Talk:Finasteride: Difference between revisions

Updated Patient Information Leaflet (PIL) - Reference 12 now has broken link

The Patient Information Leaflet (PIL) for Propecia has been updated on 2010-03-18. When the new PIL was published by the Swedish MPA the address to it was changed, so the document can no longer be found using the current link in Reference 12. Hence the link should be updated to point to the new PIL.

The new address is: Patient Information Leaflet in English (http://www.lakemedelsverket.se/SPC_PIL/Pdf/enhumpil/Propecia%20film-coated%20tablet%20ENG.doc)

Can someone please update the reference with the new link address? (This Wiki page is semi-protected so I cannot do it myself) —Preceding unsigned comment added by 90.230.5.41 (talk) 11:45, 13 May 2010 (UTC)

Finasteride linked with male breast cancer!

UK medicines regulator The Medicines and Healthcare products Regulatory Agency (MHRA) did an indepth analysis and found that Finasteride is linked to an increase in incidents of male breast cancer among users after 53 men using the drug developed the disease. New warnings will now be added to the packaging of Finasteride informing users of this risk.[1]

Could someone please add this to the article - I cant because its in a state of semi-protection. This news is important. —Preceding unsigned comment added by 86.138.236.249 (talk) 02:19, 4 December 2009 (UTC)

this article needs help

First of all, anyone who's looked on the footnote regarding a "male hormone specialist" can see this does not qualitfy as a reference by WPN standards. It is merely a YOUTUBE video of some guy pushing his own hair-growth formula. Doesn't make thsi drug a health risk. The only correlation is depression and hair loss, that is men with thinning hair tend to be miserable, or at least post this on the "internet groups" referenced in this article. Impotence in about 1% (stats via a controlled study). Certainly not causative regarding PROSCAR, which, incidentally, has been proven to re-grow hair on a man's head (a good thing!), increase testosterone (another good thing!) and reduce risk of prostate cancer (ditto!).

Somebody clean this article up!

Jessicabest9 (talk) 23:31, 6 October 2009 (UTC)

poison

Thanks to whoever deleted the "Beware: Propecia is pure poision..." section... I was about to delete it, but you beat me to it! -cmsmith81 (I am not signed in).

• "In internet discussion groups, some men report side-effects lasting long after cessation of the drug, such as difficulty concentrating, testicular pain, and frequent urination. It is uncertain whether these problems can be attributed to finasteride."

gynecomastia

Can anyone confirm this observation? Does gynecomastia really last long after discontinuing Finasteride? As far as I remember, everything else I've read indicates side-effects stop after usage is stopped. That's also what the clinical trials reported. --Nectarflowed ^T 08:53, 17 Jun 2005 (UTC)

Well, gynecomastia is often irreversible. The internet news groups were an attempt at POV by an anon. Feel free to remove it if you can't find the evidence. JFW | T@lk 01:21, 19 Jun 2005 (UTC)

____________

"The men who took the finasteride lowered their PSA levels by a full 48%. They literally cut their PSA levels in half, but got almost eight times the cancer tumors!" This is from "young again" web site. I have no idea if it's true but it's worth investigating before you that finasteride for any reason.(User_talk:Berryham) —Preceding unsigned comment added by Berryham (talk • contribs) 22:15, 28 September 2008 (UTC)

Prostate cancer

Sfahey, the article now says Finasteride is used to treat prostate cancer, but also increases incidences of aggressive prostate cancer. What was your source for this?--Nectarflowed ^T 23:52, 20 July 2005 (UTC)

I've added this. It is still being worked out, but apparently even though it increases the incidence of the worst type, overall it decreases mortality from prostate cancers. This was demonstrated at the higher dose, the one NOT used for hair loss. Sfahey 01:19, 22 July 2005 (UTC)

Thanks. The dosage information, though, isn't in the current reference. Do you have another reference? --Nectarflowed ^T 02:06, 22 July 2005 (UTC)

see journal skinMED (3-4/05,pp 67-68), which can be found at <www.lejacq.com> by searching for article #3978

It says in the Propecia drug leaflet, that Prostate Cancer is less likely whilst taking the drug, but of those who do get it it is more likely to be agressive. I don't think the article makes this clear in the opening section, that this is a downside. —Preceding unsigned comment added by 78.150.153.10 (talk) 15:13, 2 December 2007 (UTC)

Would need some update, just released study shows clearly a 30 % reduction in all types of cancer (including more agressive ones), it seems the original study found more agressive tumors in the treatment group because of better diagnostic due to smaller prostate gland - its just realeased in the new - looks very promising guys. —Preceding unsigned comment added by 67.241.7.135 (talk) 01:40, 15 June 2008 (UTC)

Indeed, references 2 and 3, cited early in the article, cite the later studies showing no higher incidence of more aggressive prostate cancer, while ref 17, cited later, makes the earlier and opposite claim. Internal contradiction is hard on the innocent reader, and this issue could be very significant to those making an important health choice. Dave94703 (talk) 23:32, 11 September 2008 (UTC)

Re Par.3..."Further, finasteride increased the specificity and selectivity of prostate cancer detection, thus, a seemingly increased rate of high Gleason grade tumor."

  This statement is inaccurate and critically misleading.  A Gleason score (not "grade") is determined by a trained technician or physician examining, by microscope, tissue samples obtained by biopsy.  There is no way a drug (as opposed to a selective stain) can influence this visual evaluation of the "aggressiveness" of cancer cells which are present.  Thus, finasteride increases (not "seemingly increases") the probability of a high Gleason score and a prostate cancer's aggressiveness.  

<Wolf Lorber (not registered).

What about this - "One hypothesized explanation for this increase is that finasteride reduced prostate volume, leading to detection of more high-grade tumors due to increased sampling density." http://jnci.oxfordjournals.org/cgi/content/abstract/99/18/1366Pondle 15:56, 8 October 2007 (UTC)

Autoimmune disease

Some anon added autoimmune disease as a complication[2]. Not a single study is reported on PubMed. Sounds like a myth. The mechanism is also not explained, nor is there any truth in his assertions that Alzheimer's, heart disease and skin cancer are "autoimmune diseases". JFW | T@lk 14:46, 7 June 2006 (UTC)

Ingestion of semen

"It appears that Finasteride can pass into the semen of men, thus, at certain dosages, caution should be used to avoid ingestion of semen during oral sex if a woman is pregnant or may become pregnant." Well, is this true? So does this actually mean that it can be harmful at conception if used by the male? --James Bond 02:00, 20 June 2006 (UTC)

According to Merck: "Yes, you can take PROPECIA if you and your wife are trying to conceive or if your wife is currently pregnant. Contact with the semen from a man being treated with PROPECIA is not a risk to the unborn child of a pregnant woman." http://www.propecia.com/finasteride/propecia/consumer/facts/faq.jsp

Available data indicate that the level of PROPECIA in the semen of a man taking PROPECIA does not pose a risk to an unborn child. Accordingly, a man can take PROPECIA while conceiving a child with his partner, or have sexual intercourse with his partner if she is already pregnant. http://www.propecia.com/finasteride/propecia/consumer/about-propecia/faqs.jsp —Preceding unsigned comment added by Themightythor1212 (talk • contribs) 23:23, 11 March 2009 (UTC)

(Please sign your talk page entries. I didn't write the paragraph above.) This doesn't actually answer the technical question of "does finasteride pass into semen", but from a fetal-safety point of view, it doesn't seem to be an issue, so I'm going to rephrase that statement in the main page. -- JdwNYC 15:55, 1 March 2007 (UTC)

Depression

Finasteride has been linked to depression, this should be included

http://www.leaddiscovery.co.uk/admin%20gu/files/14467.asp

http://www.hairsite4.com/dc/dcboard.php?az=show_topic&forum=10&topic_id=5980&mode=full —The preceding unsigned comment was added by My phantom limb (talk • contribs) 14:02, 4 March 2007 (UTC).

