Finasteride Canada: Effectiveness, Side Effects, and Treatment Options

For over 25 years, finasteride has been one of the most widely prescribed oral medications for hair loss in the world. But despite its long track record, many Canadians still have questions about how Finasteride works, whether it’s safe, and how to actually get it.

Some of that confusion is understandable. Finasteride is available in Canada as both an oral tablet and a compounded topical formulation made to an individual prescription. Furthermore, in recent years, conversation around its side effects has become increasingly polarized, with strong opinions on both sides.

Whether you’re just starting to research treatment options for hair loss or are comparing finasteride to other medications, this guide covers everything you need to know about finasteride in Canada. We’ll look at how finasteride works, the different formulations available, side effects, costs, and how to get a prescription.

What Is Finasteride?

Finasteride is a prescription medication that was originally developed in the early 1990s to treat benign prostatic hyperplasia (BPH), or enlarged prostate. It was approved at a 5 mg dose under the brand name Proscar, and it became the first drug to address the underlying hormonal cause of prostate enlargement, rather than just managing symptoms.

During those early clinical trials, researchers noticed that older men taking finasteride for their prostate were regrowing hair. This observation led to further studies, and in 1997, finasteride was approved at a lower 1 mg dose under the brand name Propecia, specifically for the treatment of male pattern hair loss.

Today, generic finasteride is widely available in Canada from manufacturers like Teva, Apotex, and Sandoz. Both finasteride 1mg (for hair loss) and finasteride 5mg (for BPH) require a prescription, as finasteride is classified as a Schedule I drug in Canada. Topical finasteride solutions have also become available through prescription, offering an alternative for patients who prefer not to take the medication orally.

How Does Finasteride Work for Hair Loss?

Male pattern hair loss (androgenic alopecia) is caused by an interplay between hormones and genetics. Specifically, pattern hair loss is driven by dihydrotestosterone (DHT), a potent androgen that can cause hair follicles to progressively shrink in genetically susceptible men.

Here’s how the male pattern hair loss process works: 

• Testosterone, the primary male sex hormone, is converted into DHT by an enzyme called 5-alpha reductase. 
• DHT binds to androgen receptors in the hair follicle with roughly five times the strength of testosterone. 
• In people genetically predisposed to hair loss, this causes the follicles to shrink over time, producing thinner and shorter hairs with each growth cycle, until the follicle eventually stops producing visible hair altogether.

Finasteride works by selectively blocking the Type II 5-alpha reductase enzyme, which is the main form found in hair follicles on the scalp. A daily 1 mg dose of finasteride reduces scalp DHT levels by approximately 60-70%, effectively removing the hormonal trigger that causes follicular shrinking.

How Finasteride Differs From Other Hair Loss Treatments

Minoxidil, the other main hair loss treatment available in Canada, is thought to work by stimulating hair growth directly at the follicle by improving blood flow and extending the growth phase. Minoxidil was originally designed as a blood pressure medication and does not impact hormones.

Finasteride is different from minoxidil because it addresses the root hormonal cause of why hair is being lost in the first place. It’s worth noting that finasteride does not lower testosterone. It blocks the conversion of testosterone into DHT, so testosterone levels may actually increase slightly.

Does Finasteride Regrow Hair?

Studies show that 48% to 66% of men experience some degree of hair regrowth when taking finasteride, depending on treatment duration and the area of the scalp. More importantly, approximately 80-90% of men who take finasteride stop losing hair. This means that even if regrowth isn’t dramatic, the drug prevents things from getting worse.

Finasteride Results: What to Expect

Finasteride doesn’t produce overnight results. Because hair grows in cycles, it takes time for the effects of DHT suppression to become visible. 

Here’s a general timeline of how finasteride results usually work:

• During the first one to three months, you may notice little visible change (some men actually experience a temporary increase in shedding). This can be alarming, but it’s a normal part of the process. Finasteride shedding occurs as dormant follicles are pushed from the resting phase (telogen) into a new growth phase (anagen), causing older hairs to fall out before being replaced by new growth.
• Between months three and six, shedding typically stabilizes and hair loss slows noticeably. 
• From six to twelve months, visible regrowth may begin to appear, particularly on the crown and vertex of the scalp. Maximum benefit is generally observed between one and two years of consistent use.

The Importance of Patience

Long-term data reinforces the value of patience when measuring results from finasteride. 

Five-year studies show that while men on placebo continue to lose approximately 25% of their baseline hair count, men on finasteride maintain their count or show improvement, creating a significant net difference over time.

The vertex and crown tend to respond better than the frontal hairline, though finasteride can slow recession in both areas.

Oral vs Topical Finasteride in Canada

Finasteride is available in Canada in both oral (tablets) and topical (liquid, cream, or gel) formulations

Oral Finasteride

Oral finasteride 1mg taken once daily is the standard treatment for male pattern hair loss. Finasteride tablets can be taken with or without food, as absorption isn’t significantly affected by meals.

