Safety
Finasteride has no boxed warning, but its label lists postmarketing reports of depression, suicidal ideation and behavior, and sexual problems (erectile, libido, ejaculation and orgasm disorders) that continued after stopping, plus male infertility and male breast cancer. In year-one trials, decreased libido (1.8% vs 1.3% on placebo), erectile dysfunction (1.3% vs 0.7%) and ejaculation disorder (1.2% vs 0.7%) were more common than on placebo. Women who are or may be pregnant should not handle crushed or broken tablets. Finasteride lowers PSA, and 5-alpha reductase inhibitors may raise the risk of high-grade prostate cancer. Tell a clinician about any mood change.
Legal status
Prescription only; FDA-approved. FDA-approved for men, and not a controlled substance. The label’s postmarketing reports of suicidal ideation and persistent sexual side effects must be disclosed, so we list it with warnings.
What finasteride (oral) is
Finasteride (oral) is made by Organon (Propecia). Generic finasteride 1 mg is FDA-approved. Use in women is off-label, and some providers sell compounded finasteride capsules, which are not FDA-approved.
FDA-approved for male pattern hair loss (androgenetic alopecia) in men only.
Dosing
Tablet. 1 mg once a day, with or without food. The label says it usually takes 3 months or more to see a benefit, and the effect reverses within 12 months of stopping. Your clinician sets the dose for you.
How well it works
In 12-month trials of 1,879 men aged 18 to 41, 14% of men on finasteride had further hair loss vs 58% on placebo; at 5 years it was 35% vs 100%. Investigators rated hair growth as increased in 65% of men on finasteride vs 37% on placebo at 12 months. Individual results vary.
Finasteride (oral) cost
None of the online providers we compare publishes a price for generic finasteride tablets. For the steps, read How to get a finasteride prescription online.