This could be due to a confounding variable - hair loss.Pondle 10:58, 12 August 2007 (UTC)

The two cited studies describe moderate to severe clinical depression as classified using verifiable tests (see sources) in a majority (!) of examined cases. This is very different from frustration about hair loss. Personally, I have quit Finasteride after only 2 months due to recurring symptoms of depression the like of which I had never even imagined before. I would not have related this to Finasteride if I had not seen other users on internet forums reporting similar experiences. Even if many may use Finasteride without any effect on their mental well-being, depression should not be taken lightly as a possible side-effect, even though the producer's information leaflet does not (yet?) mention it. —Preceding unsigned comment added by 149.225.92.116 (talk) 22:27, 29 December 2007 (UTC)

You see a lot of claims about alleged Propecia side effects on internet forums. The depression study in question was not a placebo-controlled trial, so does not meet the scientific 'gold standard'.Pondle (talk) 14:53, 30 December 2007 (UTC)

about gynecomastia

I removed the little reference that propecia cause gynecomastia. Feel free to revert my change once you can show a serious reference about that claim. Paldiski 04:59, 4 July 2007 (UTC)

It is a POSSIBLE side effect...it doesn't ALWAYS cause it. It is one of the listed possible side effects when you purchase the medication. That little form the pharmacy gives you with each medication explaining everything about it, it is listed in there. I am taking that med so I can attest that it is listed in that form. I think it deserves mentioning since it is being advised as being a listed side effect by every pharmacy that distributes it.164.214.1.54 14:34, 13 July 2007 (UTC)

It is possible, but the clinical trials showed no difference between the incidence of gyno in the treatment and placebo groups.Pondle 10:59, 12 August 2007 (UTC)

generic

AUROFINA? There apprears to be a generic vesion of PROPECIA 1mg made by Cipla (India) http://www.mail-rx.com/shop/product.php?productid=16413&cat=251&page=1 This product is sold under the name AUROFINA-1. Code No: MH/DRUGS/KD-19. Does anyone have more information? Should it be added to the generic section?

i believe there is now a generic finasteride, at least for the 5mg. there may or may not also be a generic 1mg (at least in canada?). it woudl be helpful to include this information NorthernLad79

The Proscar (5mg) patent has expired, and there are now legit generic versions available. The only 1mg generics available are Indian versions. Indian patent law allows local drug companies to copy drugs and sell them in the domestic market.Pondle 11:00, 12 August 2007 (UTC)

Does the generic version that you mentioned above - aurofina-1 actually work as it is not available in the UK, and the hair loss clinic i visited have said that it will probably be ineffective, however, they may just be saying this so i am co-erced into purchasing their £400 propecia. i am very unsure. —Preceding unsigned comment added by 82.47.83.135 (talk) 12:49, 12 March 2008 (UTC)

Prosmin

Prosmin is another brand under which finasteride is sold

As per: http://www.unitedpharmacies.com/Prosmin_Finasteride___5mg_30_Tablets_p_188.html

Could someone add this to the article? Thanks ;-)

ref?

In the text a reference is made to a paper Rossi 2004, however, in the reerences list, this is not mentioned. What could it be?

80.221.61.231 20:40, 27 October 2007 (UTC)

That's probably a reference to the Australian Medicines Handbook. I'll check the history and see if I can track it down. Fvasconcellos (t·c) 01:29, 28 October 2007 (UTC)

Got it. I couldn't find it because it was ported over from Baldness treatments in August 2006; that article, however, didn't have the reference either, because its content had been copied and pasted from Baldness in May 2005. Thank God for page histories :) Fvasconcellos (t·c) 01:36, 28 October 2007 (UTC)

protection

Could a protection template be added to the article, and the reasoning be stated here on the talk page? 132.205.44.5 (talk) 05:16, 22 November 2007 (UTC)

OK, I've added the template. This article has been semi-protected to due persistent long-term vandalism. --Ed (Edgar181) 12:04, 22 November 2007 (UTC)

And not just vandalism: spam and junkpiling. JFW | T@lk 12:20, 22 November 2007 (UTC)

Proscar and Pregnancy

I am an RN and I am about 9 weeks pregnant. I crushed Proscar, put it into a med cup, added water to disolve it to put it down a peg tube. Before doing so, it settled to the bottom of the med cup and I put my pinky finger into the cup and stirred it so that it would not clog up the peg tube. (Before becoming aware of the risks.) 1 hour after, I began having severe cramping. I am worried. What is the rist of birth defects to my baby, with the med crushed in water? I read it absorbs through the skin. Is my risk greatly decreased since the crushed tablet was disolved in water and my skin is in tact? —Preceding unsigned comment added by 76.181.4.47 (talk) 00:35, 9 January 2008 (UTC)

You should seek professional medical advice.Pondle (talk) 20:32, 9 January 2008 (UTC)

Typo?

There appears to be a typo in Finasteride---Brand Names: Here's the quote: "There is 1 mg of Finasteride in Propecia and 5 mg in Proscar." I believe the '5 mg' should be 0.5 mg, that is 1/2 mg, instead of FIVE mg.

No Proscar is a 5 milligram dose, Propecia 1 milligram Pondle (talk) 22:28, 4 March 2008 (UTC)

Antiandrogen

Reference 11 on this page states "Finasteride has no affinity for the androgen receptor and does not act as an anti-androgen, nor does it have androgenic, estrogenic, antiestrogenic, progestational, or other steroidal properties." Clearly this wikipedia entry is in error. —Preceding unsigned comment added by Flying Hamster (talk • contribs) 10:40, 3 April 2008 (UTC)

No this statement is made by the manufacturer. Finasteride is a specific 5AR inhibitor rather than a general anti-androgen.Pondle (talk) 11:49, 12 April 2008 (UTC) I am now injecting 250mg of testoviron depot once a week and injesting 50mg dhea daily to try to raise my testoterone level. I am 65 and in general very good health. I have been taking Tamsulsin Hydrochlorde 0.4mg daily for my enlarged prostrate. If I take finasteride 1mg daily for my thinning hair, will it cause any problems in a reaction with my testosterone treatments?Yours, Spacydick —Preceding unsigned comment added by Spacydick (talk • contribs) 09:43, 23 August 2009 (UTC)

What kind of birth defects occur?

The article does not go into much detail concerning the birth defects that may result from a woman's contact with finasteride while she is with child. The article, however, does not go into a lot of detail on which defects occur. Are the birth defects typically intersex conditions such as non-virilization, or some other type of defect?

