I am part of a group of doctors who discussed the value of long term finasteride. There is a general consensus that this drug has good long term effects, even if it just in slowing hair loss ‘progression’ however, a few patients pop up periodically who actual start losing hair while on the drug long-term. Some patients switch from Propecia to Proscar 5mgs tablets cut in quarters, or genetic 5mg tablets cut in quarters. These people, as a general rule, do not see changes in their hair loss from these switches. On the other hand, some doctors are reporting that a switch to the 1mg finasteride is causing more shedding within a month of that switch, suggesting that either the 1mg is counterfeit or not pure finasteride. So if you see shedding after switching your routine finasteride, then think seriously about going back to your doctor and going back on the real finasteride Either Propecia of Proscar in quarter tablets).
Suggestions for those who are really experiencing hair loss after long term use of finasteride, include combining minoxidil with the finasteride (Propecia) as there are different effects when the drugs are worked in combination. This is worth a try if you are disappointed in the results of the finasteride or if it is losing effectiveness over time. On rare occasion, a few doctors may prescribe dutasteride (Avodart) but must doctors are reluctant to do so, as I am since there is no clear evidence that it is better drug for hair loss.