How to save on hair loss medication: finasteride and minoxidil

What finasteride does

Finasteride is a tablet used to treat male pattern hair loss and an enlarged prostate (BPH). It works by blocking the body’s production of a male hormone in the scalp that stops hair growth. It’s taken once a day (MedlinePlus).

• It takes time. It may take at least 3 months to see any improvement. If you’ve taken it for 12 months with no improvement, further treatment probably won’t help (MedlinePlus).
• It only works while you take it. You’ll probably lose any regrown hair within 12 months after you stop (MedlinePlus).
• It’s for men only. Women, especially those who are or may become pregnant, shouldn’t touch broken or crushed tablets, because they may harm a fetus (MedlinePlus).
• Brand names. Finasteride is sold as Propecia and Proscar (MedlinePlus). FDA says Proscar was approved for BPH in 1992 and Propecia for male pattern hair loss in 1997 (FDA).

Side effects to discuss first

MedlinePlus says finasteride may lower sexual desire and cause ejaculation problems or trouble getting or keeping an erection, during treatment and after it’s stopped. It may also decrease fertility. Call your doctor right away about breast changes, signs of an allergic reaction, or new or worsening depression or thoughts of self-harm. Finasteride may raise the risk of high-grade prostate cancer or breast cancer (MedlinePlus). If you’re in crisis, call or text 988.

What minoxidil does

Minoxidil is a liquid applied to the scalp, usually twice a day. MedlinePlus says it’s most effective for people under 40 whose hair loss is recent, and it has no effect on receding hairlines. You need to use it for at least 4 months, and possibly up to a year, before you see results. Most new hair is lost within a few months after you stop (MedlinePlus).

Call your doctor right away about weight gain, swelling, trouble breathing, a rapid heartbeat, chest pain or lightheadedness (MedlinePlus).

FDA’s warning on topical finasteride

Some compounding pharmacies and telemedicine platforms sell topical finasteride sprays and creams. FDA says there’s no FDA-approved topical finasteride product. FDA received 32 adverse event reports from 2019 to 2024 for compounded topical finasteride, and most people said their symptoms continued after they stopped using it. FDA also warns that topical products can spread to others, including women, through skin contact (FDA).

What insurance and Medicare cover

• Medicare Part D. By law, Part D doesn’t cover drugs used for cosmetic purposes or hair growth. The same drug may be covered for another approved use, such as finasteride for BPH. Some enhanced plans may offer excluded drugs as an extra benefit (CMS).
• Private and Marketplace plans. Coverage varies. Check your plan’s drug list. If your doctor thinks a drug is medically necessary and your plan won’t cover it, you can ask for an exception (HealthCare.gov).
• Paying cash. Medicare.gov notes that drugs you buy with a discount card instead of your plan don’t count toward your plan’s out-of-pocket limit (Medicare.gov).

How to pay less

• Choose the generic. FDA says generic drugs usually cost less, and prices tend to drop as more companies make the same drug (FDA).
• Compare cash prices. Prices for the same prescription can differ from one pharmacy to the next. Check a free discount card such as RxGo before you fill it.
• Buy online safely. Use FDA’s BeSafeRx tips to spot a legitimate online pharmacy. A real one requires a valid prescription.
• No insurance? HRSA-funded health centers offer care on a sliding fee based on income. Find one near you.