Strategies to prevent side effects of Finasteride | Dr Bhatti's Regime

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  • Опубліковано 26 лип 2024
  • Side effects of Finasteride (Propecia) though are not common, there is a significant psychological overlay given so much bad press and social media gone crazy. Dr Bhatti's 5 strategies that he has been using for the past over 15 years for better compliance of Finasteride have helped reduce the likelihood of side effects significantly in his practice. Many patients want a hair transplant without Finasteride but if they are young and with extensie baldness, Dr Bhatti's advice is meant for them more than any one else.The pillars of Dr Bhatti's hair loss regime using Finasteride are-
    CASE SELECTION: Detailed counseling to bring out personality types like OCD, body dysmorphia syndrome and rational goals and objectives. Avoid Finasteride in patients with BMI more than 30, those who live sedentary lifestyles, incurable smokers, uncontrolled diabetics and patents with depression & anxiety disorders. In the last video I even discussed various personality types and how to match Finasteride for each for better compliance.
    CUSTOMISED DOSING: Start low and then scale up. I start with 0.5 mg on alternate days and in others 1 mg on alternate days and then scale up titrating the does with the response after 3 months are over. Since the patient’s psyche is pretty much labile in the first few weeks after starting the drug, he needs constant reassurance. Many a times patient will report some breast tenderness but this all goes down at the 4-6 weeks mark. You may need to add Dutasteride if the effect of Finasteride over the years begins to wane.
    SWITCH-OFF/ SWITCH-ON STRATEGY: Finasteride levels in the body keep building in the tissues and these may cause late onset side effects. To flush out excessive Finasteride, I advise my patients to take a break from Finasteride for 15 days if asymptomatic and 30 days if they have a concern. This helps in long term compliance in patients especially youngsters who are on long term Finasteride to maintain thinning hair and the hair transplant result.
    LET 2 PEAKS COINCIDE: The spike in testosterone levels in the body follows a circadian rhythm and levels are highest early in the morning. So as to facilitate the peak blood circulation levels of Finasteride match the testosterone surge in the early morning for best suppression of DHT even with low doses, the drug Finasteride should be taken late in the night for those who go to bed past midnight and early morning for members of the 5 AM Club. If you follow this advice, even lower levels of DHT blockers will be beneficial to you. For example if you were taking the medication at say 10 AM, the peak of the Finasteride level has already happened and 1 mg may even loose effect. But if you coincide the intake of medication with the circadian testosterone surge, even 0.5 mg taken daily will have a better effect.
    WEEKEND BOOST: Weekends see a surge of testosterone levels due to increased physical activity. This period of intense activity needs to be adequately covered. A patient of mine achieved very good balance by taking 0.5 mg on alternate days and 1 mg a day on Saturday and Sunday with good compliance.
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КОМЕНТАРІ • 1,4 тис.

  • @routinelylazy8682
    @routinelylazy8682 3 роки тому +7

    Hello dr, my age is 22 years and I have had hair thinning from a long time. It has been going downhill from the year 2015. I don't have mpb but my overall density of hair has significantly reduced in these years. Diffuse thinning I believe. Mothers and fathers side is all bald, father got rapidly bald at 29.
    For a past year I have started working out and my hairfall has aggravated. My head has become visible. My diet has been very good and balanced with good amount of protein. Last 4-5 months my workout has been even more harder and so my hairfall is getting even quicker.
    I used to have social anxiety about my body but now I am a very fit mascular indivisual so my confidence is sky high.
    I want to hop on fin and min, have done the research and understand that the risk is not as severe as people make it out to be. What should be my course of action from here?

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +2

      Thanks for the message and for watching my video. Please start with 0.5 mg a day and then we can scale up.
      What is your total testosterone level?

    • @routinelylazy8682
      @routinelylazy8682 3 роки тому

      @@hairtransplantinindia Thanks for the reply doc, I am not really aware about the specific numbers but I have a full beard, good libido and ample body hair.

    • @routinelylazy8682
      @routinelylazy8682 3 роки тому

      @@hairtransplantinindia sir I wanted to ask if I should start minoxdil too or not. Coz fin alone wont do much to cover the patchy areas in the head.

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому

      @@routinelylazy8682 Yes 5% Minoxidil can be started alongwith.

    • @SaifiSpeaks18
      @SaifiSpeaks18 2 роки тому

      Hey brother ! My condition is same though so just want to check whats your status now? Hav u been on fin?? Do your hair grow??

  • @user-dl7mq4qj4d
    @user-dl7mq4qj4d 2 роки тому +8

    I learned more from this Dr in an hour than any other youtube videos from the western world which is all about making more money. An honest well informed advice.
    I am impressed. Thank you dr

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      Great to hear! And for keeping me motivated.

    • @marcnur1488
      @marcnur1488 5 місяців тому

      I think the hair loss show is also pretty good. Them and Dr Bhatti 😊

  • @allauddinkhan9382
    @allauddinkhan9382 3 роки тому +29

    Dr Bhatti is the sea of knowledge he is having a heap of knowledge about hair transplant no body can beat him

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +1

      Thanks for the encouragement.

    • @ashishhinduja3277
      @ashishhinduja3277 3 роки тому

      Agreed

    • @mikerobyn6823
      @mikerobyn6823 3 роки тому +1

      What's the best time to take 1mg finasteride.
      Morning once out of bed or night time before sleep..?

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому

      @@mikerobyn6823 Please find the reply here. The timestamp has links to all 107 Q+A : ua-cam.com/video/xmj7uEWAvDc/v-deo.html

  • @wparsa
    @wparsa 2 роки тому

    Thanks. Very very helpful and intelligent solution.

  • @misterbacano3735
    @misterbacano3735 3 роки тому +1

    Excellent video!!! New perspectives for those who have doubts. Congratulations, Dr🙏

  • @nuriceri6207
    @nuriceri6207 2 роки тому +6

    You are a very good person, thank you for everything.