Please let me know at your earliest convenience. Pine (talk) 18:45, 11 April 2008 (UTC)

The Proscar product information simply states that if a pregnant woman comes into contact with the drug, "it may affect the normal development of the baby’s sex organs". Pondle (talk) 11:44, 12 April 2008 (UTC)

Please read the following abstract: http://pubs.acs.org/doi/abs/10.1021/jm00161a028 —Preceding unsigned comment added by Yid (talk • contribs) 17:24, 7 April 2010 (UTC)

Compounded Finasteride

The availability (and abundance) of US-manufactured generic finasteride now allows compounding pharmacists to custom-create finasteride capsules in accordance with physician's prescriptions. Prescriptions may be similar to the Propecia (1mg) dose, higher or lower. While dosages similar to the 1mg are not expected to change the pharmacological properties of the medication (safety, efficacy, side-effects, etc.) it is important because it allows patients access to a Propecia-alternative which is less costly than the name-brand, without splitting pills or risky/illegal importing. It is also possible for the physicain to titrate the dose up or down if it is determined that this may be beneficial for the patient. Anecdotal reports of slight decreases in dosing may decrease side-effects.

This is not considered "Generic Propecia" as Merck's patent is still in effect for at least 4 more years and these capsules are custom-made/compounded on a patient-by-patient basis, not manufactured. Typically, compounded finasteride is approxmately 30% less expensive than name-brand propecia, which is significantly cheaper for patients. Propecia has increased in cost on a regular basis in the 10+ years since FDA-approval. Keep in mind that this medication is not typically covered by insurance, and is typically paid for out-of-pocket by patients.

Preliminary research:

1997 FDA Modernization Act: Compounding Pharmacists are not manufacturing drugs, so are exempt from standard FDA regulation on that basis. [3]

2002 US Supreme Court ruled that the FDA could not restrict pharmacists from advertising or promoting products solely because they were compounded

Sept 2006 -- TX judge rules that compounded drugs are not 'new' and not subject to sanction by FDA. [4]

August 2006 -- FDA warns against purchasing/using prescription drugs from "unreliable Canadian websites" that apparently sell illegal, counterfeit products. FDA found that 87% of meds from "Canadian websites" were actually from 27 other countries [5]

[6] Compounding pharmacy that fills physician's prescriptions for custom-compounded finasteride.

[7] page 45; recent info regarding FDA and compounding.

Obviously, this is an issue which is expected to evolve. Dralanbauman (talk) 18:40, 10 August 2008 (UTC)

Synthetic?

Can it be found in nature? Shouldn't the article specify? Or perhaps it is obvious to the expert?
--Jerome Potts (talk) 23:24, 27 August 2008 (UTC)

It's synthetic. I'll note it in the article, which is incidentally in serious need of some cleanup. An interesting (and not overly technical) article on the chemistry of finasteride is available here, at the Virginia Commonwealth University School of Pharmacy website. Fvasconcellos (t·c) 01:38, 28 August 2008 (UTC)

Hip fracture

Finasteride-like drugs don't seem to increase the risk of osteoporosis despite their anti-androgenic effect. Thankyou. http://jama.ama-assn.org/cgi/content/abstract/300/14/1660 JFW | T@lk 22:03, 7 October 2008 (UTC)

Investigation by the Swedish Medical Products Agency

This investigation concluded in late 2008. The Agency has issued new guidance on Propecia, including advice that some users may experience persistent difficulty achieving an errection, even after discontinuing use of Propecia.

A copy of the new advice can be found on the Agency's website, here: http://www.lakemedelsverket.se/upload/SPC_PIL/Pdf/enhumpil/Propecia%20film-coated%20tablet%20ENG.pdf

Currently the finasteride article states that this investigation is still underway. Can someone with the power to do so please update the article?

GoodThought101 (talk) 16:18, 22 December 2008 (UTC)

The wording should be changed to highlight "PERMENANT ERECTICAL DYSFUNCTION" can be caused by Finasteride. —Preceding unsigned comment added by 12.129.211.97 (talk) 19:04, 22 February 2010 (UTC)

The Swedish FDA lists this side effect as 'incidence unknown' and 'based on spontaneous reports.' That should be mentioned. The huge 7 year FCPT and 2 year follow up should count just as much as 'spontaneous reports' with 'unknown incidence'. The take on that 19,000 subject study was: "Now, with ***several studies allaying concerns about the drug’s possible drawbacks, including concerns about sexual dysfunction,*** Thompson believes men should be told routinely about the potential benefits of finasteride when they come to the doctor’s office for a PSA test, in much the same way patients at risk of heart disease are told about the benefits of statin drugs." If anyone can demonstrate actual double blind peer-reviewed research demonstrating persistent (how can we call them permanent) sexual side effects, instead of a governmental agency responding to emails, I'll quickly admit that I was wrong.67.84.209.60 (talk) 21:41, 10 August 2010 (UTC)

According to private correspondence, there is one case of documented permanent erectile dysfunction: "Hello,

To answer the question, there is one spontaneously reported case describing erectile dysfunction, in the Swedish database. Concerning data regarding cases in clinical trials (exposed patients compared to controls) please contact the company.

Best regards; Cecilia Bergengren MD, Clinical assessor Unit for Efficacy and Safety 1 Medical Products Agency Uppsala"

In response to my question: (paraphrased) how many people in "post-marketing" spontaneously claimed this side effect: persistence of erectile dysfunction after discontinuation of treatment with PROPECIA. Steelblade (talk) 15:53, 11 December 2010 (UTC)

wiil nottaking finasteride bring my semen quantity to normal? how long after?

miguel angel ngel —Preceding unsigned comment added by 98.244.204.1 (talk) 07:07, 8 February 2009 (UTC)

Finasteride for Tourette's Syndrome

Apparently some researchers in Italy have reported excellent results in treating certain instances of Tourette's syndrome [8].

'A 34-year-old man with a 25-year history of severe Tourette’s syndrome was referred to our service following a precipitation of his clinical conditions. His symptoms included self-injuring motor tics (i.e., glass smashing and knuckle rubbing against rough surfaces), explosive bouts of complex vocalizations, stereotyped coprolalic utterances, ritual behaviors, aggressive and contamination-theme obsessions, cleaning and checking compulsions, and excessive sexual drive. Magnetic resonance imaging and laboratory tests were normal. His current treatment—initiated 2 years before and included pimozide (4 mg/day), clomipramine (37.5 mg/day), chlorpromazine (25 mg/day), and lorazepam (7.5 mg/day)—had only resulted in a transient, slight decrease of motoric compulsions and anxiety. After obtaining informed consent, we added finasteride (5 mg/day) to his current treatment and periodically assessed his symptoms by means of the Yale Global Tic Severity Scale and Yale-Brown Obsessive Compulsive Scale.

Finasteride gradually reduced both motor and phonic tics. Because of a misunderstanding about the regimen duration, the patient discontinued treatment at week 18. Three days later, he called our service complaining of a dramatic exacerbation in Tourette’s syndrome symptoms. Notably, the prompt reinstatement of finasteride led to a clear clinical improvement. After 28 weeks of treatment, finasteride led to a dramatic reduction in Yale Global Tic Severity Scale (Figure 1) and Yale-Brown Obsessive Compulsive Scale scores (obsessive score: 58.3% initial values; compulsive score: 38.4% initial values). The patient also reported a normalized sex drive, enhanced mood and life quality, and no untoward effects.'

