The difference between "Proscar" and "Propecia"

Do you have such questions: "Proscar" and "Propecia", both drugs are manufactured by the same company, and both are called finasteride tablets, are there any differences between the two drugs? Why is the price difference so large? Can I choose the cheaper one instead?

First of all, let me make it clear that although both drugs are called finasteride tablets, there are still big differences between them. Although the two tablets look about the same size, in fact, the outer packaging of "Proscar" clearly states that the specification is 5mg, which means that each tablet contains 5mg of effective finasteride, while the specification of "Propecia" is 1mg, which means that the effective ingredient content of 1 tablet of "Proscar" is about the same as that of 5 tablets of "Propecia". With such a big difference in content, the two drugs are of course different.

Apart from the difference in content, the indications of the two drugs are also very different. Here we need an interesting story before the advent of finasteride. As early as the 1960s, the purpose of the R&D personnel to design finasteride was to use it to treat adolescent acne. The theory at that time believed that adolescent acne was related to the increase of dihydrotestosterone (DHT) in the body. DHT is converted from testosterone through an enzyme called type II 5α reductase. Finasteride can compete with this enzyme and prevent the process of testosterone conversion to DHT, thereby reducing the DHT content. However, as the research progressed, the researchers found that the use of hormone drugs in adolescents was resisted by most parents, and no one would be interested in the new drug, so the research was once stagnant.

Just when the research team was about to disband, the appearance of a hermaphrodite patient in a Dominican hospital saved the entire team. In this remote tribe, many people were born as girls, and these girls developed into boys during puberty. These boys have smaller prostates than normal people and rarely proliferate in old age, and rarely have symptoms of hair loss. Why can seemingly unrelated news bring a turnaround to the research on finasteride for the treatment of acne?

Because DHT is also the "culprit" of prostate hyperplasia and male pattern baldness. DHT is widely distributed in the prostate, liver and skin. If DHT in the prostate increases, it will lead to prostate hypertrophy; if DHT in the scalp increases, it will become the "barber" of the head. Since finasteride can reduce DHT, can it be used to treat prostate hypertrophy and male pattern baldness?

After the unremitting efforts of researchers and a large number of clinical trials, 5mg of Proscar was approved for marketing in 1994. Its indications are benign prostatic hyperplasia (BPH) and prevention of urinary system events. It can shrink the enlarged prostate and improve symptoms. It is usually used alone or in combination with tamsulosin. 1mg of Propecia was approved for marketing in 1998. Its indication is androgenic alopecia.

If the only difference is the content, and 5mg of "Proscar" is cheaper than 1mg of "Propecia", then can "Proscar" be divided into 5 parts to replace "Propecia"? This question has not yet been verified by authoritative test results. Both drugs are prescription drugs, one for urology and the other for dermatology. In theory, patients with androgenic alopecia cannot get 5mg of "Proscar". The most important thing is that before all drugs are put on the market, their dosage and indications have undergone rigorous clinical trials and conclusions drawn from scientific and massive data. If the original tablet shape is rashly destroyed by cutting, even if it can be evenly divided, it is difficult to guarantee the original efficacy. Therefore, pharmacists recommend that if conditions permit, please take the drug in accordance with the doctor's instructions and the indications, usage and dosage in the drug instructions.

References:

[1] Tian Helin, Zhao Rugen, Su Xianhui. New progress in the study of the pharmacological effects of finasteride[J]. Chinese Pharmacy, 2008, 019(034):2707-2709.

[2] Chen Jingran. Clinical application of finasteride[J]. China Pharmaceutical Industry, 2007, 16(003):62-63.

[3] Zhao Hong. Observation on the efficacy of finasteride combined with tamsulosin in the treatment of benign prostatic hyperplasia in the elderly [J]. Health Vision 2021, Issue 1, Page 86, 2020.

[4] Zhang Qihong. Efficacy of finasteride in the treatment of androgenic alopecia[J]. Guangdong Medical Journal, 2013, 34(19):3027-3029.

[5] Finasteride Tablets Drug Instructions