  • @SSjLuigi1
    @SSjLuigi1 Рік тому +9

    Wow, many thanks for actually responding to all of these people's comments. You do more than some people's GP's, we don't deserve you.

  • @lucasp8804
    @lucasp8804 3 роки тому

    Thankks! Amazing video!!

  • @emileleroy136
    @emileleroy136 2 роки тому

    Thanks a lot. This is so useful !!!

  • @AdamOakmanComposer
    @AdamOakmanComposer 3 роки тому +11

    Hello! Thank you very much for sharing your very broad knowledge and experience in the hair loss area. Do you have any video where you explain best strategies for people that worry about bad effects of using finasteride when trying to have a baby? Both before and during the pregnancy? Any precautions a man should take in order not to harm the newborn?

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +2

      Thanks for watching. This video has all about the information you seek- ua-cam.com/video/DX8tSXw-K9k/v-deo.html

    • @amithaiyappa1
      @amithaiyappa1 2 роки тому

      What is the ideal time of the day or night to take finasteride?

  • @ashishhinduja3277
    @ashishhinduja3277 3 роки тому +5

    Dr bhatti knowledge is so to the point and detailed that listening to you for hours gives hopes to so many of people.. God bless everyone.

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +5

      Thanks for the kind words and the happiest moment for me is when a hair loss sufferer benefits from my advice.

    • @agrimsingh-fn7op
      @agrimsingh-fn7op 9 місяців тому

      @@hairtransplantinindiasir my age is 20 I am taking finasteride and minoxidil from the 11 days so it will increase thickness and density of hair or not finasteride 1 mg daily ,minoxidil 20 percent?

    • @hairtransplantinindia
      @hairtransplantinindia  9 місяців тому

      Yes it will if your doctor has assessed your level of baldness and your family history of baldness correctly. 20% Minoxidil is not available in the market since it is dangerous and only as effective as 5% Minoxidil.@@agrimsingh-fn7op

    • @agrimsingh-fn7op
      @agrimsingh-fn7op 9 місяців тому

      @@hairtransplantinindia so how much thickness can I gain if I am having thin hair at stage 2 baldness?

    • @hairtransplantinindia
      @hairtransplantinindia  9 місяців тому

      @@agrimsingh-fn7op a lot

  • @myhtchannel5227
    @myhtchannel5227 3 роки тому

    Your channel is all about great information 👍👍👍👍👍👍👍

  • @kaddykanda3799
    @kaddykanda3799 3 роки тому +1

    Knowledgeable dr bhatti thanks a lot for video

  • @brahimdif1700
    @brahimdif1700 2 роки тому +3

    Thank you for the video! Great content! What strategy would you advise for bodybuilders and people who go to the gym regularly? Im sure that has effects on testosterone levels

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому +1

      You need to see my videos on TRT and Finasteride. Your questions will be answered in great detail there. Also do not miss out the video on Exercise and hair loss.

    • @brahimdif1700
      @brahimdif1700 2 роки тому

      @@hairtransplantinindia thanks for the reply, sure! I will certainly watch the recommended videos :)

    • @qsdailydose8970
      @qsdailydose8970 2 роки тому

      I’m on TRT and about to start finasteride. I’m sure I will need more e2 control.

  • @syedzaidi312
    @syedzaidi312 2 роки тому +10

    Hello Doctor. You’re doing such a wonderful job by educating us on different hair issues.
    I’m a 50 years old healthy man who just started taking 1 mg of Finasteride on alternate days. Just after my second dose I’m noticing an urge to urinate specially at night time which I have never experienced before. I have been doing regular kegel exercise from many years and that helped me with my bladder control.
    Since this medication is for prostate, like to know if this is a side effect that causing me an urge for urinating. If so, what can be done?
    Please advise.
    Thanks

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому +10

      This is not a side effect. The medication was initially used for just this purpose. To help people to have easy micturition. In fact hair growth is a side effect.

    • @syedzaidi312
      @syedzaidi312 2 роки тому

      Thanks for your reply. Much appreciated!
      there are lots of suggestions and videos on the benefits of Rosemary oil for hair restoration and growth.
      Wondering, if you have done any such videos on this involving science.
      And if one can start applying such oils after their hair transplant procedure as a replacement for minoxidil.
      Thanks

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому +2

      @@syedzaidi312 It may be useful but I would refrain from prescribing it after a hair transplant i place of Minoxidil.
      Cannot experiment in that phase.

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому +2

      @@syedzaidi312 Theer are thousands of magical lotions and potions sold down the ages which are merely Old Wive's tales- supposedly truths but mere superstition.

    • @sudan9735
      @sudan9735 Рік тому

      @@syedzaidi312 Hello sir, when did your actual balding start ??

  • @blazingbernard5457
    @blazingbernard5457 3 роки тому +2

    I am a big fan of Dr. Bhatti, he speaks good English too. 👍🇮🇳👌

  • @amaneetbrar5628
    @amaneetbrar5628 3 роки тому +1

    Rational explanations , I would like to start on this medicine , please advice , Great Thanks !

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому

      Kindly share pictures on whatsapp.

    • @chris5897
      @chris5897 2 роки тому

      @@hairtransplantinindia could I share with you also some WhatsApp photos? I would like your advice on whether I should start finasteride. What's your WhatsApp?

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      @@chris5897 +91-9814531111

  • @billdimitriou3187
    @billdimitriou3187 3 роки тому +8

    Great video, very useful information - thank you
    Question regarding when to take finasteride - as mentioned, it's best to match the spikes of testosterone ("7-8am") and finasteride."
    Does finasteride get absorbed quickly, whereby taking it in the morning would match the testosterone spike, or would it be better to take it the night before say for instance 10pm so it can spike in the morning with ones testosterone ?

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +7

      It takes just aboe 6 hours for it to peak so the later in the night it is taken, the better.

    • @semirhage7
      @semirhage7 10 місяців тому

      Was gonna ask the same. Thank you.