Interesting. Anyone care to work a reference into the article? The page appears to be protected. Although, you have to acknowledge that the regimen of drugs that the patient was on is pretty heavy-duty, including Ativan (lorazepam), Thorazine (chlorpromazine), and other psychotropic/neuroleptic medication. 71.17.52.50 (talk) 06:19, 21 February 2009 (UTC)

I'm sure the the poor bastard is dead by now: reason one. no real meds were given such as neuro-protecting cannabinoids. reason two. if the chlorpromazine didnt get him, the Finasteride surely would have. The FDA IS the conspiracy and are no less than drugcompany-paid assassins. —Preceding unsigned comment added by 4.158.0.26 (talk) 07:40, 7 March 2009 (UTC)

Yeah right, "neuro-protecting cannabinoids" are (possibly the only) real meds and FDA is the conspiracy. --Wayfarer (talk) 19:25, 20 August 2009 (UTC)

reference disapeared

Ref number 17 should be changed with this one http://www.fda.gov/ohrms/dockets/dailys/00/jun00/060700/cp00001.rtf —Preceding unsigned comment added by 132.187.51.130 (talk) 13:58, 5 September 2009 (UTC)

Is a satisfactory article on this subject likely?

As an enthusiastic booster of Wikipedia for almost any kind of inquiry, I hate to see her verge into areas where her model is not particularly applicable. Detailed pharmacology, even detailed examination of adverse effects, is one such area. Evaluating drug safety, effectiveness, interactions, dosage, adverse effects and so forth can only be achieved (at least at the present time) by long-term prospective studies along with rigorously conducted statistical analysis. Even for the best of such studies, interpretations still vary.

This article is now part rehash of published data, part anecdotal material not much above the discussion forum level. I don't see how Wikipedia can realistically do much better in this particularly difficult and unusual realm. —Preceding unsigned comment added by Dratman (talk • contribs) 17:30, 14 October 2009 (UTC)

Irreversible Side Effects

{{editsemiprotected}} there is a number of people who have gotten irreversible side effects due to finasteride. In Sweden they changed the side effects on their manuscript.

It is proven that finasteride can cause irreversible side effects that including erectile disfuntion, brain fog, and low libido. A man named Nicholas Berg speaks about his first hand experience with these irreversible side effects.http://www.propeciasideeffects.com/ http://www.youtube.com/watch?v=2nXWVTStnHs

Also it is talked about many times by dr. John Crisler.http://www.hairlosstreatment.org/dr-john-crisler-permanent-finasteride-propecia-proscar-side-effects/ http://www.youtube.com/watch?v=B8e7HERXA3s —Preceding unsigned comment added by Chiller20 (talk • contribs) 22:34, 10 November 2009 (UTC)

YouTube isn't a reliable source.--Pondle (talk) 22:37, 10 November 2009 (UTC)

YouTube is not a reliable source hence I'm not going to add the requested information into the article. BejinhanTalk 03:34, 11 November 2009 (UTC)

A Neuroendocrinologist named Alan Jacobs now confirms that men "develop(ed) significant degrees of clinical hypogonadism - low sex drive, erectile dysfunction, reduced sexual sensations and listlessness, fatigue and/or "brain fog" - while either taking finasteride or after stopping the medication, even long after stopping it." http://blog.alanjacobsmd.com/alan-jacobs-mds-blog/2010/04/a-neuroendocrine-approach-to-finasteride-side-effects-in-men.html —Preceding unsigned comment added by 208.82.14.213 (talk) 18:11, 24 May 2010 (UTC)

That is a blog, not peer reviewed research, unlike the 5 year Proscar FDA Study (n~=3000), or the FCPT (n~=19,000). The article could mention that the Swedish FDA did add a warning about persistent ED, but it should be noted that the side effect is listed as 'incidence unknown', and based on 'spontaneous reports'. 5.1% of the placebo group had ED in the FDA study, and I'm sure a good portion of those men swear that sugar pills cause ED. The reason I feel it is important to point this out is that those spontaneous reports likely come from a site called propeciahelp.com which links to the FDA-like agencies of various nations, and encourages their user base to contact all of them. The take on the huge (n ~= 19,000) FCPT study says "Now, with several studies allaying concerns about the drug’s possible drawbacks, including concerns about sexual dysfunction, Thompson believes men should be told routinely about the potential benefits of finasteride when they come to the doctor’s office for a PSA test, in much the same way patients at risk of heart disease are told about the benefits of statin drugs." They followed men in their mid 60s for seven years and could not prove persistent ED. In fact, the research is described as 'allaying concerns', not exacerbating them.67.84.209.60 (talk) 21:35, 10 August 2010 (UTC)

BELOW IS A PEER-REVIEWED ARTICLE THAT STRONGLY POINTS TOWARD EVIDENCE OF 5 ALPHA REDUCTASE INHIBITORS CAUSING PERSISTENT (PERMANENT) ERECTILE DYSFUNCTION. IT WAS CONDUCTED BY DR. TRAISH AT THE BOSTON UNIVERSITY COLLEGE OF MEDICINE AND PUBLISHED IN THE JOURNAL OF SEXUAL MEDICINE. WILL SOMEBODY PLEASE UPDATE THE WIKIPEDIA ARTICLE PROPERLY TO WARN THE PUBLIC OF THE POTENTIAL RISKS OF TAKING PROPECIA? http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2010.02157.x/abstract —Preceding unsigned comment added by 76.108.160.140 (talk) 21:29, 25 January 2011 (UTC)

Finasteride vs prostate cancer

Editor182 (talk · contribs) has now twice reinserted the claim that finasteride decreases the risk of prostate cancer, insisting that this was shown by a study published in May 2008. I think this is a typical case of not overemphasising the result of a single study in the WP:LEAD. Primary prevention of any disease is difficult (see e.g. the recent volte face with regards to aspirin in cardiovascular disease), and prostate cancer is no different. It makes little difference whether we state that it is not approved - this is not an accepted use of finasteride. JFW | T@lk 17:43, 10 March 2010 (UTC)

The two interpretations (more high-risk cancers yes or no) of the PCPT data could well be mentioned in the article, provided that no WP:Undue weight is given to either interpretation. I agree with JFW that this doesn't belong in the lead, however. --ἀνυπόδητος (talk) 18:55, 10 March 2010 (UTC)

Sadly Editor182 continues to add mention of this in the lead. It sounds like protection may be needed. JFW | T@lk 22:12, 11 March 2010 (UTC)

Don't go overboard. If the consensus is to exclude prostate cancer prevention from the lead, there's no need for "protection". I merely thought it was worth mentioning as an off-label indication as it is, afterall, mentional as one of three uses for finasteride. I've had to remove "permanent sexual dysfunction" from the lead a number of times, which I find more inappropriate. This allegation should only be mentioned under side effects. If it weren't for a single citation it shouldn't be mentioned at all. In my opinion, there is far more evidence for the potential of prostate cancer prevention or BPH, than "permanent sexual side effects", which are nonetheless worthy of mentioning, but not in the lead. Editor182 (talk) 01:22, 12 March 2010 (UTC)

Here is another study confirming the finasteride cancer prevention study follow up. http://med.stanford.edu/news_releases/2009/july/prostate.html It was done by stanford university, so no one can claim bias by Merck or whoever. It seems clear now that there was measurement bias in the first study, as every time the smaller prostate size on fin is taken into account it is confirmed that finasteride lowers the risk of high grade cancer as well. Also, the follow-up study from 2008 is not just a 'new spin' on old data. They pysically examined the excised prostates of men in the study who underwent prostatectomies. If someone knows of a better way to determine the grade of cancer than by physically examining a prostate after it's removed, I'd be curious to know it. Also, where does the reference for 18% sexual side effects come from? The reference clearly states that in years 2, 3, 4, and 5 of the study, on average, there was no increased incidence of ED or decreased libido between the treatment group and placebo group.67.84.209.60 (talk) 20:55, 10 August 2010 (UTC)

