Efficacy And Safety Of Topical Solution Of 0.25% Finasteride Admixed With 3% Minoxidil

[alscarmuzza]

A randomized, double-blind controlled study of the efficacy and safety of topical solution of 0.25% finasteride admixed with 3% minoxidil versus 3% minoxidil solution in the treatment of male androgenetic alopecia.
Authors:
Suchonwanit P; Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Srisuwanwattana P; Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Chalermroj N; Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Khunkhet S; Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Source:
Journal Of The European Academy Of Dermatology And Venereology: JEADV [J Eur Acad Dermatol Venereol] 2018 Jul 04. Date of Electronic Publication: 2018 Jul 04.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9216037 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1468-3083 (Electronic) Linking ISSN: 09269959 NLM ISO Abbreviation: J Eur Acad Dermatol Venereol
Imprint Name(s):
Publication: Oxford : Wiley-Blackwell
Original Publication: Amsterdam ; New York : Elsevier Science Publishers, c1992-
Abstract:
Background: The synergism of combined use between oral finasteride and topical minoxidil has been established in treating androgenetic alopecia among men. However, the concern regarding adverse effects of finasteride use has been rising.
Objective: To compare the efficacy and safety of topical solution of 0.25% finasteride admixed with 3% minoxidil versus 3% minoxidil solution in men with androgenetic alopecia.
Methods: Forty men aged 18 to 60 years with androgenetic alopecia were randomized to 24 weeks of treatment with a finasteride/minoxidil or minoxidil solution twice daily. Primary efficacy endpoint was the change from baseline in hair density and hair diameter at week 24. Secondary endpoints included global photographic assessment by treatment-blinded investigators and subjects. Changes in plasma dihydrotestosterone levels and adverse events were recorded.
Results: At week 24, the combined solution of finasteride and minoxidil was significantly superior to minoxidil alone in improvements of hair density, hair diameter and global photographic assessment (all P < 0.05). About 90% of patients treated with the combined solution experienced moderate to marked improvement. The combined solution also had minimal effect on plasma dihydrotestosterone levels, approximately 5% reduction. There were also no systemic adverse events reported by patients in both groups.
Conclusion: Treatment with topical solution of 0.25% finasteride admixed with 3% minoxidil was significantly superior to 3% minoxidil solution for promoting hair growth in male androgenetic alopecia, and well tolerated. This article is protected by copyright. All rights reserved.
(This article is protected by copyright. All rights reserved.)
Contributed Indexing:
Keywords: androgenetic alopecia; finasteride; male pattern hair loss; topical finasteride; topical minoxidil
Entry Date(s):
Date Created: 20180705 Latest Revision: 20180704
Update Code:
20180705
DOI:
10.1111/jdv.15171

 

[Trichosan]

Been using using that combo plus bimatoprost added for over a year now. No significant improvement in terms of new hair growth.

 

[washed_up]

If companies started offering this I would probably use it in conjunction with Finasteride itself because I had zero side effects. Lots of studies coming out on finasteride and minoxidil combo.

Polichem P-3074 is a topical finasteride that just concluded their phase III trials. It could come to market sometime next year.

It's interesting that this study shows a much lower reduction of systemic DHT than they did.

 

[Btg]

does it say anywhere how much topical finasteride they applied ?

 

[Badbald]

This is great news guys showing that it hardly goes systematic, DHT reduction at 5% is amazing! I dont understand why more people aren't looking into this instead of sticking with "finasteride is finasteride it has to go systematic to work" it sort of blows my mind that so many people on this forum are looking for a side effect free way of oral finasteride like results yet hardly anyone is willing to consider trying the topical which could be their solution.

I am confused about these percentage concentrations though, please point me out if im being extremely stupid but how is it possible this has the dose of 0.25% is effective but Hasson and Wong is 2.5%

Polichem P-3074 is a topical finasteride that just concluded their phase III trials. It could come to market sometime next year.

It's interesting that this study shows a much lower reduction of systemic DHT than they did.

when you say shows a much lower reduction of systematic DHT are you talking about the polichem studies? because I thought no results had been released

 

[FinasterideCessation2018]

does it say anywhere how much topical finasteride they applied ?

I read the paper.

Participants were randomized to apply 1 mL of either FMX or MX solution twice daily for 24 weeks.

I think the results are pretty impressive with no systemic absorption.

They used a liquid with 0.25% finasteride and 3% minoxidil in an ethanol/propylene glycol/water base.

Is it possible to copy that mixture?

 

[Fahad]

Whats the different between this and morr-f and minoxidilmax ?
Sorry i dont know alot about these things

 

[Btg]

I read the paper.

Participants were randomized to apply 1 mL of either FMX or MX solution twice daily for 24 weeks.

I think the results are pretty impressive with no systemic absorption.

They used a liquid with 0.25% finasteride and 3% minoxidil in an ethanol/propylene glycol/water base.

