visible, with the “final” results visible after about one year of consistent use.

During the first 3 to 4 months of treatment, some may also develop a slight increase in hair loss. If you start to experience hair shedding after you start using Finasteride/ Minoxidil either on their own or in combination, it’s important to stay the course as this is a temporary phenomenon. After 3 to 4 months, you should begin to notice real improvements in your hair density and general hair growth.

Dosage and How to Use​

• This medication may be taken with or without food.
• If you experience stomach upset, take the medication with food.
• Do not take more than the recommended dose by your healthcare professional.
• This medication should not be touched or handled by pregnant women or women who are of childbearing age as the active ingredient of the medication (finasteride) can be absorbed through the skin. If contact with the tablet occurs, wash the area immediately with soap and water thoroughly as the medication may harm the development of the fetus.

What to do if I missed a dose?

If you forget to take a dose, take it as soon as you remember. Then take your next dose at the usual time. Do not take two doses to make up for the missed dose.

What are the possible side effects of oral Minoxidil?

While side effects are uncommon at the low doses used to treat hair loss, some potential side effects may include:

• Excessive hair (Hypertrichosis) - excess hair growth elsewhere on the face and body.
• Temporary shedding - common on initiation. It is important to note that this is a temporary phase that should go away on its own after continuous usage of at least 4-6 weeks.
• Low blood pressure and feeling lightheaded.
• Fast heart rate - however this is very uncommon at low doses used for hair loss treatment.
• Headaches.

What are the possible side effects of oral Finasteride?

Common side effects include:

• Unable to get or sustain an erection
• Decreased libido (sex drive); less desire to have sex
• Difficulty with ejaculation

These side effects may be temporary and reversible. If they are persistent and become bothersome, please discuss it with your doctor.

Finasteride use in males planning to have children:

• Finasteride may reduce the amount of sperm and the ability of sperms to move
• For a man and his partner who have difficulty in having children, please consult your doctor for further assessments

What precautions should I take?

• Use a condom during sexual intercourse to avoid exposing your partner to the medication. This is because the medication can be found in semen. This is to protect your partner if your partner is or may be pregnant, as the medication may affect the normal development of the baby’s sex organs.
• Avoid donating blood during treatment or for 1 month after you stopped the treatment as there may be a risk that your blood may be given to a pregnant female transfusion recipient.

Individuals with certain medical conditions are not good candidates for this medication. Some conditions include those with:

• a history of arrhythmia,
• a significant cardiac condition,
• chronic kidney or chronic liver disease, and/or
• liver, prostate or urological diseases.

Inform your healthcare professional if:

• You are going for a prostate specific antigen (PSA) test. Finasteride may decrease the level of PSA, which is a prostate-specific tumour marker, in the blood.
• You have abnormally low mood or have depression.

It is therefore crucial to discuss your medical history with a doctor before considering this treatment. Our doctors will be able to better advise if you're suitable for combination or single medication treatment for hair loss.

What other medications and foods should I avoid when taking this medication?

Inform your healthcare professional if you are taking or intend to take any other medication, supplements, traditional medications, or herbal remedies.

Handling and storage

• Keep away from children.
• Keep in a cool, dry place, away from direct sunlight.
• Keep this medication away from children, pregnant women and women who are of childbearing age.
• To dispose this medication safely, pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin.

The above information answers some common questions about this medicine. It does not contain all the available information. It also does not take the place of talking to your doctor or pharmacist.

References

https://www.aad.org/dw/dw-insights-and-inquiries/archive/2022/low-dose-oral-minoxidil-alopecia

https://www.healthhub.sg/a-z/medications/469/Finasteride-for-hair-loss

https://www.jaad.org/article/S0190-9622(20)32109-5/fulltext

https://pubmed.ncbi.nlm.nih.gov/32970299/

https://pubmed.ncbi.nlm.nih.gov/9951956/

https://www.researchgate.net/publication/337105943_Long-term_10-year_efficacy_of_finasteride_in_523_Japanese_men_with_androgenetic_alopecia