What is Propecia?
Propecia (finasteride 1 mg) is a prescription-only oral medicine approved by the European Medicines Agency (EMA) for the treatment of androgenetic alopecia — male pattern hair loss — in adult men. It is a 5-alpha reductase inhibitor, a class of medicines that works at the hormonal level to address the underlying cause of male pattern baldness.
Male pattern hair loss is the most common form of hair loss in men, affecting up to 50% of men by the age of 50. It is driven primarily by the action of dihydrotestosterone (DHT) on genetically susceptible hair follicles.
How does Propecia work?
Finasteride inhibits the enzyme 5-alpha reductase type II, which is responsible for converting testosterone into dihydrotestosterone (DHT) in the scalp, skin, and prostate. DHT is the primary hormonal driver of androgenetic alopecia: it binds to androgen receptors in hair follicles, causing progressive miniaturisation — the gradual shrinking of the follicle until it can no longer produce visible terminal hair.
By inhibiting 5-alpha reductase type II, finasteride reduces scalp and serum DHT concentrations by approximately 60–70%. This reduction slows or halts the miniaturisation process, allowing the follicle to recover and produce thicker, longer hair over time.
Propecia addresses the hormonal cause of male pattern hair loss, distinguishing it from topical treatments such as minoxidil, which act through a different (vascular and proliferative) mechanism.
Who is Propecia for?
Propecia is indicated for adult men with androgenetic alopecia (male pattern hair loss). It is most effective when started earlier in the course of hair loss — before significant follicle miniaturisation has occurred — but clinical evidence supports benefit at various stages of hair loss.
Propecia is specifically approved for use in men. It is not approved for use in women or children.
Finasteride is not appropriate for all men. È necessaria una valutazione medica per confermare suitability. Contraindications include:
- Known hypersensitivity to finasteride or any excipient
- Women of childbearing potential must not handle crushed or broken finasteride tablets — finasteride can be absorbed through the skin and may cause abnormalities in the external genitalia of a male foetus
Posologia
Propecia is taken as a 1 mg oral tablet once daily, with or without food. It should be taken at approximately the same time each day.
| Dose | Frequency | Notes |
|---|---|---|
| 1 mg | Once daily | Standard approved dose for androgenetic alopecia |
There is no titration period — treatment begins at the full therapeutic dose. The benefit of finasteride is dependent on continued use. Clinical evidence shows that hair counts return to pre-treatment levels within 12 months of stopping the medicine.
Results are typically not visible until 3 to 6 months of consistent use, and full assessment of the medicine’s effect should be made after at least 12 months of treatment.
Effetti collaterali
Come tutti i farmaci, Propecia può causare effetti collaterali. The majority of men taking finasteride do not experience side effects.
Effetti collaterali comuni (may affect more than 1 in 100 people)
- Decreased libido (reduced sex drive)
- Erectile dysfunction
- Ejaculatory disorders (reduced volume of ejaculate)
These sexual side effects were reported in a small proportion of men in clinical trials (approximately 1–2%) and resolved in most patients after discontinuation of treatment. They may also improve with continued use in some men.
Effetti non comuni ma significativi
- Breast tenderness or enlargement (gynaecomastia) — rare but reported
- Hypersensitivity reactions including rash, urticaria, or swelling of the lips and face
- Testicular pain (uncommon)
Segnalazioni post-commercializzazione
Post-market surveillance data and the medical literature include reports of persistent sexual dysfunction (including reduced libido and erectile dysfunction), depression, and cognitive effects in a small number of patients following discontinuation of finasteride. This is referred to in the literature as post-finasteride syndrome (PFS). The EMA has reviewed this safety signal, and prescribing information in the EU includes relevant warnings. Patients should discuss any personal or family history of mood disorders or sexual dysfunction with their doctor before starting treatment.
Prostate-specific antigen (PSA)
Finasteride reduces serum PSA levels by approximately 50%. Men on finasteride who undergo PSA screening for prostate cancer should inform their doctor, as the reduced PSA value must be interpreted accordingly (typically by doubling the result to estimate the true PSA level).
Propecia vs alternatives
The two primary treatments for male pattern hair loss approved in Europe are finasteride and minoxidil. They have distinct mechanisms of action and can, in some cases, be used in combination under medical supervision.
| Treatment | Active Ingredient | Mechanism | Form | Indication |
|---|---|---|---|---|
| Propecia | Finasteride 1 mg | 5-alpha reductase inhibitor (hormonal) | Oral tablet | Male androgenetic alopecia |
| Rogaine | Minoxidil | Vasodilator / hair follicle stimulant | Topical solution or foam | Androgenetic alopecia (men and women) |
Differenze principali:
- Propecia vs Rogaine (Minoxidil): Finasteride acts on the hormonal cause of hair loss (DHT reduction), while minoxidil stimulates blood flow to hair follicles through a vascular mechanism. Finasteride is taken orally once daily; minoxidil is applied directly to the scalp once or twice daily. Finasteride is approved for men only; minoxidil is approved for both men and women. Both have demonstrated effectiveness in clinical trials, and some men use both concurrently under medical supervision for complementary effects.
- Treatment duration: Both require continuous use to maintain benefit. Stopping either treatment typically results in reversal of hair loss gains within 12 months.
