"Flutamide at a dose of 250 mg daily induced a modest improvement in alopecia after 1 year, whereas cyproterone acetate and finasteride were not effective. Treatment for more than 1 year may be required for better results."
source: https://www.ncbi.nlm.nih.gov/pubmed?term=12524069
This tells us that low dose flutamide monotherapy (250 mg) let to improvement in hair loss scores, whilst cyproterone acetate (50 mg) combined with ethinyl estradiol (EE), and finasteride (5 mg) daily did not.
Note: (750mg Flutamide = 50mg Bicalutamide)
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"After only 6 months of therapy, flutamide caused a maximal reduction in the hirsutism score to a value within almost normal range; during the same period, spironolactone caused only a 30% reduction of the hirsutism score. Whereas flutamide caused a dramatic (80%) decrease in total acne, seborrhea, and hair loss score after only 3 months of therapy, spironolactone caused only a 50% reduction in acne and seborrhea, with no significant effect on the hair loss score."
source: https://www.ncbi.nlm.nih.gov/pubmed?term=8299783
This tells us that when either flutamide or spironolactone was in association with a triphasic oral contraceptive (OC) pill, the group that used flutamide had a 30% more decrease in total acne and seborrhea scores, 70% more decrease in hirsutism scores, and a 80% more decrease in hair loss scores that the group that took spironolactone.
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Methods: The cohort included 101 women diagnosed with FPHL from January 1991 to January 2006 (study was published in 2011 and was started in 2007). These women received yearly reducing doses (250, 125, and 62.5 mg/day) of flutamide for 4 years. The cohort included 33 patients treated with flutamide alone and 68 treated with flutamide combined with an oral contraceptive.
Results: Both groups showed a marked decrease in alopecia scores after 12 months of flutamide therapy, compared with baseline values. The maximum drug effect occurred after 2 years and was maintained during the following 2 years of treatment. Androgens were strongly suppressed. During the first year of treatment, 4% of patients abandoned the study due to hepatic disorders related to the drug. During the following years, with the lower treatment regimen, no patient abandoned the study because of hepatic alterations.
Conclusions: Flutamide is a satisfactory therapeutic regimen for treatment of FPHL in the long run. Moreover, the use of very low doses (62.5 mg/day) of flutamide is associated with complete hepatic tolerability and high adherence.
source: https://www.medscape.com/viewarticle/741433_1
Results
Clinical Results
Figure 1 shows the mean (SD) changes in the alopecia Ludwig score from baseline to 4 years of treatment in both groups of patients studied. No significant difference was found during the treatment between the 2 groups, expressed as effect upon the constant term (intercept) of 2-way analysis of variance (Figure 1). Alopecia improved significantly in Ludwig scores just after 6 months of treatment (p < 0.001) and continued to improve to 2 years of treatment, when we had the best results, and remained stable from that point on. In percentage values, the mean improvement was about 15%, 20%, 26%, and 28% at 0.5, 1, 1.5 and 2 years.
This tells us that 1)hair regrowth is possible even after 1-16 years of hair loss, 2)62.5mg Flutamide was not inferior to 250mg Flutamide for treatment of hair loss, 3)hair regrowth was about 28% after 2 years on the drug 4)adding an estrogen to bicalutamide/flutamide does not increase the effectiveness at all
I outlined that if you run IC50 values and relative Kd and half-lives of Bicalutamide versus Flutamide, then 50mg bicalutamide = 750mg flutamide and they have the same mechanism of action
so 62.5mg flutamide = 4mg Bicalutamide, I outlined in other posts that Bicalutamide has no increased effectiveness when T concentrations are below 10ng-12ng/dl per mg of the drug.
Since women have T levels between 2-45ng/dl and 4mg of bica*12=48, a woman using more than 4mg of bica would not benefit in comparison to a woman using 50mg bicalutamide (since all the AR signaling would already be blocked by 4mg).
chained source: https://www.uptodate.com/contents/f...men-treatment-and-prognosis/abstract/21,31,32
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Gonna attach some diagrams of the studies below
I hope this fixes the misconception that E + CPA/spironolactone is the godsend for hairloss.
Three studies here just proved that (Bicalutamide)Flutamide even at LOW doses was able to reverse hair loss drastically in people who had been diagnosed with hairloss up to 16 years prior.
The main reason I believe that Flutamide/Bicalutamide > CPA for example is because...
of Androgen receptor partial agonism: Cyproterone acetate binds to the androgen receptor and causes it to express much more weakly than if an androgen such as testosterone or DHT had bound to it
BUT it still causes the AR to express, allowing for SOME gene transcription whilst (Bicalutamide) Flutamide is a PURE nonsteroidal androgen receptor antagonist. It binds to the androgen receptor and prevents the expression of AR-regulated genes completely if used at the correct dose.
Hope this helped!
