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Finasteride is a daily 1 mg tablet, and it is one of the few hair-loss medicines formally authorised for this purpose in EU countries. It works by lowering DHT, a hormone made from testosterone that gradually shrinks hair follicles in male pattern hair loss, and it is authorised for men only.

What it is

Propecia contains the active ingredient finasteride, a 4-azasteroid 5-alpha-reductase inhibitor, taken as a 1 mg film-coated tablet, with or without food, once a day. Propecia holds national authorisations rather than a single EU-wide one; the details here come from the Spanish authorisation (AEMPS CIMA registration 62441, holder Organon Salud, S.L.), authorised since 1 February 1999. The authorised age band is narrow — men aged 18 to 41 with androgenetic alopecia — and it is not authorised for use in women.
Active ingredient: finasteride. Dosage: 1 mg / day.

How it works

Male pattern hair loss is driven by dihydrotestosterone (DHT), a hormone the body makes from testosterone. A balding scalp contains miniaturised follicles and higher amounts of DHT, so each growth cycle produces a thinner, shorter hair until visible growth stops. Finasteride blocks the 5-alpha-reductase type II enzyme that converts testosterone into DHT, so less DHT reaches the scalp.
1

Months 1–3

Daily 1 mg; changes build silently.
2

Months 3–6

Shedding stabilises.
3

Months 6–12

Visible improvement is assessed.

What the studies reported

The trials enrolled only men aged 18–41 with vertex-pattern loss (Kaufman et al., J Am Acad Dermatol 1998, PMID 9777765), and did not establish an effect on bitemporal recession or late-stage hair loss. The EU product information states continued use is needed to keep the benefit.

What has been reported

About 1% of men in each group stopped treatment for a sexual side effect in the first 12 months (EU SmPC, section 4.8). Persistence of decreased libido, erectile dysfunction and ejaculation disorders after finasteride is stopped has been reported in post-marketing use, at a frequency that is not known because these are spontaneous reports. Male breast cancer has been reported during post-marketing use; frequency cannot be estimated from the available data.
Mood and suicidal ideation. Depression is listed as uncommon in the EU SmPC; anxiety and suicidal ideation are listed at a frequency that is not known. After an EU-wide Article 31 review (started October 2024, European Commission decision August 2025), suicidal ideation was confirmed as a side effect of finasteride 1 mg and 5 mg tablets, at an unknown frequency, and a patient card is now included in 1 mg packs. Anyone who experiences mood changes should seek medical advice and, on finasteride 1 mg, stop treatment.

Who it is not suitable for

The EU product information contraindicates use in women, because finasteride can cause abnormalities of the external genitalia in a male foetus if taken during pregnancy. The authorised age band is men aged 18 to 41.
Female hair loss sometimes involves finasteride prescribed off-label, at a different dose and under different safeguards. See the finasteride for female hair loss guide.

How Hi-Doctor handles it

Our doctors review every hair-growth option and recommend what fits your history and goals. An EU-licensed doctor reviews your case and, if eligible, issues an electronic prescription valid at any EU pharmacy under Directive 2011/24/EU. See how it works for the full process, pricing for the consultation fee, and topical minoxidil for another EU-authorised hair-growth option.

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Hair-growth consultation

Answer the hair-growth questionnaire and a registered doctor reviews it. They decide whether treatment is appropriate, which one, and at what dose — and declining is a normal outcome. See what it costs and how the review works.
This page is reference information, not medical advice and not a prescription. Whether a medicine is appropriate for you is decided by a registered doctor after reviewing your consultation.