2023 – year in review

Fitness influencers and physicians raised alarms about risks of finasteride for hair loss this year, reaching millions of people through tweets, videos and podcasts. On the regulatory front, in France boxed warnings were added to finasteride packaging. Health Canada added a warning about suicidality while the UK regulator launched a safety review. Forty-four relevant research … Read more

FDA quashed internal warning on suicidality linked to Propecia; changed course in 2022

In 2010, Merck requested to add a warning of depression to the Propecia label. A safety group within FDA concurred, but FDA’s dermatology products group did not support the change. Over a decade later, FDA required the addition of ‘suicidal ideation and behavior’ to the Propecia label.

The Merck files, part 2: Merck responds to regulatory concerns about persistent adverse effects of Propecia

In 2006, the Swedish Medical Products Agency asked Merck for an analysis of all adverse events affecting the male reproductive system which persisted after stopping Propecia. In subsequent documents, there is a back-and-forth between Merck and the Agency as to the validity of these reports and the overall safety concern. Merck used an arsenal of arguments to discount these reports and claim its own data is superior to postmarketing data.

The Merck files, part 1: An inside look at the development of Propecia

Merck first developed finasteride for benign prostatic hyperplasia, a condition typically found in men aged 55 and older. After receiving approval for the application in 1992 and bringing the drug to market as Proscar, Merck decided to seek approval of finasteride for male pattern hair loss—to be branded as Propecia. In a 1994 memo below, … Read more

The Merck files: a series

Selected documents from Propecia litigation were released by court order in 2021. This series walks through these documents, revealing Merck’s strategy for discounting safety concerns arising from clinical trials and adverse event reports. The collection is divided into three parts: 1. An inside look at the development of Propecia (1994–2001) 2. Merck responds to regulatory … Read more

Adverse effects on the Propecia label: a history of changes

In its Drugs@FDA database, FDA has at least nine versions of the Propecia label going back to 2001. This post will trace the history of changes to adverse effects in the label for consumers. A summary of label changes: 2001 – “Side effects went away in men who stopped taking Propecia” “A small number of … Read more