  • @fatalradius
    @fatalradius Рік тому +5

    Excellent advice. 1mg is too powerful for most men. I was on 1mg/3x a week to avoid sides and still got them after about 3 months. I think 60-90 days is when the Finasteride begins its peak levels of DHT suppression, which then brings the side effects.

    • @hairtransplantinindia
      @hairtransplantinindia  Рік тому

      Thanks for sharing your experience.

    • @drwayne_carter9115
      @drwayne_carter9115 8 місяців тому +2

      Agreed, which is why I think there are so many reports of side effects and so many more of unreported sides. I am not sure how the industry came to the conclusion that 1mg daily should be the standard dose. Especially since .2mg daily has the same beneficial results with 80% less dosage.

    • @marcnur1488
      @marcnur1488 5 місяців тому

      ​@drwayne_carter9115 they unfortunately never updated the recommended dosage since the 1990s like they do with other drugs. Don't know why though

    • @marcnur1488
      @marcnur1488 5 місяців тому

      @fatalradius I just started taking it 3 times per week, what sides did you get? And did you try out the 15 days pause after 3 months like recommended in this video?

    • @DilshadAlam-gr4qt
      @DilshadAlam-gr4qt 2 місяці тому

      Brother..did u get recovery from side effects of finasteride

  • @kumarprateek238
    @kumarprateek238 10 місяців тому +1

    You are a legend for answering so many questions, as a derm student I wish one day I can do the same

    • @hairtransplantinindia
      @hairtransplantinindia  9 місяців тому

      Thanks for the compliment.

    • @niksingh2947
      @niksingh2947 5 місяців тому

      Kumar prateek i want to take with you i have some questions to ssk

  • @jasminesumi1564
    @jasminesumi1564 3 роки тому +1

    Thank you for the information doc. can I use derma roller on transplanted hair? It’s been 55 days

  • @mudassirahmeddar3680
    @mudassirahmeddar3680 3 роки тому +9

    Honestly, I watch your videos mostly because of your communication skills.. Hair info is secondry reason

  • @esinar98
    @esinar98 3 роки тому +3

    Hello Dr. Bhatti, thanks for the very informative video. Is there a reason that you avoid prescribing finasteride to patients with a history of OCD or anxiety/depression? Even if the patient is otherwise physically healthy, has ideal hormone levels, with no history of ED, and is willing to take microdoses of the drug?

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +1

      I have a not too positive experience with people with OCD on Finasteride. They have a high chance of getting sides since they keep thinking about the effect Finasteride could have on their potency all the time- and this psychological overlay works negatively for them and for the drug's reputation.

    • @gamefowltv1271
      @gamefowltv1271 2 роки тому

      I have history of anxiety anf depression. Didnt mention it on my doctor. Lol. Coz im really desperate to maintain what i currently have. You gotta have a strong mind and muscle through it.

  • @sanjeewanrajamogan6112
    @sanjeewanrajamogan6112 2 роки тому

    Thank you Dr 🙏

  • @wasteman3259
    @wasteman3259 3 місяці тому +1

    All doses of finasteride gave me symptoms of chest and nipple pain for years.
    Finally got a full blood test. Turns out my estrogen is on the higher side, but the main issue - my SHBG is very high…

  • @bellwell
    @bellwell 2 роки тому +3

    Hey doc. Recently I completed 1 year on finesteride 1mg per and i stopped it every 3 month for 15 days. Now I am considering to take every alternate day, so should I take Or continue like before 1mg/day. If I will alternatively take it now then will it cause low dht blocking effect?

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      In the 15 days you stopped it, did you notice hair loss that is excessive? Next time take a 4 weeks gap and observe. We can then see if you can go on half dose.

  • @sneakerkingzcom
    @sneakerkingzcom 3 роки тому +3

    Excellent Video, many thx doc, Community appreciates. You recommend to take finasteride for 6 months post surgery. Is there any higher risk to extend to 12 months Or even more? Iam taking 1mg of finasteride daily since 6 months meanwhile, without any side effects, plus twice a week dutasteride as lotion to rub in.iam not sure wether its a bit overdosed! Any recommendations? thank you

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому

      Thanks for encouraging. At 6 months i assess the patient. If most transplanted hairs have normal caliber, and if his baldness has stabilised i will advise him to stop. But in the young in whom baldness is progressive, I will likely decrease the dosage and advise continuation of the drug for a few more years.

  • @nisargrajguru4125
    @nisargrajguru4125 Рік тому

    Thankyou so much doctorz appreciate your honestly❤️

  • @ShahnawazKhan-np5my
    @ShahnawazKhan-np5my 3 роки тому

    Yes sir plz make a video on fanistriede shedding sir as soon as possible sir thank you very much sir we all are waiting sir

  • @harikrishnanku7192
    @harikrishnanku7192 3 роки тому +4

    Doctor is there any relationship between period of usage and chance of side effects, like usage for longer period have more chances than usage for few months..?

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +2

      No there is no such correlation. In fact people who use it for a longer duration, do so since they do not have any side effects.

  • @matthiaslarcal1560
    @matthiaslarcal1560 2 роки тому +3

    Hello Doctor,
    I’ve already been using Finasteride for 7 months everyday (0.5 mg 5 times per week and 1 mg dose 2 times per week, for a total of 4,5 mg per week) but at the 6th month I increased the dose and I had sides. Now I’ve interrupted for 2 months because I’ll have a hair transplant, I’m young Norwood 4 almost 5.
    Can I take after my hair transplant 0.5 mg per day (maybe once or twice a week 1mg) at 11 pm so that I can increase the effectiveness of the pill and avoid sides? Thanks in advance

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому +3

      Thanks for watching. As mentioned in my video titled '100 points you should know about Finasteride', one should not take a chance by reducing the dosage from 1 mg a day for 6 months. Most strategies work by trial and error, and this 6 months period does not allow this luxury. Grafts are limited and we would not wish to lose them forever.

