Rankings / Hormones & Endocrine

Finasteride (oral / topical)

Hormones & Endocrine · 5-alpha reductase inhibitor (type II)

Also known as: Propecia ·Proscar

Tier A-

Reviewed by Read Off Label · Last reviewed · How we grade

5-ar-inhibitorprescription
7.6 / 10
Tier A-
Ev 8 Bn 8 Sf 7

Bottom line

Read Off Label grades Finasteride (oral / topical) as A- (7.6/10) based on strong evidence, strong benefit magnitude, and a low-med-risk safety profile.

Topical formulations aim to reduce systemic exposure and sexual side effects; emerging RCT data (Piraccini 2022) shows similar efficacy with lower systemic DHT reduction.

Typical use: Oral: 1 mg/day (AGA) or 5 mg/day (BPH); topical 0. — Rx.

What this is

Topical formulations aim to reduce systemic exposure and sexual side effects; emerging RCT data (Piraccini 2022) shows similar efficacy with lower systemic DHT reduction. PFS (post-finasteride syndrome) is a real patient complaint pattern, though incidence debated — reasonable to counsel. Women of childbearing age must avoid due to fetal risk.

Mechanism

Selective inhibitor of 5-alpha reductase type II; reduces DHT ~70% systemically (oral) or locally (topical); preserves/regrows hair in androgenetic alopecia; also FDA-approved for BPH

Dose & route

Oral: 1 mg/day (AGA) or 5 mg/day (BPH); topical 0.25-0.5% solution (compounded)

Citations

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Common questions

Does Finasteride (oral / topical) work?
Read Off Label rates the evidence for Finasteride (oral / topical) as Strong and the benefit magnitude as strong, producing an overall grade of A- (7.6/10). Topical formulations aim to reduce systemic exposure and sexual side effects; emerging RCT data (Piraccini 2022) shows similar efficacy with lower systemic DHT reduction.
Is Finasteride (oral / topical) safe?
Finasteride (oral / topical) has a low-med risk profile in published human data. Legal status: Rx. This is not medical advice — see the disclaimer.
What is the typical dose for Finasteride (oral / topical)?
Oral: 1 mg/day (AGA) or 5 mg/day (BPH); topical 0.25-0.5% solution (compounded)
How does Finasteride (oral / topical) work?
Selective inhibitor of 5-alpha reductase type II; reduces DHT ~70% systemically (oral) or locally (topical); preserves/regrows hair in androgenetic alopecia; also FDA-approved for BPH

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.