Is it possible to copy that mixture?

so they used 2.5 mg and got minimal plasma reduction ? even p3074 couldnt contain more than 0.6mg from reaching the prostate

 

[FinasterideCessation2018]

The study sayss that the finasteride/Minoxidil solution decreased plasma DHT levels by approx 5% at the sixth month.

That's pretty impressive.

I don't know how much mg you need to Reach the 0,25% solution tho

 

[FinasterideCessation2018]

... I would start treatment immediately if this topical would be available.

The results are great. Much better than Minoxidil alone

 

[Trichosan]

... I would start treatment immediately if this topical would be available.

The results are great. Much better than Minoxidil alone

Call Regenere, they might compound it for you. Or Murray Avenue Apothecary. USA companies and you pay an additional of about $50, for MD to write the prescription.

 

[Fgsfds]

That's 2.5 mg per ml, not 25.

See: Effects of a novel finasteride 0.25% topical solution on scalp and serum dihydrotestosterone in healthy men with androgenetic alopecia. (2016)

RESULTS:
Change from baseline in scalp DHT was -70% for P-3074 o.d. and approx. -50% for P-3074 b.i.d. and the tablet. Serum DHT decreased by 60 - 70%. The doses of 100 and 200 μL P-3074 resulted in a -47/-52% scalp DHT reduction, similar to the 300 and 400 μL doses (i.e., -37/-54%). A -5.6% inhibition was observed for the vehicle. Serum DHT was reduced by only -24/-26% with 100 and 200 μL P-3074 and by -44/-48% with 300 and 400 μL P-3074. No relevant changes occurred for serum testosterone.


This study has a similar amount (0.25% topical finasteride) hitting serum levels hard. Only the super tiny 100/200 microliter doses didn't ruin their nuts.

How do we resolve this inconsistency?

My guess is this study is bunk and the "topical finasteride is only as effective as it goes systematic" hypothesis remains true.

There seems to be a nonlinear relationship between serum/scalp DHT at low doses of finasteride though, so any oddities are probably stemming from a tiny amount going systemetic.

 

[orphanfunkhouser]

why isnt this being sold?

 

[FinasterideCessation2018]

My guess is this study is bunk and the "topical finasteride is only as effective as it goes systematic" hypothesis remains true.

There seems to be a nonlinear relationship between serum/scalp DHT at low doses of finasteride though, so any oddities are probably stemming from a tiny amount going systemetic.

have you read the paper?

it cleary shows finasteride-minoxidil topical is far superior compared to minoxidil only.

perhaps the systemic action depends on the vehicle that is used? in this study it seemed that they have found the ideal one.

 

[reuters]

i use topical 0,1%finasteride with 10%minoxidil and started bald, but had regrowth (still bald but less than before) and am happy with the result i had considering age and nw7
i had no side effects at all after the first 10 days when i could feel dizzy.

 

[Fgsfds]

have you read the paper?

it cleary shows finasteride-minoxidil topical is far superior compared to minoxidil only.

perhaps the systemic action depends on the vehicle that is used? in this study it seemed that they have found the ideal one.

Of course it's more effective than minoxidil. Duh.

I posted a sobering study that will dissappoint those who expect to get similar (lack of) serum DHT reduction using 2.5 mg topical finasteride.

It could be the vehicle as you suggest.

 

[hilbert]

finasteride doesn't have to go systemic to work on follicles... but it does, in most of the cases.

 

[FinasterideCessation2018]

So in the m

Of course it's more effective than minoxidil. Duh.

I posted a sobering study that will dissappoint those who expect to get similar (lack of) serum DHT reduction using 2.5 mg topical finasteride.

It could be the vehicle as you suggest.

So they have to commercial release the Formulation of this study, cause it didn't get systemic and has great results.

Please read the paper.

 

[FutureSaitama]

Just this morning I was thinking of asking farmacia Parati to add to my topical finasteride gel 5% minoxidil. In theory, liposomal minoxidil should work better than the alcohol one, because it's basically anchored there by the liposomes, thus it stays longer. What do you guys think about this ?

 

[nmcbs]

I believe you guys are refering to this study/paper (attached). The theory/practice seems interesting even if is a short/experimental study. In any case yes Farmacia Parati does galenic formulations by request. Meaning in the concentration you want (or your doctors want/advise). Finally I´ve find a doctor here in my country Portugal that actually works with them so i can get a prescription. I will begin with 0,05% finasteride topical formulation (no minoxidil added) and see what happens. Now bare in mind that Caserini study and Parati formulations use different veichles. The first one uses HPCH (Hydroxylpopyl chitosan) film-forming technology and Parati uses lipossomes. Also applying to the scalp is a different story that taking an oral dose, in terms of absorbtion, ability to reach the right receptors in the folicular unit/bulb to be effective, systemic/peripheric reach, practicability, state of your hairloss,.... Thats why i believe topical finasteride for some doctors still isnt so mainstream.