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What Are The Side Effects Of Finasteride And Cyclosporine?

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Posted on Wed, 22 Apr 2015
Question: Hello Doctor,
I have less dense packed hairs with slight thinning in the hairline & on the vertex... i have this condition from 2003.
I am applying Minoxidil 5% 10 yrs now from 2005 without fail for even a single day......My concern is I was diagnosed for Pure Red Cell Aplasia an Auto immune disorder and have been under immuno suppressive drug cyclosporine 300mg/day for 2 yrs now since FEB 2013...surprisingly the cyclosporine has helped controlling further thinning..But now I would like to take at least .25 mg of finasteride/day (1/4 of 1mg tab) for improvement on already thinned areas...When discussed with my dermatologist in XXXXXXX about whether i could take the .25mg of finasteride while Im on 150 mg cyclosporine twice a day...She told i can take it & there wont be any problems if i take lower dosage of .25mg finateride...

Brief Note on my PRCA disease History from where it started:
Actually i was first diagnosed for PRCA first in XXXXXXX 2008 with Hemoglobin 6.4 g/DL..I was put forth for 1 & 1/2 years of Immuno suppression cyclosporine Tablets 150mg twice/day till SEP 2009 && when my hemoglobin reached 12 g/DL in SEP 2009 i was advised by my Hemotologist @ CMC Medical vellore to stop the Cyclosporine intake... So from SEP 2009 till Dec 2012 I was doing good with my Hemoglobin @ 12 g/DL without any immuno suppressants..Suddenly after DEC 2012 the "Relapse" of the PRCA occurred and as of now I have been advised to be on some amount of Immuno Suppression dosage with the Cyclosporine thr out life to prevent the relapse to occur again..
Right now my Hemoglobin is 12 g/DL..I have attached my latest Cell by Cell Blood Report..Cyclosporine in take right now advised to be reduced to 100mg twice/day.

So I am just continuing to apply the 5% minoxidil for right from 2004 till this date without fail..
And during the period between SEP 2009 to DEC 2012 while I was doing good without any Immuno suppressive cyclosporine medication, I took Finasteride 1mg for period of 5 months under supervision of Dermotologist Dr XXXXXXX Rassman as I was in US @ that time...I didn't have any sexual side effects except for my semen become more liquid and my hair thinning improved a lot..Even I had good amount of new hairs grown out on the hairlines,temples & on vertex....But I stopped Finasteride with fear of possibly having side effects after long term usage.

Could you please advise whether its safe to start & intake .25mg of Finasteride now..As i am on Immuno suppressant cyclosporine & have to continue at least minimal dosage through out life,,will taking .25mg of Finasteride have interactions with cyclosporine or any adverse effects..

Also I had discussion with one of the dermatologist over HCM and he suggested Saw Palmetto capsules instead of Finateride (which has fear of sexual side effects) and a topical solution with with Biochanin-A which is natural phytoestrogen which inhibits both isoforms of 5╬▒-reductase exactly similar to finasteride....
So please advise whether i can take
i)Saw Palmetto capsules, Topical Biochanin-A & Minoxidil 5% safely along with my Immuno suppressant medicine cyclosporine.
If so please specify whether the Saw Palmetto Amway brand -NUTRILITE® Saw Palmetto & Nettle Root is ok && specify a brand for topical solution with with Biochanin-A..
OR
ii) I can simply try taking .25 mg of Finasteride(1/4 of 1mg)..

Awaiting your Valuable Reply,

Thanks & Warm Regards,
XXXX
doctor
Answered by Dr. Dr. Kakkar (1 hour later)
Brief Answer:
I would suggest finasteride and minoxidil as recommended.

Detailed Answer:
Hello. Thank you for writing to us at healthcaremagic

I have taken note of your query and I have understood it.

You can safely take finasteride and rather than taking quarter of a dose I would suggest that you take it as a full dose.

Only Minoxidil and Finasteride are US FDA approved for andogenetic alpecia.

There is no interaction whatsoever between cyclosporin Or finasteride.

Regarding the sexual side effects they are reversible.
Moreover they are transient and are not a problem with continued treatment.

Other treatments like saw palmetto extract and Biochanin-A though in use for androgenetic alopecia are not approved treatments.

Therefore I would suggest you to go for approved treatments rather than these.

Hypertrichosis is a well known side effect of cyclosporin and probably that had an effect on your androgenetic alopecia

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (20 hours later)
Thank you so much Doctor !! for your valuable advise...

I am advised to take cyclosporine whatever dosage - twice/day Morning & Evening -(Right now 100mg Mor & Eve)....

Could you please advise when can I take Finasteride?
Is it safe to take it Mor (after BF) or Eve (after Dinner) along with cyclosporine ?
Won't there be any problem while taking Finasteride along with Cyclosporine ?

OR

Shall i take Finasteride in the noon after Lunch as daily dosage ?

Also right now I am taking 2.5mg -Half of 5mg Folic acid tablets only along with Cyclosporine during my after Dinner Dose in the night as advised by my Hematologists...Thankfully Folic acid intake nourishes my skin & protects hair including pre-mature greying...

Could you please advise whether i can continue with the Folic acid only or instead of that shall I go for Biotin capsules ? - If so please recommend the brand for Biotin capsules and the dosage level for it..

Awaiting your valuable reply,
Thanks & Warm Regards,
XXXX
doctor
Answered by Dr. Dr. Kakkar (8 hours later)
Brief Answer:
Finasteride at Noon. Biotin has no role in androgenetic alopecia

Detailed Answer:
Hi.

You can take finasteride once daily at Noon.

Interaction between finasteride and cyclosporin is unlikely, minor, or nonsignificant.

Biotin has no role in androgenetic alopecia. I won't advocate it.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9608 Questions

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What Are The Side Effects Of Finasteride And Cyclosporine?

Brief Answer: I would suggest finasteride and minoxidil as recommended. Detailed Answer: Hello. Thank you for writing to us at healthcaremagic I have taken note of your query and I have understood it. You can safely take finasteride and rather than taking quarter of a dose I would suggest that you take it as a full dose. Only Minoxidil and Finasteride are US FDA approved for andogenetic alpecia. There is no interaction whatsoever between cyclosporin Or finasteride. Regarding the sexual side effects they are reversible. Moreover they are transient and are not a problem with continued treatment. Other treatments like saw palmetto extract and Biochanin-A though in use for androgenetic alopecia are not approved treatments. Therefore I would suggest you to go for approved treatments rather than these. Hypertrichosis is a well known side effect of cyclosporin and probably that had an effect on your androgenetic alopecia Regards