Prostate Cancer Drug for Baldness? 10 Double-Duty Drugs

Medical advances can be slow -- a fact frustrating to some who want the "latest and greatest" cure for their ailment, and don't want to wait out the testing process.

But once a drug has been approved for one use, doctors can prescribe it "off-label" when it is shown to be useful for something else. And an increasing number of drugs are prescribed in this manner. Off-label use of medicines accounts for about one-fifth of all prescriptions, according to a study released last April in the New England Journal of Medicine.

And so we have a skin cancer cream used to smooth out your facial wrinkles, Viagra to help avoid an amputation, a baldness drug to protect against prostate cancer, and now a drug for enlarged prostate and possibly prostate cancer that may stop baldness.

Many of these off-label uses meet with controversy and questions about their value, particularly since the FDA has not yet approved the uses. (As a result, drug companies cannot advertise off-label uses.)

Though the hair loss drug finasteride is recommended by some medical organizations as a preventative measure against prostate cancer, many doctors say that such a use is inefficient and ill-advised.

In the case of Viagra, which was administered to at least one patient to stimulate blood flow and help prevent amputation, no conclusive studies yet exist that confirm a definite benefit when used in patients at risk of amputation.

But in many other cases, the alternative uses are well-known in the medical community -- though perhaps not among the general public -- and are regularly exploited.

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And while a November article in the journal Pharmacotherapy warned doctors to exercise more scrutiny in their prescription of drugs for purposes other than their primary intended use, it is clear that some of these MacGyvers of the pharmaceutical world are destined for double duty in the years to come.

Avodart

Approved for the treatment of enlarged prostate, Avodart, like Propecia, has been tested for prevention of prostate cancer as well.

But the drug from GlaxoSmithKline, chemically known as dutasteride, finds a third use: preventing baldness. Smaller studies have shown some encouraging results.

"It seems to have more benefit [than finasteride] in regrowing hair from pattern hair loss," said Dr. Amy Newburger of Dermatology Consultants of Westchester, N.Y., noting that "it is not yet approved for this indication."

That Avodart would work makes some sense. Like Propecia, the drug targets the pathway that converts testosterone to DHT, which is the suspected culprit in hair loss.

"There are good studies that show it is effective," said Dr. Marc Avram, clinical associate professor of dermatology at Weill Medical College at Cornell Medical Center. "There are doctors who do give it out there for hair loss.

"Doctors are using it off-label for men," Avram said. "It absolutely should not be used off-label for women."

While women should not use the drug because of the risk of birth defects, questions also remain about its safety as a baldness remedy for men.

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