A Pill for Male Pattern Baldness Wins Approval From the F.D.A. (second part)
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The active ingredient in Propecia is one milligram of finasteride, which Merck already sells in a five-milligram dose as Proscar, a treatment for enlarged prostate glands. Finasteride works by inhibiting production of dihydrotestosterone, or DHT, a potent form of the male hormone testosterone that contributes to male pattern baldness.
Finasteride also causes an abnormality in male fetuses, a condition known as hypospadias, in which the opening of the penis is on its underside rather than on the tip. Because the drug can be absorbed through the skin, Merck encases its tablets in a coating, and warns that women should not touch the actual powder.
The company has said there is no risk to the female partners of men who use Propecia. But Dr. Carlos Puig, president of the Hair Loss Council, a trade group whose membership includes doctors, said more research was needed because most of the safety data on finasteride came from studies on Proscar, which is typically given to older men.
”My suggestion,” Dr. Puig said, ”is that we use caution.”
Merck officials said they expected that Propecia, which is to be available in pharmacies in January, would cost $45 to $49 a month.
There is only one other F.D.A.-approved medicine for baldness: minoxidil, an ointment sold over the counter as Rogaine by Pharmacia & Upjohn Inc. Because there have been no studies testing Rogaine against Propecia, there is no accurate way to compare the two.
Dr. Frank, the Boston dermatologist, predicted a high demand for Propecia, particularly among hair transplant patients who do not want to lose more hair after their expensive procedures.
But Mr. Capps, the founder of the bald men’s group, suggested another treatment: ”We try to let people know that it’s more important what’s in their head than what’s on top of it.”