Possible hepatotoxicity of drugs:
Finasteride:
"Finasteride has been associated with a low rate of serum aminotransferase elevations that, in controlled trials, was no higher than with placebo therapy. These elevations were transient and rarely required dose modification, and have occurred with both the 5 mg dose for prostatic hypertrophy and the 1 mg dose for hair growth. There have been published reports of transient serum enzyme elevations occurring during finasteride therapy, but none of clinically apparent liver injury.
Likelihood score: E (unlikely cause of clinically apparent liver injury)."
Bicalutamide:
Bicalutamide therapy is associated with mild, asymptomatic and transient elevations in serum aminotransferase levels in approximately 6% of patients. The frequency and height of the ALT elevations appears to be less with bicalutamide than flutamide. Similarly, there have been rare case reports of clinically apparent liver injury due to bicalutamide, but less frequently than with flutamide. In the Spanish pharmacovigilance study, there were 11 reports of hepatotoxicity from bicalutamide, none of which were fatal. On the other hand, the product label for bicalutamide mentions that a few cases of fatal hepatic failure have been reported. The clinical pattern of liver injury with bicalutamide appears to resemble that of flutamide. The latency to onset is usually 2 to 3 months, but can be shorter with reexposure and occasionally arises 4 to 6 months after starting. The typical pattern of serum enzyme elevations is hepatocellular and severe, fulminant cases have been described. Rash, fever and eosinophilia are not common and autoantibody formation is not described.
Likelihood score: B (likely cause of clinically apparent liver injury).
Raloxifene:
In large, prelicensure clinical trials, the rate of serum enzyme elevations during raloxifene therapy was less than 1% and was no higher than with placebo or comparator arms. In addition, no episodes of hepatitis or clinically apparent liver injury attributable to raloxifene were reported. In the two decades since its approval and wide scale use, there have been isolated reports of liver injury attributed to raloxifene. One report described a case of cholestatic hepatitis arising a month after starting raloxifene which resolved with stopping, but full recovery was delayed (Case 1). The injury was accompanied by mild immunoallergic features, but autoantibodies were not present. A second case of cholestatic hepatitis was reported in a patient on long term raloxifene who had been started on fenofibrate two weeks before the onset of jaundice. The injury was attributed to the combination of the two agents and possible drug-drug interactions. Finally, several cases of an exacerbation of nonalcoholic steatohepatitis during raloxifene therapy have been reported, a pattern of injury that has been reported more commonly with tamoxifen. Thus, raloxifene may be a rare cause of liver injury, but the relationship to the drug has not been very well established.
Likelihood score: C (probable rare cause of clinically apparent liver injury).
Minoxidl (oral):
Serum aminotransferase elevations during oral minoxidil therapy are uncommon, but have been reported even with topical administration. Despite many decades of use, oral minoxidil has not been implicated in convincing cases of clinically apparent acute liver injury. Severe rash, toxic epidermal necrolysis and Stevens Johnson syndrome have been reported after minoxidil therapy (generally arising within 2 to 6 weeks of starting), but published cases have not been marked by concurrent hepatic injury.
Likelihood score: E (unlikely cause of clinically apparent liver injury).
Dutasteride:
"Dutasteride has been associated with a low rate of serum aminotransferase elevations that, in controlled trials, was no higher than with placebo therapy. These elevations were transient and rarely required dose modification. There have been no published reports of clinically apparent liver injury due to dutasteride therapy.
Likelihood score: E (unlikely cause of clinically apparent liver injury)."
TL; DR:
Finasteride is safe for long term use.
Oral Minoxidil is safe for long term use.
Raloxifene might be safe, there shouldn't be problems either, only, if you have a sensitive liver. An overreaction leads to problems, so always keep an eye on the liver for the first weeks when starting a drug, if you are doing great, your future-time may be bright! Lol
Bicalutamide should be the only concern, because it's metabolites may inhibit the enzyms which process the medication. But this is rare -> see the experience I posted earlier with the member's grandpa, tho that is anecdotal again...
Dutasteride gets processed in the same way as Finasteride and Bicalutamide, + through another system. It would be good, if you would rely on Finasteride.
Either choose for Finasteride OR Dutasteride, because then it might be that you OVERRUN your liver+body with too many drugs.
My only concern is that Finasteride and Bicalutamide get both processed by the "cytochrome P450 system".
This may be a problem if your liver can't handle both medications at the same time.
If you live a healthy life style and your liver is doing super good and has no damage to start with, there shouldn't be a problem. It would be wise to make a break after a long term use (of 4-5 years) for 15-19 weeks, to let your liver and the metabolizing systems regenerate.
It would be as well good if you would test your levels (blood levels, hormone levels and liver levels) every 3-6 months.
In my eyes; if you are a healthy person, it's safe, but make sure to check every 3-6 months and make a break after a long session of a few years.
@Almas
@Hair attack
@nicoandgello
Sorry for overrunning you guys, but please make sure to read it, this is not a joke or candy, we take.
Stay healthy!
And hairy! Lol