Poor quality image detracting from article

Closing.
The following discussion has been closed. Please do not modify it.
File:Propecia (finasteride).jpg Editor182 is very protective of this image, but in reality it is of very bad technical quality. It is out of focus, over exposed, and taken with a flash. The box nor the tablet itself is in focus. I suggest this image be replaced as soon as possible with a technically sufficient image. As is his history, Editor182 may enter into an edit war with anyone attempting to update the illustrations. However, poor images like this one are detracting from an otherwise very good article. --Kristoferb (talk) 12:42, 27 June 2010 (UTC) Do you think anybody is going to agree to removing an image of brand name Propecia? I'm surprised that you originally replaced this image with your illegitimate (Propecia is still patented) generic version of the drug, which may not even have finasteride in it for all we know. Users who contribute something to this article aren't interested in your personal crusade. Editor182 (talk) 13:29, 27 June 2010 (UTC) Patent laws vary by country - India has legitimate generic versions due to the patent laws in place in that country. Do you understand that? Moreover, many people use Indian generics all over the world. And, finally, I replaced your image not because it is branded (which is irrelevent, since the article is on finasteride and NOT Propecia), but because your image is of poor technical quality. --Kristoferb (talk) 13:35, 27 June 2010 (UTC) You can include both images, I haven't seen any other than the one to the right, but it's really not a big deal.... It's more of the writting that makes an article good, not necessarily the pictures.  – Tommy [message] 13:51, 27 June 2010 (UTC) Thank you, my point exactly. When I came in and saw the image replaced, I simply added it back to the article, rather than returning the favor and replacing the generic image. I hope this case is closed to your satisfaction, Kristoferb, and there's no need for the image here, people can see it in the article. Editor182 (talk) 14:17, 27 June 2010 (UTC) Your image is STILL of poor quality. Why can't you just take a better picture? No flash, in focus with proper lighting? (Also, stop editing my posts.) --Kristoferb (talk) 14:28, 27 June 2010 (UTC) I didn't edit your post, this image belongs in the article, not the discussion page, which is for discussion. This dispute is over. Editor182 (talk) 14:33, 27 June 2010 (UTC) The discussion is ABOUT the image. It is my post - ask me to remove it, don't edit it. The dispute is not over because you say so. Why don't you re-shoot your image properly with some basic level of skill?? --Kristoferb (talk) 14:37, 27 June 2010 (UTC) The image above is fine. It could include the pill in more detail, but it's fine for a reader in all honestly.  – Tommy [message] 15:04, 27 June 2010 (UTC) The pill is totally and completely out of focus: how can that be "fine"? An image of a finesteride tablet where you can't even see the tablet is acceptable in your estimation? I respectfully disagree. I see no pressing reason to set the bar so low when it is relatively simple to take a technically sufficient photo to replace this one with. --Kristoferb (talk) 15:14, 27 June 2010 (UTC) Dude, it's a pink pill, what else do you wanna see?  – Tommy [message] 17:10, 27 June 2010 (UTC) To be honest I don't think that this is really a major issue. There was a proposed guideline on image quality, I think that this photo meets the requirements of clearly portraying what it is supposed to.--Pondle (talk) 17:17, 27 June 2010 (UTC) Do either of you understand what "in focus" means? You can read this if you want to know more: Focus (optics) --Kristoferb (talk) 17:24, 27 June 2010 (UTC) As per proposed guideline on image quality: If the picture is too dark, too light, blurry, or has other issues that cast doubt upon this recognition, the image should be removed from the article, and in some cases, may be deleted. It's not a perfect image by any means, but IMO it's better to have this reasonable photo of a Merck finasteride packet than just an Indian generic or none at all. After all, Merck developed the drug and Propecia is still protected by patent in most countries. If someone with a camera and a packet of Propecia or Proscar can be prevailed upon to take a better pic, then fine. But in the meantime, if you are so concerned about this, you should pursue one of the steps at dispute resolution.--Pondle (talk) 17:32, 27 June 2010 (UTC) My point is that someone should take a new photo that complies with the guidelines of clear, in focus and proper lighting. Editor182 takes this fact very personally. --Kristoferb (talk) 17:35, 27 June 2010 (UTC) TLDR, but there is no point including any image here that is not crisp, clear and in focus - otherwise, what is the point of having an illustration? The image above is none of these and should be removed. --CliffC (talk) 18:37, 27 June 2010 (UTC) I think the point of the picture is to show the brand name, chemical name, the packaging and the pill. Because of the distance, the front is always going to be blurry, unless the camera you used focused on the pill, the background would be blurry.  – Tommy [message] 20:24, 27 June 2010 (UTC) That's not true. If done properly and with a little skill, it can all be in focus. Which is also why this should be removed: a good photo is easy to do. --Kristoferb (talk) 20:42, 27 June 2010 (UTC) Kristoferb, this image has been in the article since December of 2009, why didn't anybody else discuss this here or on my Talk page, or outright removed it much earlier? I could have taken another photograph at that time. The image isn't perfect, but it is definitely not worthy of deletion. Although I do contribute images to Wikipedia, far more of my work is focused on contributing to the written content of articles, but that being said, I have never had image quality questioned on any article, not before the vindictive crusade of Kristoferb, who has all of a sudden questioned multiple images based on their own personal agenda. There is no doubt that the consensus on this image from the majority of established Wikipedia editors would not differ from the rationale Tommy and Pondle have already stated. There really isn't more to be said on this. Editor182 (talk) 07:22, 28 June 2010 (UTC) As CliffC (talk) tells you too, this image is terrible quality. All of your images are terrible quality: which is why they are being replaced. Stop being so sensitive. How does your other edits change the fact that the image is bad? It does not fit the Guidelines and will be deleted as soon as a replacement is found.--Kristoferb (talk) 10:24, 28 June 2010 (UTC) If the imperfections (you admit the image is not perfect) are either being blurry or having poor lighting, then the Guidelines tell us we SHOULD remove the photo from the article. It has already been established that your image is blurry and has poor lighting. If we don't remove this image ASAP, we will be contravening the Guidelines. You can always re-shoot it properly and try to upload it again.--Kristoferb (talk) 14:17, 28 June 2010 (UTC) Has anybody had enough? 4 people are in favor of the image, and 2 are against, but feel free to reopen this case if you disagree. Editor182 (talk) 07:57, 29 June 2010 (UTC) REPLACEMENT IMAGE: You can clearly see detail of the tablet in this image. In the image it replaces, you cannot see the tablet clearly. --Kristoferb (talk) 17:56, 29 June 2010 (UTC) That's a great image, I re-added the Propecia image with the generic below, as it's mentioned in context with the section. But, as I've said before - Do NOT remove disputed images on your OWN accord. This is exactly what you did on the temazepam article. REPLACEMENT IMAGE!!! Guess what? As was the case there, the case is here, I don't want your image gone, the article can have two brand name Propecia images from two different English speaking continents. Let me say this once again, and pay close close attention so it just may get through to your head this time; you're not an administrator. Disputes are discussed, you may not implement your decisions before a consensus. Editor182 (talk) 21:05, 29 June 2010 (UTC) Well, now that we have a good image, we don't need your image anymore. What is there to talk about? The idea was always to replace your image once a replacement was available. They both show the exact same thing - just yours does it badly. Sorry, but you need to get a grip. Now the question is do we keep two images of the same thing - one that meets the Guidelines and one that doesn't? The answer is obviously "no". --Kristoferb (talk) 21:29, 29 June 2010 (UTC) You're well aware that this image does meet the guidelines, as stated by several other users. You need to get a grip. Your image is there, both of them are, and one of them is closer to the lead, but you can't accept the image being in the article at all. Vindictive much? Both the image and generic are situated in a suitable position in the article. The answer is not "no", the answer is UNRESOLVED, because surprise surprise, nobody made you administrator. Wait for user input, do you get it? It's not all up to you. Stop this personal attack. Even if you left and it were up to me, I would leave the layout as it is, because I care about the article, doesn't matter who took what image, and your stance against this being of unacceptable quality is a first. A first on many in the past few days. Editor182 (talk) 22:00, 29 June 2010 (UTC)

