Combined use of MINOXIDIL with FINASTERIDE and ANDROGENETIC ALOPECIA TREATMENT.Dear colleagues,
in this article, we will examine a preparation in which the active substance MINOXIDIL is formulated together with FINASTERIDE, which I have previously published twice. This formula is particularly effective in Androgenetic baldness, the most common type of alopecia.When minoxidil is used together with finasteride, hair loss is prevented more effectively through a synergistic effect. The concurrent use of these two FDA-approved medications is generally recommended.MINOXIDIL
Minoxidil is the first FDA-approved medication for the prevention of hair loss. Minoxidil has the property of preventing hair loss and stimulating hair growth by increasing blood flow in the scalp. It is thought to exert a therapeutic effect by activating weak hair follicles and prolonging the growth (anagen) phase of the hair cycle.
Rather than stimulating new hair follicles, minoxidil acts by normalizing the diameter and depth of existing small follicles and inducing hypertrophy.Minoxidil is originally a vasodilator (causing blood vessels to widen) medication that lowers blood pressure. The drug’s initial purpose of development was the treatment of hypertension and it was produced in oral tablet form.
Some time after the drug emerged in the 1970s, an interesting side effect of the drug was discovered. Increased body hair, darkening of existing hair, and hair growth were observed in individuals using minoxidil. Observing this side effect, the American company Upjohn began producing a topical (externally applied) solution containing 2% minoxidil under the brand name Rogaine/Regaine in 1986 and presented it to the world as a miracle drug. The drug later (1993) continued to be manufactured to contain 5% minoxidil for men and 2% for women, and continued to be used in the treatment of hair loss.
How minoxidil affects hair growth has not been fully understood for approximately 30 years. However, there are various hypotheses put forward by experts regarding the drug’s mechanism of action.
In studies conducted on animals, minoxidil has been shown to shorten the telogen phase of hairs and induce an early transition into the anagen phase. The drug is believed to have the same effect in humans as well. Additionally, it is known that the drug relaxes vascular muscles and lowers blood pressure by opening cell membranes through its sulfate metabolite. Likewise, there are hypotheses arguing that minoxidil sulfate stimulates hair growth by opening potassium channels in hair follicles. However, proving this hypothesis is difficult, and there is currently no conclusive evidence regarding the presence of potassium channels in hair follicles. Furthermore, minoxidil is thought to play a role in hair cell proliferation, inhibition of collagen synthesis, and prostaglandin synthesis.
Perhaps all or some of these hypotheses may be correct. However, due to the complex biological structure of the hair follicle, it cannot be definitively proven with today’s capabilities how minoxidil affects hair growth.
Research on minoxidil has focused on androgenetic alopecia (male pattern baldness), the most common type of hair loss. In male pattern baldness, the duration between the anagen and telogen phases of hair shortens and hair follicles miniaturize. Although male pattern baldness is more common in men, it can also be seen in women. In trials conducted using minoxidil for these types of hair loss, hair growth, an increase in hair count, and increased density have been observed in both men and women. Since this effect manifests within 12–16 weeks from the start of minoxidil use, it can be stated that the drug’s action is very rapid. This rapid effect can be explained by the reversal of miniaturized hair follicles. Additionally, because existing hairs exit the telogen phase and transition back to the anagen phase, the hairs become stronger and thicker.
The maximum effect of minoxidil use is observed between 6 months and 2 years. After this period, its effect gradually diminishes. With continuous use, hair loss slows down, and it is effective against hair loss especially in the crown (vertex) area, as well as the frontal and temporal regions.
Finasteride, on the other hand, originally emerged in 1992 under the name Propecia as a drug preventing prostate enlargement, and its use in the treatment of hair loss was approved in 1997 by the FDA (Food and Drug Administration). Propecia is the brand name of the drug finasteride. The same drug is also sold under the name Proscar.
The enzyme responsible for converting testosterone into dihydrotestosterone, which acts on hair follicles causing them to shed, is the 5-alpha reductase enzyme. The drug that prevents hair loss by inhibiting the activity of this enzyme is “finasteride”. When the finasteride substance taken at an ORAL dose of 1 milligram per day was used for 5 years, an increase in hair amount was observed in 48% of users, and no change in baseline hair amount was observed in 42%. In other words, while it provided benefits in 90% of users, a decrease in hair amount was observed in only 10% of patients. In two years of use, a 34% increase in hair volume was observed.
Finasteride-containing drugs are sold on the market under the brand names Proscar and Propecia.
Finasteride (Propecia and Proscar) is currently recognized worldwide as the most successful drug in the treatment of DHT-related hair loss. However, alongside finasteride’s great success in hair loss treatment, it also has significant side effects.
On the other hand, although not listed among the “known” side effects of Propecia, some users have reported developing blackheads on their foreheads and noticing an overall oiliness on their facial skin.
Some known side effects of finasteride include:
- Impotence
- Decreased sexual desire
- Decreased sperm count
- Gynecomastia (Breast enlargement in men)
- Otitis media (Middle ear infection)
- Weight gain
These side effects are observed due to the decrease in DHT levels in the body, because even though DHT causes hair loss, it has many beneficial functions in the human body.
Some functions of DHT in the human body are:
- Growth of the penis and testes
- Sperm production
- Erection
- Secretion of skin and ear secretions
- Protein Synthesis
- Increase in confidence/aggression in the brain (Aggression)
In conclusion, we can state the following:
Since DHT is not a virus or a harmful bacterium to the body, it does not need to be treated. Medications containing finasteride interfere with the body by altering its normal function. Reducing DHT can lead to highly detrimental consequences. To give an example of how serious these consequences can be:
It has been observed that finasteride can be absorbed through the skin. Therefore, pregnant women must strictly avoid contact with these medications. If this substance is absorbed into the body and DHT is reduced, the sexual organs of the fetus in the womb may fail to develop.
The use of these medications during puberty, on the other hand, may prevent the development of masculine characteristics in males and cause many permanent sexual problems to occur.
Unless the intake of these medications is discontinued, the side effects caused by DHT reduction in the body will not resolve.
Baldness(ANDROGENIC ALOPECIA)in its long-term treatment, see how this formula is prepared in Europe for preventing hair loss and stimulating hair growth:MINOXIDIL 2% AND FINASTERIDE 0.1% SCALP LOTIONRx
Minoxidil ………………2 g
Finasteride…………….100 mg
Propylene glycol……… 20 mL
Ethanol 95%…… qs 100 mL
Preparation of the formula;
Crush the calculated amount of tablets providing 100 mg from the finasteride-containing preparation available in our pharmacy in a mortar, and mix in a closed container with 75 mL of the 95% ethanol specified in the formula, shaking occasionally. After standing for one to two hours, the solution is filtered through filter paper to remove excipients present in the tablets.
The solution is mixed with minoxidil dissolved in propylene glycol in a hot water bath, and the preparation is completed by adding ethanol to reach the final volume.
Specialist Pharmacist Ahmet Nezihi Pekcan
Pekcan Pharmacy – Konya
[email protected]
Tel: (332) 3520657http://www.majistralformul.com/