    • @matthiaslarcal1560
      @matthiaslarcal1560 2 роки тому

      @@hairtransplantinindia Thank you a lot doctor

    • @DilshadAlam-gr4qt
      @DilshadAlam-gr4qt 2 місяці тому

      Brother did u get recovery from side effects of finasteride

  • @yamunashankar2403
    @yamunashankar2403 2 роки тому

    Wonderful video sir🙏can you post a video on lab investigation

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      Thank you for watching. Yes you can watch this video-
      ua-cam.com/video/xmj7uEWAvDc/v-deo.html

  • @haseebarshad4609
    @haseebarshad4609 3 роки тому

    Hello sir! Why don’t you suggest finasteride to smokers? You have mentioned in this video. Kindly clear my doubts if I’ve misunderstood it.

  • @oncall21
    @oncall21 3 роки тому +4

    Great advice as always Dr Bhatti. So many people are too eager to throw the baby out with the bath water. Simple yet sage protocols that you have given will enable people to benefit from 5ar inhibitors that might otherwise cease treatment altogether. Thanks for sharing!

  • @vishnu.1418
    @vishnu.1418 3 роки тому +6

    Hi doctor,
    I'm a continuous follower of you from Kerala..first of all big thanks for you scientific advises for educate all the things about hair treatments..
    3 months back I have faced depression and anxiety disorder issue...now everything is ok..but I have to take medicine for 1 year..now I have been talking antidepressants since last 3 months..mirsol 45 mg and ventab 150 mg...6 months back I did my hair transplant..I never took finastrade yet..Now planning to take finastrade 1 mg in Monday, Wednesday and Friday...my humple question for you is is there any interaction with medicines...is finastrade affect my mental issue...? I have no fear on finastrade..I know most of the news about finastrade is exaggerated things..My is question is is there any interaction with my antidepressants medicine and is finastrade has any role in depression and anxiety disorder...kindly advise me😊

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +1

      These 22 drugs interact with Finasteride:
      www.drugs.com/drug-interactions/finasteride.html
      Also watch my video: ua-cam.com/video/Tu63QpxFGxM/v-deo.html

  • @ShaanNSN
    @ShaanNSN 2 роки тому

    Dear doctor, thank you so much for this video.
    Does a cardio workout or hiit increase testosterone levels and then lead to more baldness?

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      Yes it does as explained in this video-
      ua-cam.com/video/DeCJ1f5TRcM/v-deo.html

  • @mikecronin6265
    @mikecronin6265 2 роки тому

    Great video! Do antidepressants inhibit that effectiveness of finasteride? Fluoxetine in particular.

  • @MathwithMrShukla
    @MathwithMrShukla 3 роки тому +3

    Got my hair transplant on 29th ...with dr bhatti...it was smooth with zero pain...second day ..no scar ! Hope I get good results

  • @realdaybreaker8013
    @realdaybreaker8013 3 роки тому +3

    Sir, how much of an impact does an intake of 1mg every other day have as opposed to 0.5mg daily.
    Also, while on 1 mg daily, can I apply a Min(10%)+Fin(0.1) topical solution, would you recommend avoiding this topical application, so as to not overdose myself with Fin

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +5

      1 mg a day or 0.5 mg a day Finasteride may have same effect on different individuals. Topical Finasteride is a commercial preparation with no scientific basis. Finasteride cannot cross the skin barrier.

    • @realdaybreaker8013
      @realdaybreaker8013 3 роки тому

      @@hairtransplantinindia don't you think the topical solution can be absorbed by bloodstream??
      Do u recommend oral over topical??

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +1

      @@realdaybreaker8013 It will first have to cross the skin barrier. Oral only is effective.

  • @marcnur1488
    @marcnur1488 5 місяців тому

    Thanks Dr. Bhatti for this informative video about finasteride. I just started to take it and I'm definitely going to subscribe to your channel for more information.
    Greetings from Germany.

    • @hairtransplantinindia
      @hairtransplantinindia  5 місяців тому

      Thanks.

    • @studiohouse54321
      @studiohouse54321 5 місяців тому

      ​@@hairtransplantinindiathanks dr for the vedio , i want to ask that i involve into regular exercises, so how should I take finasteride? ❤

    • @hairtransplantinindia
      @hairtransplantinindia  5 місяців тому

      You will need a consultation for this. or you can see my video on hair loss and exercise on this channel@@studiohouse54321

  • @zibtihaj3213
    @zibtihaj3213 3 роки тому

    Great vid no doubt . What about using Finastaride on TRT therapy (testosterone therapy, minimum amount of test per week to maintain in old age) ??

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому

      Thanks. This has been explained in my TRT videos: ua-cam.com/video/IKKOgb4f8oQ/v-deo.html

  • @Thrillseeker8922
    @Thrillseeker8922 2 роки тому +3

    Hello doctor. I recently started taking Finasteride for the first time ever, 0.5 mg daily, but after 6 days I experienced mild sexual side effects. Would you recommend to stop and then start again with 0.5 mg every 2 days, or is there no point in stopping and I can just continue to take it by lowering the frequency right away? Thank you.

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      Hi. What was your total testosterone level before starting Oral Fiansteride?

    • @Thrillseeker8922
      @Thrillseeker8922 2 роки тому

      @@hairtransplantinindia I didn't measure it. How long do you think I need to be off Finasteride before I can take a testosterone test to measure its levels?

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      @@Thrillseeker8922 60 days

    • @Thrillseeker8922
      @Thrillseeker8922 2 роки тому

      @Møø Mîn No, I take 1mg every two days now.

    • @Thrillseeker8922
      @Thrillseeker8922 2 роки тому

      @Møø Mîn After resuming no side effects whatsoever.