Outside party's image opinion

File:Propecia_(finasteride).jpg needs completely removed, it is a bad picture, blown highlights, out of focus. File:Propecia box and tablet.jpg is a fine image, can completely replace the first. I also uploaded some other images as alternatives, although I think File:Propecia box and tablet.jpg is a fine image. — raeky ^{(talk | edits)} 08:40, 30 June 2010 (UTC)

• 
  out of focus & low quality, probably not a good choice
• 
  brand name next to an Indian generic
• 
  crop of the Indian generic
• 
  crop of the brand name
• 
  closeup of a brand name bottle

Also suggest that if File:Generic Propecia.jpg is kept that it be moved further up so it doesn't look weird with the big molecule picture where it is messing with now. — raeky ^{(talk | edits)} 08:42, 30 June 2010 (UTC)

• Editor182 has done a "new" layout including, again, File:Propecia_(finasteride).jpg. --Kristoferb (talk) 13:53, 30 June 2010 (UTC)
  • Yea I saw where he deleted this whole section too on the talk page... very VERY bad form. — raeky ^{(talk | edits)} 23:45, 30 June 2010 (UTC)
    • I had not noticed that, thanks for bringing it up. He clearly cannot understand this is a chemistry page and not one on the brand Porpecia. There is really no point in attempting to parse his arguments as there is little logic or rationality to them. For example, on one hand he argues to keep three (3) images of the brand but simultaneously argues against keeping two (2) images of the generic finasteride tablets when the page, in fact, is entitled "Finasteride": a chemical not a brand. --Kristoferb (talk) 00:13, 1 July 2010 (UTC)

Proposed Image Layout

Generic Finasteride pills

Can we cut to the chase? Please state whether you're for or against the current layout which is viewable on my latest edit on finasteride, and compare it to the version proposed by taking a look at the latest version by Kristoferb. Votes are tallied by numbers, it's time to put an end to this debate. Editor182 (talk) 13:32, 1 July 2010 (UTC)

We don't vote on Wikipedia, we work by consensus. File:Propecia_(finasteride).jpg needs removed and is redundant behind the far superior image File:Propecia_box_and_tablet.jpg and File:Finpecia_from_India_is_Cheap_Propecia.jpg. Consensus is against you, and you've WELL gone beyond violating WP:3RR, so if you manage to not get banned it would be a miracle. — raeky ^{(talk | edits)} 14:17, 1 July 2010 (UTC)

Since I've been contacted to contribute here consider my !vote moot. Regardeless, Editor182, we work on WP:CONSENSUS, and you have none. Frankly, you should have been blocked already per WP:3RR, WP:DISRUPTIVE, WP:CIVIL, and WP:AGF. N419BH 14:57, 1 July 2010 (UTC)

If going light on showing packing is something we want to do, then I suggest File:Generic Propecia.jpg for the generic image. --Kristoferb (talk) 17:45, 1 July 2010 (UTC)

We should avoid packaging and just focus on pills... we don't have any really GOOD closeups of this specific pill, if you have access to them again, I suggest that for a picture... — raeky ^{(talk | edits)} 17:53, 1 July 2010 (UTC)

I can do that without problem. --Kristoferb (talk) 17:54, 1 July 2010 (UTC)

Be sure to upload your images to Commons, if you don't have an account yet, click this magic link: Special:MergeAccount. — raeky ^{(talk | edits)} 18:02, 1 July 2010 (UTC)

Let me know if it is suitable: File:Generic finasteride tablets cipla.jpg --Kristoferb (talk) 18:21, 1 July 2010 (UTC)

Looks good... although those are pretty generic pills, no markings what so ever? lol. Do you still have access to the brand name pills as well? — raeky ^{(talk | edits)} 18:24, 1 July 2010 (UTC)

Well they are what they are... not really our job to judge the subject. (Moreover, as far as Indian generics go, there is a nearly standard packaging of the small foil wrapper with clear plastic on the underside. e.g.:File:Generic Propecia.jpg) I do.--Kristoferb (talk) 18:29, 1 July 2010 (UTC)

It's relevant for a generic, no doubt, and quality is good. You didn't answer the question about the brand names ;-) — raeky ^{(talk | edits)} 18:31, 1 July 2010 (UTC)

I did, actually. I said 'I do'. --Kristoferb (talk) 18:33, 1 July 2010 (UTC)

Sorry I missed that. ;-) — raeky ^{(talk | edits)} 18:35, 1 July 2010 (UTC)

So you don't want to marry me? That's highly disapointing. ;-) --Kristoferb (talk) 18:39, 1 July 2010 (UTC)

I think a good quality picture of generic and brand name pills would be more then sufficient for the article, then we can get rid of the trademarked packaging altogether. And no comment on the marriage part, lol. — raeky ^{(talk | edits)} 18:42, 1 July 2010 (UTC)

Very well, I'll see what I can do. In general, my criteria for these technical images is merely to be in focus and on some neutral background. I really dislike these images taken on the kitchen counter with the stove and cupboards in the background. That's not very encyclopaedic. --Kristoferb (talk) 18:46, 1 July 2010 (UTC)

I agree with the backgrounds. — raeky ^{(talk | edits)} 18:48, 1 July 2010 (UTC)

What's wrong with including an image of the packaging? Surely the label an essential aspect of patient information.--Pondle (talk) 18:59, 2 July 2010 (UTC)

I don't have anything against packaging either, but this is an encyclopaedia not a patient information leaflet. The image is to illustrate, not to provide definitive guidance to users. Moreover, no matter ones view of the aforementioned, ANY image used on Wikipedia must meet certain basic technical standards of photographic quality to be considered for inclusion. --Kristoferb (talk) 19:18, 2 July 2010 (UTC)

I think that in at least this case, including the packaging would be helpful. As a comment, I hope I never get my no-name, no-stamp generic finasteride pills mixed up with my no-name, no-stamp cyanide pills. --CliffC (talk) 19:26, 2 July 2010 (UTC)

Most Indian generics are dispensed in foil packets of 10 tablets, one used per day or dose. The foil packet contains all the relevent information and the tablets are normally not seperated from the package except at time of use. E.g.:File:Generic Propecia.jpg--Kristoferb (talk) 19:32, 2 July 2010 (UTC)