@Ein @Ikarus
source: https://www.ncbi.nlm.nih.gov/pubmed?term=12524069
This tells us that low dose flutamide monotherapy (250 mg) let to improvement in hair loss scores, whilst cyproterone acetate (50 mg) combined with ethinyl estradiol (EE), and finasteride (5 mg) daily did not.
Note: (750mg Flutamide = 50mg Bicalutamide)
---------------------------------------------------------------------------------------------------------------------------------------------------
"After only 6 months of therapy, flutamide caused a maximal reduction in the hirsutism score to a value within almost normal range; during the same period, spironolactone caused only a 30% reduction of the hirsutism score. Whereas flutamide caused a dramatic (80%) decrease in total acne, seborrhea, and hair loss score after only 3 months of therapy, spironolactone caused only a 50% reduction in acne and seborrhea, with no significant effect on the hair loss score."
source: https://www.ncbi.nlm.nih.gov/pubmed?term=8299783
This tells us that when either flutamide or spironolactone was in association with a triphasic oral contraceptive (OC) pill, the group that used flutamide had a 30% more decrease in total acne and seborrhea scores, 70% more decrease in hirsutism scores, and a 80% more decrease in hair loss scores that the group that took spironolactone.
---------------------------------------------------------------------------------------------------------------------------------------------------
Methods: The cohort included 101 women diagnosed with FPHL from January 1991 to January 2006 (study was published in 2011 and was started in 2007). These women received yearly reducing doses (250, 125, and 62.5 mg/day) of flutamide for 4 years. The cohort included 33 patients treated with flutamide alone and 68 treated with flutamide combined with an oral contraceptive.
Results: Both groups showed a marked decrease in alopecia scores after 12 months of flutamide therapy, compared with baseline values. The maximum drug effect occurred after 2 years and was maintained during the following 2 years of treatment. Androgens were strongly suppressed. During the first year of treatment, 4% of patients abandoned the study due to hepatic disorders related to the drug. During the following years, with the lower treatment regimen, no patient abandoned the study because of hepatic alterations.
Conclusions: Flutamide is a satisfactory therapeutic regimen for treatment of FPHL in the long run. Moreover, the use of very low doses (62.5 mg/day) of flutamide is associated with complete hepatic tolerability and high adherence.
source: https://www.medscape.com/viewarticle/741433_1
Results
Clinical Results
Figure 1 shows the mean (SD) changes in the alopecia Ludwig score from baseline to 4 years of treatment in both groups of patients studied. No significant difference was found during the treatment between the 2 groups, expressed as effect upon the constant term (intercept) of 2-way analysis of variance (Figure 1). Alopecia improved significantly in Ludwig scores just after 6 months of treatment (p < 0.001) and continued to improve to 2 years of treatment, when we had the best results, and remained stable from that point on. In percentage values, the mean improvement was about 15%, 20%, 26%, and 28% at 0.5, 1, 1.5 and 2 years.
This tells us that 1)hair regrowth is possible even after 1-16 years of hair loss, 2)62.5mg Flutamide was not inferior to 250mg Flutamide for treatment of hair loss, 3)hair regrowth was about 28% after 2 years on the drug 4)adding an estrogen to bicalutamide/flutamide does not increase the effectiveness at all
I outlined that if you run IC50 values and relative Kd and half-lives of Bicalutamide versus Flutamide, then 50mg bicalutamide = 750mg flutamide and they have the same mechanism of action
so 62.5mg flutamide = 4mg Bicalutamide, I outlined in other posts that Bicalutamide has no increased effectiveness when T concentrations are below 10ng-12ng/dl per mg of the drug.
Since women have T levels between 2-45ng/dl and 4mg of bica*12=48, a woman using more than 4mg of bica would not benefit in comparison to a woman using 50mg bicalutamide (since all the AR signaling would already be blocked by 4mg).
chained source: https://www.uptodate.com/contents/f...men-treatment-and-prognosis/abstract/21,31,32
--------------------------------------------------------------------------------------------------------------------------------------------------
Gonna attach some diagrams of the studies below
I hope this fixes the misconception that E + CPA/spironolactone is the godsend for hairloss.
Three studies here just proved that (Bicalutamide)Flutamide even at LOW doses was able to reverse hair loss drastically in people who had been diagnosed with hairloss up to 16 years prior.
The main reason I believe that Flutamide/Bicalutamide > CPA for example is because...
of Androgen receptor partial agonism: Cyproterone acetate binds to the androgen receptor and causes it to express much more weakly than if an androgen such as testosterone or DHT had bound to it
BUT it still causes the AR to express, allowing for SOME gene transcription whilst (Bicalutamide) Flutamide is a PURE nonsteroidal androgen receptor antagonist. It binds to the androgen receptor and prevents the expression of AR-regulated genes completely if used at the correct dose.
Hope this helped!
@Ein @IkarusAttachments
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