Finasteride is the generic form of Propecia — a 5-alpha reductase inhibitor that reduces DHT and slows or reverses male-pattern hair loss. Taken as 1 mg once daily, it's the most effective oral medication for androgenetic alopecia, with visible results at 3–6 months. Bidwell's licensed nurse practitioner reviews your intake same day for $45 flat. Generic finasteride at the pharmacy is $15–$30 per month with a discount card.
Finasteride is a selective inhibitor of type II 5-alpha reductase, the enzyme that converts testosterone to dihydrotestosterone (DHT). In men with androgenetic alopecia, scalp hair follicles are genetically sensitive to DHT — chronic DHT exposure causes follicles to miniaturize over time, producing progressively thinner, shorter hairs until they stop growing altogether. By lowering scalp DHT by about 60%, finasteride slows miniaturization and allows some follicles to return to normal caliber. The FDA DailyMed label is the authoritative reference.
Merck first brought finasteride to market as Proscar (5 mg) in 1992 for benign prostatic hyperplasia, and then as Propecia (1 mg) in 1997 for male-pattern hair loss. The U.S. patent on Propecia expired in 2013 and FDA-approved generic finasteride has been widely available since. The American Academy of Dermatology lists oral finasteride 1 mg daily as first-line therapy for androgenetic alopecia in men.
You can be prescribed finasteride through Bidwell if you:
Finasteride is not appropriate for alopecia areata (autoimmune patchy hair loss), scarring alopecia, post-chemotherapy hair loss, telogen effluvium (stress or postpartum shed), or traction alopecia. If your pattern doesn't match androgenetic alopecia, the reviewing provider may recommend a dermatology referral.
Use caution — not absolute avoidance — if you have liver impairment (finasteride is hepatically metabolized), have a history of depression (case reports of mood changes on finasteride), or are planning to have your PSA checked for prostate cancer screening (finasteride lowers PSA by about 50%; your clinician should adjust the interpretation). The NIH StatPearls monograph is a useful clinical reference.
| Indication | Dose | Notes |
|---|---|---|
| Androgenetic alopecia | 1 mg orally once daily | Any time of day; with or without food. Consistency matters. |
| BPH (Proscar) | 5 mg orally once daily | Bidwell does not prescribe for BPH via our hair-loss intake; see your urologist or PCP. |
For hair loss, take one 1 mg tablet daily, at any consistent time. Pick a cue you won't forget (with breakfast, when you brush your teeth, before bed). Missing a day occasionally is not a disaster — but regular adherence is what produces results. If you miss a dose, take it when you remember; don't double up.
Clinical response is slow. Hair doesn't grow fast, and the miniaturization process takes time to reverse:
Finasteride is generally well tolerated. Per the FDA Propecia label, the most common side effects (all under 2% in pivotal trials) are:
Most side effects are mild and reversible on stopping. A small subset of patients report persistent sexual side effects after discontinuation ("post-finasteride syndrome"); the frequency is debated but the risk exists. Counsel before starting. If you develop bothersome symptoms, talk to your provider about dose reduction (0.5 mg every other day has been studied), topical finasteride, or stopping.
Rare but important: finasteride was associated with a small increase in high-grade prostate cancer in the PCPT trial at 5 mg (BPH dose), though overall prostate cancer diagnosis decreased. The 1 mg hair-loss dose has not shown this signal. Get PSA screening if indicated and tell your clinician you're on finasteride — it roughly halves PSA values.
| Formulation | Quantity | Typical cash + discount |
|---|---|---|
| Finasteride 1 mg (generic) | 30-day supply | ~$10–$25 |
| Finasteride 1 mg (generic) | 90-day supply | ~$20–$40 |
| Finasteride 5 mg (generic, for quartering) | 30 tablets | ~$10–$20 |
| Propecia (brand) | 30-day supply | ~$80–$120 |
Branded Propecia isn't worth the money — generic finasteride is therapeutically equivalent at a small fraction of the cost. Compare pharmacy prices at GoodRx. Some commercial insurance plans cover finasteride at a low copay when prescribed for hair loss; Medicare Part D coverage is variable. Your $45 Bidwell visit covers the clinical review; the pharmacy fill is separate.
You must be physically located in one of these states at the time of your visit.
Yes. It's routinely prescribed via telehealth after a licensed provider reviews a hair-loss intake. Bidwell reviews same-day for $45 flat.
Stabilization at 3 months. Visible regrowth at 4–6 months. Full effect assessed at 12 months. An initial shed in month 1–2 is common and normal.
1 mg once daily, any time of day, with or without food. The 5 mg tablet is for BPH.
Yes for most men. Over 25 years of post-marketing data. AAD lists it as first-line for male-pattern hair loss. Side effects are uncommon (<2%) and usually reversible; persistent effects after stopping are rare but possible.
In pivotal trials, decreased libido 1.8%, ED 1.3%, ejaculatory dysfunction 1.2% — each modestly higher than placebo. Usually reversible on stopping; rare cases of persistent symptoms.
Finasteride is pregnancy Category X. Women who are or may become pregnant must not take it or handle broken tablets. Bidwell does not prescribe finasteride to women.
With GoodRx or similar: $10–$25 for a 30-day supply, often under $30 for 90 days. Branded Propecia is $80–$120/month and not worth it.
Hair gained on treatment is lost over 6–12 months as scalp DHT returns to baseline. Long-term continuous use is what maintains results.
Yes — standard combination. Finasteride (oral) reduces DHT; minoxidil (topical) extends follicular growth phase. Additive effects.
Dutasteride (0.5 mg, off-label for hair loss) is more potent but has a longer half-life. Topical finasteride is a compounded option designed for lower systemic absorption. See our finasteride vs dutasteride comparison.