Ugh. As an uninvolved Admin -- who also reads articles in the areas I have little expertise -- do we really need images for these drugs at all? What the Physicians' Desk Reference does is furnish images of the pills themselves, not their packaging, in case they are separated from their labelled container; I don't see any other need for an image, unless there the packaging is discussed in the article. AFAIK, these pills are identical throughout the world, due to economies in mass production; if they are different in different countries, then a photo would be of use. We could reproduce that by creating image templates, say {{infobox capsule|size=regular|label="50 mg"|shape=round|color=yellow}}, & then we do the politically correct thing & delete all of these presumably Fair use unfree images.

llywrch (talk) 16:36, 1 July 2010 (UTC)

That is the quote I was referring too above from the ANI post... I tend to agree with him, that we should move the drug articles more along those lines of having clear images of the medications themselves for reference purposes, although the logistics of that might be near impossible for us. The packaging themselves doesn't serve much in the EV realm, imho, since either the patient won't ever see the pharmacy packaging and just get them in a generic pill bottle or for the admin's stated reasoning of needing to identify a lone pill separated from it's packaging. — raeky ^{(talk | edits)} 19:28, 2 July 2010 (UTC)

About 55% of all prescriptions are dispensed with a generic equivalent. This means images of the original brand are, indeed, irrelevant to over half of perspective readers. It is misguided in the extreme to enforce some quai policy of brand name image prominence or exclusivity in articles on chemical compounds. Where brands are significant in their own right, a separate article is created for them (i.e.: Panadol or Tylenol.) Generic drug images play an important and indeed crucial educational role in the article. Without them, readers are given the incorrect impression that the brand name version is the only legitimate formulation, which is plainly false. Omission of illustrative examples of generics casts doubt on their legitimacy by conspicuous omission from an article ostensibly on the generic formulation (i.e.: the chemical compound not the brand). This is an encyclopaedia, not the marketing department of Merk or Pfizer.--Kristoferb (talk) 19:32, 2 July 2010 (UTC)

I'm not saying that we should include the label for patient information purposes, simply that medicine packaging is supposed to clearly and unambiguously identify the product, therefore IMO is just as relevant to the article as showing pics of the pills themselves. I'm happy to include images of Indian generics including their packets, but we should remember that Propecia is still patent protected in most countries and therefore the brand is (for now) the only legitimate 1mg dose of finasteride on the market outside India.--Pondle (talk) 19:40, 2 July 2010 (UTC)

(ec)I've already read that, and I agree. What I'd personally like to see is a series of high quality images like File:Temazepam_DOJ.jpg (Without the text) of basically every prescription drug, brand name and dosage and generics, etc... be made available for us. Then we could create those templates and standardize how we present the images on the drug pages. But thats where I tend to think that might be logistically impossible for us.. but it's where I'd like to see the "ideal" illustration go for drug pages. As for packaging, I don't see it having much value to the reader since unless it's an over-the-counter medication or some special medication it MOST LIKELY will be dispensed like File:Temazepam-bottle.jpg, at least here in the united states thats how almost all medications in pill form is dispensed. Blister packs are I think kinda rare here. — raeky ^{(talk | edits)} 19:41, 2 July 2010 (UTC)

Other places produce legal generics of Propecia too. The situation is different depending on the laws of the nation in question. In general, I have no issue with packaging, but I just want to avoid any discussion on from which country it can and cannot be from. It should be recognized from the outset that Propecia packaging is likely to vary by market and showing them all is impossible. It is only illustrative, not a definitive worldwide, constantly updated Propecia packaging database.--Kristoferb (talk) 19:46, 2 July 2010 (UTC)

I firmly agree that generics need to be illustrated as favorably as brand names, even if there is no generics available in the primary markets due to patents still active, so Indian generics would be relevant since they are obtainable by people. As for packaging, I think pill pictures are of much greater EV over their packaging, and that would be how i'd rate pictures, having a clear shot of the pill will be more favorable then a nice picture of a box. — raeky ^{(talk | edits)} 19:51, 2 July 2010 (UTC)

If this was a directory of drugs, I would clearly agree with you. But, as you say, I am not sure that is practicable for this type of endeavour. I personally include packaging merely to give an indication of the type of markings likely to be on the medication as dispensed by the pharmacy. I think that is the proper ambit for an encyclopaedia of general knowledge (rather than a specialist publication). —Preceding unsigned comment added by Kristoferb (talk • contribs) 19:56, 2 July 2010 (UTC)

Probably, and I would think if we did ever acquire the specialized pill pictures to do that project it would be in complement with other pictures in the article which would naturally include packaging for some drugs. As packaging photography, I think it would be important to also include the pill in with the packaging though. — raeky ^{(talk | edits)} 19:59, 2 July 2010 (UTC)

No question, I don't think showing just a cardboard box is sufficient. --Kristoferb (talk) 20:03, 2 July 2010 (UTC)

New studies of sexual side effects of finasteride

here is one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840927/ not sure about it's credibility anyone have others? —Preceding unsigned comment added by 124.188.96.167 (talk) 12:30, 20 July 2010 (UTC)

Side Effects Listed Do Not Match The Reference

The reference is drugs.com.

The Side Effects Listed in the source are:

TABLE 2. Drug-Related Adverse Experiences for PROSCAR (finasteride 5 mg) BENIGN PROSTATIC HYPERPLASIA N = 1524 and 1516, finasteride vs placebo, respectively

.

YEAR 1 Impotence- 8.1 vs 3.7 Decreased Libido 6.4 vs 3.4

YEARS- 2, 3, 4: Impotence 5.1 vs 5.1 Decreased Libido 2.6 vs 2.6

http://www.drugs.com/sfx/propecia-side-effects.html#ixzz0vhaRJxr4

The article makes no mention of the fact that there is no significant difference in ED and Decreased Libido after the first year of treatment. It also, inexplicably, puts the incidence of ED at > 18%!67.84.209.60 (talk) 04:24, 5 August 2010 (UTC)

You can be bold and add the reference and data yourself... — raekyT 04:27, 5 August 2010 (UTC)

I can't edit this page, and I don't feel like making an account on the assumption that is the problem.67.84.209.60 (talk) 09:38, 5 August 2010 (UTC)

To edit this page you do have to have an account... — raekyT 22:00, 10 August 2010 (UTC)

Edit request from 128.36.205.2, 20 October 2010

{{edit semi-protected}} The link to source #13, the Swedish leaflet, doesn't work. The correct link should be: http://www.lakemedelsverket.se/SPC_PIL/Pdf/humpil/Propecia%201%20mg%20tablet.pdf 128.36.205.2 (talk) 16:00, 20 October 2010 (UTC)

Done. Thanks. -Atmoz (talk) 21:22, 20 October 2010 (UTC)

New Study - October 2010

A new study published in the "Archives of Dermatology" concludes that 1 in 80 finasteride users experience erectile dysfunction. http://www.reuters.com/article/idUSTRE69J3IW20101020 - Could someone please add this new info to the article. 86.163.201.239 (talk) 01:43, 23 October 2010 (UTC)

Environmental persistence?