  • @ayanbhattacharjee3034
    @ayanbhattacharjee3034 2 роки тому

    Great channel. Subbed already. Wish you good health doctor.
    I have one question. I have food allergy and hashimoto. I have good amount of hair but my peaks have become shiny. Though I have a big forehead but hairline is distorted. My doctor has prescribed me fin,1mg per day. I'm a bit fearful and take .5 mg alternate days and three days a week and I have hairfall issue but it's not agressive. What do you think I should do? Thank you.

  • @bewithmee796
    @bewithmee796 6 місяців тому

    Hello sir , thank you very informative video. I wanted to know is it possible to club isostretine(for acne) and finasteride together ?

  • @thombareastik7447
    @thombareastik7447 3 роки тому +7

    Dr please make a video on sheeding peroid of finasteride

  • @naverich4603
    @naverich4603 3 роки тому +3

    My doctor told me to just shave my head, because "I am a man and should be glad I am not a woman"...that was her excuse. So I got finasteride off counter and started taking 1.25 mg 5 times a week and for over a month I was ok, but last week it was horrible. I am having depressions, nothing feels fun, I have no erotic thoughts, i have brain fog, I dont remember things, I feel like utter shit...and I just dont know what to do. I am 24 and already norwood 4...just shaving my head will never be enough for 20y old women, never

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому

      What was your total testosterone level before starting the medication? I think you need to stop Finasteride immediately and take your loca doctor's advice.

  • @mattmaximus538
    @mattmaximus538 2 роки тому

    Thank you doctor for all the knowledge you share with us, my question is, in my country there is only finasteride 5mg and the pill is very small, so i wonder if i can take one pill (5mg) per 10 days

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому +3

      That wil not work. You can pulverise the tablet and make 4 or 5 equal portions and consume.

  • @AnkitYadav-pl2qf
    @AnkitYadav-pl2qf 2 роки тому

    Thank you dr. For this detailed video, one quick question can someone drink alchohol while on finasteride

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      Thanks. Alcohol is no problem at all with Finastreide as I have mentioned in this video: ua-cam.com/video/xmj7uEWAvDc/v-deo.html

  • @sukeshjph
    @sukeshjph 2 роки тому +3

    Out of 4.6 million men who received Finesteride in US 10.695 had symptoms. I guess a lot of men didn't have them.It's better for doctors to check with the patients to understand if they are getting symptoms. This is a great drug but as we all are different with different hormone levels, physiological profile. A full body blood test and mental health test should be done before prescribing this. A cutomised does is also good. But ow many doctors follow this.

  • @MamtaSharma-dc2bv
    @MamtaSharma-dc2bv 2 роки тому +1

    Doc today is the day that I am impressed with your knowledge and stretegy. But we r in Delhi.How can I get treated from you?

  • @brianm4108
    @brianm4108 Рік тому

    Great video, question wouldn't the drugs half life negate the need for timing strategies? If not, to coincide with testosterone peaks how long does it take for the drug to enter and start working in the bloodstream? Thank you and impressive mountain biking skills btw :)

    • @hairtransplantinindia
      @hairtransplantinindia  Рік тому

      Thanks!
      The peak blood concentration of the drug happens in 6-8 hours and wanes off shortly thereafter. This has to coincide with the androgen peak to my mind.

  • @Justin-vg4kw
    @Justin-vg4kw 3 роки тому

    Hello. Approximately how many patients have you prescribed finasteride? You suggested only 0.1% had side effect in your experience, but do you follow up with all your patients that are taking the finasteride? Is it possible that they quit because of sides and have not communicated to you? Honest answer is appreciated. Thanks. I like to hear more from doctor with personal experience than study.

  • @magnuskarlsson8655
    @magnuskarlsson8655 Рік тому

    Hi, thank you for this informative video. I'm sorry if you have already covered this question, but is finasteride ototoxic, that is, is there a risk of getting tinnitus from taking finasteride?

  • @Shubruhhh16
    @Shubruhhh16 Рік тому

    I think I'm the only person here ,to improve my English language ,to improve attitude ,apart from gaining neesh knowledge about given topic, I always admire at u ,just got addicted to u ,to ur commanding attitude..ur my virtual guru..

  • @mohafar3429
    @mohafar3429 3 роки тому

    Great Video and to the point.
    What do you think about connection between taking finasteride and panic disorder ?

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому

      Panic due to taking Finasteride or taking Finasteride in those who have a panic disorder?

    • @mohafar3429
      @mohafar3429 3 роки тому

      @@hairtransplantinindiaI had a sort of panic disorder (panic attacks when I have to present in public) and I took finasteride 1mg for 6 months then my panic or high anxiety came back again till it exploded when I was weight training and exhausted myself… I was wondering if finasteride re-triggered it or something else random ? Coz it was gone for 10 years and came back though I had almost got over it over this period..

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому

      @@mohafar3429 I feel you can try it out for a month and see. Also discuss this with your counselor.

  • @deankerr2469
    @deankerr2469 2 роки тому

    Hello Dr Bhatti, firstly what a brilliant video!! Thanks!! I want to start fin for hair loss but I already have some gynecomastia from a different medication in the past.. can fin make gynecomastia worse if it was caused by a different drug or does it not matter is it a case of if you have gyno it can be made worse using fin regardless if it was puberty or medication induced? 👍

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому +1

      Yes it can make gynecomastia worse unless of course the gynecomazia is genetic and your hormonal levels are normal.

    • @deankerr2469
      @deankerr2469 2 роки тому

      @@hairtransplantinindia I got gynecomastia from tricyclic antidepressants in 2019. But I got my hormones checked this year and everything is normal.

  • @deepk9096
    @deepk9096 3 роки тому

    Soon going to visit u sir😍

  • @mariusfurst4898
    @mariusfurst4898 2 роки тому +2

    Hello,
    First of all I think your work is really important and not only to me, but to others as well. You are investing quite some time here without charging. I,m sure you could make more money by counselling people in your clinic. Thank you sir!
    So usually I take finasteride in the evening, but since I am always going to the gym in the afternoon, might it make more sense to take the medication before that?
    And how long should I take it before, so that it is in my system?

