medication for baldness, prostate problems with serious side effects

On October 17, 2024, the National Medicines Safety Agency (ANSM) launched a re-evaluation of finasteride, a drug intended to combat male pattern baldness. Used under the name Propecia, it is now the center of attention due to potential serious side effects, both sexual and psychiatric.

Finasteride: a medication prescribed for baldness and prostate problems

Finasteride is mainly used to treat androgenetic alopecia, better known as male pattern baldness. This medication, dosed at 1 mg, works by reducing the hormone responsible for hair loss in men aged 18 to 41. However, at higher dosages (5 mg), it is also prescribed to treat prostate disorders such as benign prostatic hyperplasia. Although initially marketed under the name Propecia by the Dutch laboratory Organon, a subsidiary of the American Merck, it is still available in generic form.

For several years, finasteride has been the subject of strong criticism for its side effects, including erectile dysfunction, reduced libido, severe depression and even suicidal ideation. So many problems which pushed the ANSM to strengthen the monitoring of this drug. From now on, finasteride boxes in France must clearly mention these risks.

The specialist magazine Prescribe has, for its part, recommended not to use this drug against baldness, considered safe, because of the potential risks for the health of users.

A reassessment of benefit and risk

The numerous complaints from patients and criticism from certain specialists have pushed the ANSM to request a re-evaluation of this drug by the European Medicines Agency (PRAC). This request was partly motivated by legal actions taken in 2019 by patients against the Merck laboratory. The complainants criticize the French agency for having taken too long to take measures, even though finasteride has been on the market for around twenty years.

Pending the results of this new study on the effectiveness and usefulness of finasteride, the ANSM calls for vigilance and recommends that patients taking finasteride or dutasteride consult a doctor in the event of psychological disorders, such as signs of depression or suicidal thoughts, or sexual disorders.

If side effects persist, it is advisable to stop treatment and report these effects to the pharmacovigilance agency. It is also requested to update initial reports in the event of worsening or prolongation of symptoms after stopping treatment.

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