From the description, it appears that this could be considered an endocrine disruptor in women. Once it leaves the patient's body, is it substantially destroyed in the waste water treatment process before release into the environment? If not, is it persistent in the environment such that it could be ingested unintentionally in drinking water? This pattern is believed to occur with certain other endocrine disruptors and is a matter of environmental concern. I don't currently have access to a university library so I can't search the journals for an answer to these questions, but if this topic has been researched it may be notable for the article. 96.228.129.74 (talk) 07:38, 10 November 2010 (UTC)

Controversy and Lawsuit

On January 24th 2010, the law firm Klein Lyons has filed a class action lawsuit against Merck Frosst Canada and its affiliated companies on behalf of Canadian men who used Propecia or Proscar and suffered continuing sexual dysfunction. press release Schpes (talk) 14:16, 29 January 2011 (UTC)

The lawsuit itself is only worth including in the article once it's resolved, and even then it depends on what happens. It might be worth mentioning the disagreement over whether symptoms actually do resolve on discontinuation, but the sources I'm used to looking at (e.g. this one) state that side effects are reversible and a quick web search doesn't turn up anything from a reliable source to put in the article. There's a comment that EU labeling has been modified, but I'm not that familiar with EMEA's website and I can't find it. The MHRA's website has a couple of approvals for generic finasteride at the 1mg and 5mg level, but I don't see anything about this complaint in there. I did find one BBC news blog that mentioned the controversy, but I'm hesitant to include blogs even if news blogs are technically capable of meeting WP:RS. SDY (talk) 16:24, 29 January 2011 (UTC)

Post-Finasteride Syndrome

I think it is imperative that Wikipedia has a section on Post-Finasteride Syndrome. I tried to post a section yesterday, however JFDWOLFF removed my posting due to the notion that it was "overblown" and some of the sources were not reliable. First, the idea that Propecia has severe long term side effects should not be surprising as it works as a 5-alpha reductase inhibitor. While Merck does not disclose the following information for obvious reasons, a 5-alpha reductase deficiency (from birth) results in a clinical state called pseudo hermaphroditism. Please see http://en.wikipedia.org/wiki/5-alpha-reductase_deficiency

Many people ignorantly dispel the ability of Propecia to cause permanent sexual side effects. However there is a forum (Propeciahelp.com) where nearly 2,000 registered users (many in their 20's) describe their cases of having sexual side effects after having taken the drug. This on its own is a statistically significant number that would warrant a serious consideration and there are many other additional victims of Propecia that have not registered for the forum. It really should come as no surprise that this is possible, given the same exact pharmaceutical company concealed thousands of deaths from one of their products in a conspiracy that was uncovered about five years ago.

A considerable number of doctors have begun research into this syndrome and there is published literature that demonstrates evidence for the existence of PFS. Additionally, several European regulatory bodies have conducted studies and concluded that Propecia can in fact cause permanent sexual side effects. This could easily be misconstrued as "overblown" due to the ease at which the media could sensationalize such a story, but it is very devastating for a drug to be effectively chemically castrating its patients in their twenties.

Without the need for further support, I think it is ABSOLUTELY NECESSARY that this be reported on Wikipedia, even if the condition is rare. Many people trust Wikipedia as a reliable source for information and know very little about human biology and medicine which can allow them to make dangerously uninformed decisions about their health. Those who see this discussion, please respond if you are against posting this information and exactly why so I can determine the proper way to do it. If I do not receive any substantive responses in the next week, I will assume that it will be considered an appropriate topic to list on the Finasteride page.

- Doors 22 — Preceding unsigned comment added by Doors22 (talk • contribs) 19:00, 2 February 2011 (UTC)

People feel they can trust Wikipedia because we absolutely insist on specific citations from reliable sources to support claims. No matter how many blogs report it, no matter how many people claim to have credentials and know inside info that is being covered up by a government or company, none of that matters because none of that is a reliable source. If it's important and there is actual vetted public information about it, it will be in scientific journals, mainstream major newspapers, etc. If it's not yet verified from those sources, well, verification is a non-negotiable requirement--every reader must be able to check for him/herself rather than trusting another editor's word. Even if it's the truth, it can't be here until it's got an available source. WP:MEDRS is a good page about the level of referencing needed. DMacks (talk) 19:17, 2 February 2011 (UTC)

Thanks for your response, DMacks. I will list several sources that should provide substantial evidence for inclusion including an article published in a medical journal, a write-up in the BBC, and links to investigations launched by the Swedish regulatory body (already listed on the article). As mentioned in the section immediately above, a lawsuit has been filed in Canada which I feel is notable. This is really just a start. I'm not proposing to include this is as irrefutable truth as it will be exposed in the near future, but these reports and complaints and certainly warrant a section highlighting the controversy surrounding Propecia. I think it would be worth mentioning the existence of PropeciaHelp.com. Assuming it is entirely fallacious (which is not the point I want to make) it is notable that a movement has organized against the drug in substantial numbers. With the following sources, would you now agree it is worth of inclusion?

http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2010.02157.x/full

http://www.bbc.co.uk/newsbeat/12040303

http://www.lakemedelsverket.se/Alla-nyheter/NYHETER-2006/Ger-Propecia-nedsatt-sexuell-funktion-efter-avslutad-behandling/

Propecia Help Dot Com (type into browser because it is blacklisted for some reason) - I do not intend this one to be used as a scientific source, but its existence alone is notable. Additionally, will you help me figure out exactly why this website is blacklisted?

If there are problems with these sources or a lack of evidence, please let me know and I will gather some more information. Thanks.

Doors22 (talk) 20:25, 2 February 2011 (UTC)

OK, nobody responded with any reasons that the section should not be included. Please do not remove the section since I have already attempted to have a discussion about it on here. If you have problems with the addition, I will be happy to discuss them on the talk page. Doors22 (talk) 18:53, 7 February 2011 (UTC)

I have a problem with it, and you even posted on my talkpage and I gave you a response. At the moment I can only recommend that you avoid the alarmist language (there is no "controversy" as far as I can see), that you use only the J Sex Med article after it has appeared in print (because it is the most reliable source available), and that you integrate the content with the present text of the article rather than in a separate paragraph. JFW | T@lk 19:57, 7 February 2011 (UTC)

I took the suggestions from your talk page. If you took the time to look at the articles I posted, you would see that it is actually a literature review which is the highest quality of medical evidence according to [WP:MEDRS]. The controversy is obvious. There is substantial evidence that Merck has mislabeled the side effects on the PCI which have the potential to truly ruin the lives of those who naively take the drug. The fact that there is a class action lawsuit pending is additional evidence of a 'controversy'. The alarmist sub-section is basically a public service announcement to ensure to those who are properly informed to the possible consequences of taking the drug so they don't naively destroy their lives. I don't see how you have a monopoly on authority to revert my posts, so I request that you edit what you feel is inappropriate rather than take down my work. Prior WIki users have posted on this discussion that the controversy is worth mentioning. You seem to be the only one to have a problem with these edits. I will stand corrected it anybody else decides to opine. Doors22 (talk) 21:08, 7 February 2011 (UTC)

This is an encyclopedia, not a forum for public service announcements. I'm not the only person troubled by the tone of your additions; DMacks has done the same. JFW | T@lk 21:24, 7 February 2011 (UTC)

From your reinsertion of the same content, without an attempt to follow my recommendations, I deduce that you are not interested in forming any degree of consensus. It would not be good if the article was locked, but this will be the next step. JFW | T@lk 21:41, 7 February 2011 (UTC)