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому +1

      Testosterone peaks in the morning. And that is the time your Finasteride blood level need to peak too and coincide with the hormonal surge. So late night is the best time.

  • @markr9571
    @markr9571 3 роки тому

    Thank you for this informative video! What time do you recommend taking finasteride?

    • @bajwa6544
      @bajwa6544 3 роки тому

      Between 7 and 8 morning

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +1

      Best is to take around midnight if you are a late night person. If you rise early, take it at 6 AM.

    • @bajwa6544
      @bajwa6544 3 роки тому +1

      @@hairtransplantinindia Sir I'm noticing testicles pain from previous some days and having finasteride from last 2months daily dose of 1mg and mine age is 24yrs and I'm facing hair loss from past 2yrs but not have notice any bald area on my scalp......can I continue the medicine

    • @markr9571
      @markr9571 3 роки тому

      @@hairtransplantinindia Thank you. I had been taking it about 22.00. I thought the peak plasma levels of the drug was approximately 8 hours? Thank you for all your videos!

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +1

      @@markr9571 Yes that covers the circadian surge of testosterone pretty much effectively.

  • @klmknop
    @klmknop 3 роки тому +2

    Hi doc, what blood tests should we take before starting finasteride?

  • @oliverlime5589
    @oliverlime5589 2 роки тому

    Sir, should i take finasteride daily or alternate days. is there any difference or it provides same results. Please sort out my confusion. you are such a great helper out there.

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      The frequency that helps you reach your sweet spot of dosage is the best for you.

  • @TokenTornado
    @TokenTornado 3 роки тому

    Can you advise topical finasteride dosage for mild gyno user?

  • @qsdailydose8970
    @qsdailydose8970 2 роки тому

    Doc, for someone on TRT who keeps their T and dht and e2 at top of range would you recommend starting with 1mg finasteride instead of your recommended .5mg?

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      Why take more medication than is needed. If your baldness is not very fast paced, seek out the best low dose that is beneficial. Customised dosing: ua-cam.com/video/GwbYW3D6OJI/v-deo.html

  • @ab360
    @ab360 3 роки тому +1

    Dr. Which Cholesterol convert in testosterone HDL or LDL, can we take statins with finaestride
    And
    Which DHT affect hair, that present in blood or that in follicles of hair

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому

      The Leydig cells of the testes snnthesize testosterone from cholesterol derived from different sources.
      Statins have no drug interaction with Finasteride.
      DHT present in skin around follicles in the tissues is what affects the follicles.

  • @ajgomez254
    @ajgomez254 Рік тому +1

    Hello doctor, how many days or months of a break should I take if I am on 0.5 duetasteride every other day? You mentioned 15 day break from finasteride and because duetasteride lasts much longer in the system, I imagine a much longer break would be needed. I’d love to hear your opinion, Thankyou

    • @hairtransplantinindia
      @hairtransplantinindia  Рік тому

      That is the tissue build up which will get removed the same time you are off it as Finasteride- 15 days every 3 months. But I have no clinical experience with Dutasteride since I do not prescribe it more than once a week.

  • @warissatar35
    @warissatar35 3 роки тому

    Hi Dr. I want to know your opinion on brintop F minox/fin topical solution. Is it of good quality ? and if anyone else use this product to please kindly tell if it works or not.

  • @Matanthierry
    @Matanthierry 3 роки тому

    hello and thank you for all your info!
    My question is what do you think about Topical Finaseride?
    How effective do you think it is to be a substitute for the pill?
    Thanks in advance!

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +3

      Thanks for the question. As I have replied so many times, topical Finasteride absorption from skin is negligible. It is unable to cross the skin barrier. Most people use it as a placebo.

  • @jebunnesabegum7452
    @jebunnesabegum7452 7 місяців тому

    Good

  • @rrrreefer9721
    @rrrreefer9721 Рік тому

    Hey Doc, what's your opinion on taking finasteride with DIM supplements while on TRT at an elevated dose. Some foggy thinking with finasteride 1mg daily.

    • @hairtransplantinindia
      @hairtransplantinindia  Рік тому

      They have their own side effects, sometimes more disconcerting than those of oral Finasteride

  • @jaguar28x
    @jaguar28x 2 роки тому

    Thank you…..this video was extremely helpful for considering my dosage for finasteride.

  • @kaanmeric7893
    @kaanmeric7893 2 роки тому +1

    Hey doc do you recommend taking propecia(finasteride) in the age of 18.5 or is it too early my hair started to lessen in both sides of forehead and can be seen clearly I tried anything else but not worked please help

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      If this hair loss along the sides is recession of the temples, do not panic. This is the age when the hairline gets pushed backwards and if your hair are not thinning, there is absolutely no ned to take Finasteride. I recommend the drug after 21.

  • @Magicmobi
    @Magicmobi 2 роки тому

    Hi Doctor. Is there any tests to measure effects of Finasteride before and after ???

  • @peppasgeorge
    @peppasgeorge 2 роки тому +1

    Hello and thank you for the great video. I'm taking a combination of 0,5 minoxidil and 0,3 finasteride foam form in a bottle of 100ml. The counsil said to take 1 dose at morning and 2 doses in the evening. Someone said to me that this is a large overall dose and I've experienced some libido issues. Is this very high? I don't know how much mg of finasteride I'm getting with these 3 doses.

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому +1

      If this is topical form you are referring to, which you most likely are, you don't have to worry.
      Finasteride topically does not have effect on your hair loss. And risk of libido issues is even more remote.

    • @PedroDias-hj2jy
      @PedroDias-hj2jy 2 роки тому

      That is a lot... 0.3% in 60ml would be 3 mg... While it reduces systemic absorption, it still absorbs systemically quite a bit. You should go to a dermatologist for advice

  • @FINAL323
    @FINAL323 2 роки тому

    Maestro!!!