How to access Propecia online in Europe
Propecia è un farmaco soggetto a prescrizione medica in tutti gli stati membri dell’UE. È necessaria una prescrizione valida da parte di un professionista medico autorizzato per la dispensazione legale.
Prescrivia opera come intermediario tecnologico: non prescriviamo farmaci, non impieghiamo medici né vendiamo medicinali. La nostra piattaforma mette in contatto i pazienti con medici indipendenti registrati nell’UE che possono condurre valutazioni sanitarie online riservate.
Il processo funziona come segue:
- Completi una valutazione della salute: Answer structured health questions covering your hair loss history, relevant medical history, current medications, and any previous treatments tried.
- Revisione medica: Un medico indipendente registrato nell’UE esamina la Sua valutazione. If finasteride is clinically appropriate, they may issue a prescription. If it is not appropriate, the doctor will explain why.
- Prescrizione e dispensazione: Se viene emessa una prescrizione, viene inviata a una farmacia partner autorizzata dell’UE, che dispensa e spedisce il farmaco a Lei.
Importante: Prescrivia non garantisce che venga emessa una prescrizione. Tutte le decisioni prescrittive vengono prese in modo indipendente da professionisti medici qualificati.
Informazioni importanti sulla sicurezza
Non utilizzi Propecia se Lei:
- Are female, or are a woman of childbearing potential (risk of foetal harm if absorbed through skin)
- Are under 18 years of age
- Are allergic to finasteride or any ingredient in Propecia
- Have liver disease that may impair finasteride metabolism
Informi il Suo medico prima di starting Propecia if you have:
- A history of depression, anxiety, or other mood disorders
- A history of sexual dysfunction
- Liver disease
- A history of prostate cancer (finasteride is not indicated for prostate cancer prevention in this context; higher doses are used separately for BPH)
- Obstructive uropathy
Importante per le donne: Women who are pregnant or may become pregnant should not handle crushed or broken Propecia tablets. Finasteride is absorbed through the skin and may cause malformation of the genitalia of a male foetus if contact occurs.
Monitoraggio del PSA: Inform any doctor ordering a PSA test that you are taking finasteride. The expected 50% reduction in PSA must be accounted for in interpretation.
Fonti
Le informazioni mediche presenti in questa pagina si basano sulle seguenti fonti:
- European Medicines Agency (EMA). Propecia (finasteride 1 mg) — Summary of Product Characteristics. Disponibile su: ema.europa.eu
- European Medicines Agency (EMA). Assessment report: Propecia. EMEA/H/C/000659.
- World Health Organization (WHO). International Programme on Chemical Safety — Finasteride monograph. who.int
- Kaufman KD, et al. Finasteride in the treatment of men with androgenetic alopecia. J Am Acad Dermatol. 1998;39(4):578-589.
Questo contenuto viene rivisto periodicamente per riflettere le linee guida cliniche aggiornate. Viene fornito esclusivamente a scopo informativo e non costituisce consulenza medica. Consulti sempre un professionista sanitario qualificato per consigli pertinenti alle Sue circostanze di salute individuali.
Frequently asked questions
- What is Propecia used for?
- Propecia (finasteride 1 mg) is approved by the European Medicines Agency (EMA) for the treatment of androgenetic alopecia — commonly known as male pattern hair loss — in adult men. It is used to slow hair loss and, in many cases, to promote some regrowth of hair in areas affected by thinning.
- How effective is Propecia for hair loss?
- Clinical trials submitted to the EMA demonstrated that finasteride 1 mg stopped the progression of hair loss in approximately 90% of men over two years of treatment. Around two-thirds of men experienced measurable hair regrowth during the same period. Results are typically seen after 3 to 6 months of consistent use, and continued treatment is required to maintain the benefit.
- How long does it take for Propecia to work?
- Most men begin to notice a reduction in hair shedding within 3 to 6 months of starting treatment. Visible hair regrowth, where it occurs, is typically apparent after 6 to 12 months. Propecia must be taken daily and continuously — discontinuing treatment usually results in a return to baseline hair loss within 12 months.
- Can I get Propecia online in Europe?
- È possibile accedere a Propecia tramite piattaforme intermediarie online che La mettono in contatto con medici indipendenti registrati nell'UE. Dopo aver completato una valutazione della salute riservata, un medico esaminerà se finasteride è clinicamente appropriato per Lei. Prescrivia non prescrive né dispensa farmaci — La mettiamo in contatto con professionisti qualificati.
- Does Propecia cause sexual side effects?
- Clinical studies found that a small proportion of men (approximately 1–2%) experienced sexual side effects including decreased libido, erectile dysfunction, or reduced ejaculate volume. These effects were reported to resolve in most patients after discontinuation of treatment. Some reports in the medical literature describe persistent sexual side effects in a small subset of patients after stopping finasteride (post-finasteride syndrome), though the clinical evidence base for this remains under investigation. All relevant health history should be disclosed to the reviewing doctor before starting treatment.
Trattamenti
Prescrivia è solo una piattaforma di intermediazione. Non forniamo servizi medici, non prescriviamo trattamenti e non dispensiamo farmaci. Tutte le decisioni mediche sono prese da medici indipendenti registrati nell'UE. Tutti i farmaci sono dispensati da farmacie autorizzate dell'UE. Questa piattaforma facilita i collegamenti tra pazienti e operatori sanitari.