Disability and deaths in men who used finasteride

Databases of drug adverse events contain tremendous variation. They include reports from patients of all ages, and many took other drugs that might explain outcomes. In this analysis, cases were limited to men ages 18–40 where the ‘Suspected Product’ field only contained finasteride or minoxidil. This is only a fraction of total cases, but helps reduce the chances that outcomes were due to other factors.

This chart shows outcomes of disability or death where the suspected product was finasteride:

Outcomes of ‘Died’ or ‘Disabled’ in men ages 18–40. In the 20-year period, there were 52 cases with an outcome of death and 714 cases of disability without death. For cases with an outcome of Disabled (excluding death), 75% were submitted by a consumer, 18% by a healthcare provider and 7% unspecified.

In each of the past three years, cases with an outcome of ‘Disabled’ reached a new high.

It would be helpful to compare cases to the total number of prescriptions written, but this data is hard to find. A comparison with minoxidil would add context. Minoxidil is another popular hair loss treatment taken by a similar population of younger men.

Outcomes of ‘Died’ or ‘Disabled’ finasteride and minoxidil from 2002–2021. Cases were filtered so that finasteride or minoxidil was the only suspected product.

Here is the same data in a table, along with the total number of cases.

Total cases2,1471,561
Number of cases with disability and death outcomes from 2002–2021. Men ages 18–40, 2002–2021. Suspected product = finasteride or minoxidil only.

We can compare the potential for serious outcomes by examining the proportion of total cases resulting in disability and death for each drug:

% Disabled35.6%2.5%
% Died2.5%0.2%
% other outcomes61.9%97.3%
Outcomes as a proportion of total cases in men ages 18–40, 2002–2021. Suspected product = finasteride or minoxidil only.

Less than 3% of reported minoxidil cases resulted in disability or death, while 38.1% of finasteride cases had one of these outcomes. These outcomes were 14.3x more common in finasteride cases vs. minoxidil cases.

Many factors influence the submission of cases to FDA’s database, so comparisons across drugs should not be considered conclusive. At the same time, the high proportion of disability and death outcomes linked to finasteride is a red flag that the drug may be dangerous for young men.

Further reading

From the depths: why finasteride harms took decades to emerge