  • @Arminjf
    @Arminjf Рік тому

    Hello doctor hope you are doing well, thank for your information it’s so helpful. Can finasteride 1 mg cut in half? Thank you

    • @hairtransplantinindia
      @hairtransplantinindia  Рік тому

      Thank you for your kind words.
      Please watch-
      ua-cam.com/video/xmj7uEWAvDc/v-deo.html

  • @BadZombieWhy
    @BadZombieWhy 2 роки тому

    So as a guy who's prone to depression/has had a history of depressive episodes would you advise me against taking finesteride?

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      I will advise that you go on a month's trial of 1 mg a day Oral Finasteride. You will know.

  • @moriombegum2338
    @moriombegum2338 Рік тому

    Nice

  • @lordvoldemort3930
    @lordvoldemort3930 2 роки тому

    Hi Doc ,
    I love to have a fuller beard and hair both .. Will using Minoxidil + Finasteride combination which is topical on the hair and use beard oil help ...
    Will using topical Finasteride reduce the side effects and blocks only the head hair DHTs ??

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      Thanks for watching. Topical Finasteride is a placebo. You can use Minoxidil on your beard f it is not yet fully developed and you are young;and take oral Finastreide on prescription for your scalp Watch: ua-cam.com/video/GCqFqkzIsAs/v-deo.html

  • @gopinath9247
    @gopinath9247 2 роки тому

    Hai sir, I became a big fan of you after seeing so many Informative videos. I am suffering from hair loss from last 6 years now my scalp is visuable, I wanted to take the this medication to stop my further hair loss. In my town dermatologists blindly prescribe 1mg per day with out any blood tests. So I wanted to start this under your guidance, I am from Andhrapradesh state so it's difficult for me to consultant you I person, does your online consultation available to me sir

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      Thanks Mr Gopinath.
      Yes you can ask Puneet to put your through to me.
      8872238888

  • @EvardAguilar
    @EvardAguilar Рік тому

    Hello dr. Bratti..can i take 5mg of generic finasteride?does the generics efficasy same with the nongeneric?

    • @hairtransplantinindia
      @hairtransplantinindia  Рік тому

      Finasteride preparations have a lot of polymorphic variation from one brand to another. Whichever you take stick to it if it is giving benefit.

  • @amarjari
    @amarjari 3 роки тому

    Hi , so i am on 0.5 topical fin 2x a week (1mg a week) and its been 3 weeks now and at the moment I have taken 3mg in total . After 2.5 ml i started to feel weird , my motivation was low and my lib got affected too...I have used fin before too with different doses 1mg of topical fin a day , 1 mg every alternate days , 0.5 mg every alternate days and all this time i got the side effects hence I am fearful about it ( can this be psychological?)and now using just 1 ml a week (0.5x2) . Also my T is 700 but i am worried my free T is lower as have lost lean muscle in these 2 years , lower lib than it was before and trouble concentrating . So these are my questions to you.
    1. Should i get my free T in order put on some weight , muscle get bulkier and then start using Fin ? May be I would be able to handle fin better than
    2. What if i stop using fin after 2.5ml ( as after this i get my sides) take a break , let it flush out and than repeat so that I dont build up fin levels more in my body.

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому

      I think you are worked up about Finasteride. You never get sides effects after 2.5 mg! Whatever the reason, I do not think psychologically you are geared to start a medicine like Finasteride. Please do not take it.

  • @jens3945
    @jens3945 3 роки тому

    Hey. Is it normal to go through a second shed? When I first started taking the drug 7 months ago I was shedding alot of hair during month 1-3. After that my hair improved greatly, and I saw alot of regrowth beyond baseline. I now feel like I'm losing a little bit of hair again. I'm still above what I was when I first started, but worse off compared to month 5-6.

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +2

      Finasteride will not stop your hair loss. There will be phases of intense hair loss and regrowth. But the baldness will continue to advance; but at a much slower pace than it otherwise would have with the drug.

    • @outlaw0076
      @outlaw0076 2 роки тому

      Yes you can get more than one shed

  • @remixrockers
    @remixrockers 2 роки тому

    sir can I use creatine monohydrate suppliment while taking minoxidil and fenasteride. wil it increase male pattern baldness

  • @luckybeast45
    @luckybeast45 3 роки тому +1

    The only doctor from whom I'm getting the depth Knowledge

  • @rahuldhingra29
    @rahuldhingra29 3 роки тому

    Sir, switch off/on technique also follow in first six months of hair transplant as well?

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому

      No not aftre hair transplant. Cannot take chances since the 6 month period will not allow us to adjust the dosage.

  • @mansigandhi971
    @mansigandhi971 2 роки тому

    Sir can 17 year old use topical finastride ii

  • @mousaaldoukali5668
    @mousaaldoukali5668 2 роки тому

    Hello Dr. could u tell me about neoxyl 7% what do you know about?

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      These sort oftreatments come and go. It is only time ested treatments like 5% Minoxidil that matter. If you care about hair, do not waste your time with these advertsements and hard sell.

  • @Mrsinpai
    @Mrsinpai 3 роки тому +1

    Hello sir, I’m a type 1 diabetic and recently received finasteride from “keeps” I’m sure you’ve heard of them they where not very informal about side affects with my diabetes do you have any tips besides just asking my endocrinologist? Such as will it make my me have to take more insulin after meals?

    • @Mrsinpai
      @Mrsinpai 3 роки тому

      I also was prescribed 1mg daily by a keeps “doctor”

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +2

      No, there is no such quantified report. I have controlled diabeteics taking Finasteride regularly.

  • @sumitsood5684
    @sumitsood5684 2 роки тому

    Hello Sir, thank you for your videos . They are very informative as always . Im 36 years old , do anaerobic weight exercises thrice a week and do smoke regularly. Im planning to get a hair transplant done but want to know if I should take Finesteride after the procedure considering my lifestyle and if yes, how much dosage should I take. Thanks in advance for your guidance .

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      Thanks you for the kind words. Please get total testosterone level checked early morning and I can advise you on this.

    • @tomshaji
      @tomshaji 2 роки тому +1

      If you care for your hair atleast after hair transplant you should stop smoking,it's the worst thing for your hair

  • @ComedyJunction19
    @ComedyJunction19 Рік тому

    Hi doc, as you mentioned about weekend rush ,what if we are running or exercising daily.. should we take 0.5mg daily in that case?

  • @abdulhakbayan7271
    @abdulhakbayan7271 2 роки тому

    Hi doctor, you said something about that the pick of fin should reach the same time at 7-8 am with the TESTO so should I take it at 12pm before sleep or in the morning at 7 , second thing I have been 2 months on fin 1 mg 3x every week and I have been shedding massive among of hair and it went worse is this normal or something wrong and i was thinking adding minoxidil and derma-rolling?

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому +1

      Shedding is a good thing to have- means the drug is working. Take Finasteride just before you go to sleep.

    • @abdulhakbayan7271
      @abdulhakbayan7271 2 роки тому

      @@hairtransplantinindia Thank you very much doctor for your Doubt cut off reply as always 🙏

  • @sandeepshukla7560
    @sandeepshukla7560 2 роки тому

    Thanks doctor for the insight, but I have personally seen the meibomian gland dysfunction as the only side effect from this drug when used, so stopped it and had to undergo ocular surgery for the same, what would you say for this? Should I ever use it again?

    • @hairtransplantinindia
      @hairtransplantinindia  Рік тому +1

      There is likely some other concomittant cause. I do not have any of my patients complain of dry eyes. Whatdid your ophthalologist say was the likely reason?

    • @sandeepshukla7560
      @sandeepshukla7560 Рік тому

      @@hairtransplantinindia no other co-morbidity associated., The latest research indicates the same, as 5 AR is needed for meibomian gland functioning, you might want to look into the research, thanks.

    • @hairtransplantinindia
      @hairtransplantinindia  Рік тому +1

      @@sandeepshukla7560 Yes, I have this knowledge but do not see this happening ever. My patients have been taking this drug for over 18 years.

  • @Rathore12438
    @Rathore12438 3 роки тому +1

    Sir i am a 34 years old man. I started losing my hair once I turned 18 and lost hair by the time I turned 25....in a meanwhile I used Minoxidil 2&5% with good result at start but useless after 2 years...hence I went for Hair Transplant and had 3 hair transplants....even after hair transplant I don't have complete coverage of head especially at crown....Do you suggest me to use FINESTERIDE? Will it bring back few of the hair or is it useless to use it at this age of 34?

    • @hairtransplantinindia
      @hairtransplantinindia  3 роки тому +3

      Precious time has been lost due to your succumbing to false information about Finasteride. The drug when used intelligently under medical supervision is the gold standard for hair loss management and has no alternative. At this stage only thinning hairs that are 50% of their original volume will return. Finasteride will need to be taken long-term.

  • @hasysn
    @hasysn 2 роки тому

    Heelo Doctor!
    I have decided to start using fianstride week ago, my plan was to take 1mg 3 times a week!
    After one day of taking the first tablet, i started to feel achy testicles, chest pain speccially the left side ( i also can feel a very very small ball under my left nipple ), Erectile difficulty and watery semen.
    Then i decided to stop it intil the side effects reverses.
    What do you think should i do ? Should i re start with a lower dose? 0.5 or 0.25mg 3 times a week ? Or switch to topical finastride?
    By the way I did not make any blood test before starting finastride, i am 25 , my baldness stage is about NW3, my BMI is around 26.

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      Please first take the total testosterone test
      Then if it is normal go on the previous dosage. Side effects will disappear as your body adjusts in 4 weeks.
      Watch this: ua-cam.com/video/GwbYW3D6OJI/v-deo.html

  • @ashekhawat372
    @ashekhawat372 2 роки тому +1

    Hello sir, just a quick question- is 0.5 mg of finasteride per day equally effective as 1 mg taken every alternate day? Thanks in advance!

  • @AlexMedina9999
    @AlexMedina9999 3 роки тому +2

    Thank you so much for responding to so many of your questions and great content. I am on 1MG per day and my only side effect is lower sperm volume. What would you suggest to combat this?

  • @KarunKris
    @KarunKris 11 місяців тому

    Hi doctor
    Which brand has the best Finasteride? What would be your recommendation? Thank you

  • @siddhartha2236
    @siddhartha2236 Рік тому

    Great video sir. Is it true that finesteride can cross the blood brain barrier and thats the reason for long lasting post finesteride symptoms. I had side effects of finesteride after being on it for a month ( 1mg / day). Can someone who is not taking finesteride at least maintain their hair without further balding on minoxidil and PRP?

    • @hairtransplantinindia
      @hairtransplantinindia  Рік тому

      It has to be a DHT blodker for these objectives. And PRP & Minoxidil are not.

  • @danielbull1804
    @danielbull1804 2 роки тому

    Some people think that scalp tension causes reduced blood flow and hair loss and dht goes to the scalp as an anti inflammatory. What do you think about this Dr?

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      Please watch:
      ua-cam.com/video/hUf2iarsL60/v-deo.html
      ua-cam.com/video/h4KVUudZRoU/v-deo.html

  • @sijusamuel9468
    @sijusamuel9468 2 роки тому

    Hai doctor
    Hope u r doing good
    Doctor I have mixed night and day duties and my sleep is improper . Can I have any suggestions of the timing of finasteride. I completed 1 mg daily for 6 months regimen. But I would like to take 1 mg alternative and to wean then to 0.5 mg alternative. Can I have suggestions regarding this?

    • @hairtransplantinindia
      @hairtransplantinindia  2 роки тому

      Pleaes take the medication late in the night around 11 PM. And get total testosterone level checked once at 8 AM before starting the drug.