Despite having a relatively short half-life of 5-6 hours, once-daily dosing is sufficient because finasteride forms a very stable complex with the 5-alpha reductase enzyme. The drug essentially locks onto the enzyme and doesn’t let go. This means that even as finasteride clears your bloodstream, the biological effect on DHT suppression persists.

Overall, oral finasteride is usually a straightforward treatment of simply taking one pill per day. However, topical finasteride has emerged as an alternative for people looking to avoid possible side effects of oral treatment.

Topical Finasteride

In recent years, topical finasteride has gained significant popularity among Canadians looking to minimize potential systemic side effects while still benefiting from DHT suppression at the scalp.

The rationale is that by applying finasteride directly to the scalp, one can achieve meaningful DHT inhibition in the hair follicle while limiting how much of the drug circulates around the rest of the body. 

Research shows that topical finasteride reduces serum DHT by approximately 30-50%, compared to the 60-70% reduction seen with oral finasteride. This “sparing” of systemic DHT is thought to reduce the likelihood of side effects like sexual dysfunction, while still delivering clinically meaningful results at the scalp.

Is Topical Finasteride Approved for Use in Canada?

It’s important for Canadians to understand that topical finasteride is not a Health Canada-approved commercial product. There is no brand-name topical finasteride with a Drug Identification Number (DIN) sitting on pharmacy shelves. 

Topical finasteride in Canada is available through compounding pharmacies, where it’s prepared to an individual prescription. Topical formulations typically contain 0.1% to 0.3% finasteride, and many compounded products combine finasteride with minoxidil (typically 5-8%) in a single topical solution.

Does Topical Finasteride Work?

The strongest real-world evidence for topical finasteride comes from a 2026 retrospective study published in JMIR Dermatology. This study analyzed data from over 638,000 male patients using a compounded topical finasteride/minoxidil product via a telehealth platform. 

Researchers found that 80.4% of users reported satisfaction with topical finasteride treatment, while the reported side effect rate of 2.7% was relatively low.

Side Effects of Finasteride

The side effects of finasteride are the most debated aspect of the drug. Therefore, it’s important to look at what the clinical data actually shows.

Please note that while the side effects described below are mainly associated with oral finasteride, they may also occur with topical treatment.

Sexual Side Effects of Finasteride

In the initial clinical trials for Propecia, sexual side effects were the most commonly reported, though they affected a small minority of users.

Here’s what the data showed: 

• Decreased libido in approximately 1.8% of men (vs. 1.3% on placebo).
• Erectile dysfunction in approximately 1.3% (vs. 0.7% on placebo).
• Ejaculatory disorders in approximately 1.2% (vs. 0.7% on placebo).

Importantly, the trials found that these effects were reversible in men who stopped taking the drug. Interestingly, they also resolved in 58% of men who continued therapy despite the initial side effects.

Does Finasteride Lower Testosterone?

One common question is whether finasteride lowers testosterone. Research shows that the opposite is likely true. In studies of men taking finasteride for BPH and male pattern hair loss, serum testosterone levels actually increased by up to 15%.

Mental Health Risks of Finasteride

More recently, regulatory bodies have flagged potential mental health risks of finasteride. Health Canada updated the finasteride product monograph in 2024/2025 to include warnings about mood changes, depression, and suicidal ideation. The European Medicines Agency (EMA) has also confirmed suicidal ideation as a potential side effect and mandated additional patient warnings in packaging.

In light of this development, patients starting finasteride should monitor their mood and speak to their doctor promptly if they notice changes in how they feel.

Topical Finasteride Side Effects

The main side effect reported with topical finasteride is localized scalp irritation in some users.

The available evidence suggests that topical finasteride may carry a lower rate of systemic side effects compared to oral finasteride. However, topical treatment still impacts serum DHT, so the risk is not zero.

Can Women Take Finasteride?

Finasteride is not typically prescribed for women and is strictly contraindicated during pregnancy. Women experiencing hair loss should speak with their doctor about alternatives like minoxidil.

Finasteride and Minoxidil: Combination Treatment

While finasteride is often effective on its own, combining it with minoxidil may produce even better results in some patients. This is because the two medications treat hair loss through entirely different mechanisms, producing a complementary effect.

In combination pattern hair loss treatment:

• Finasteride acts as the “shield,” protecting hair follicles by blocking the DHT that causes them to shrink. 
• Minoxidil then acts as the growth stimulant, improving blood flow to follicles and extending the active growth phase of the hair cycle. 

The research supports this approach, with studies showing that combination therapy produces significantly greater improvements in hair density compared to either treatment alone. 

Finasteride and minoxidil can be taken as separate medications (oral finasteride plus topical minoxidil), or as a compounded topical solution that combines both ingredients into a single daily application. For a deeper look at how minoxidil works, its different formulations, and its side effects, see our complete guide to minoxidil in Canada.

Dutasteride vs. Finasteride

Dutasteride is another 5-alpha reductase inhibitor that’s sometimes discussed as an alternative to finasteride. The key difference is that while finasteride only blocks the Type II 5-alpha reductase enzyme, dutasteride blocks both Type I and Type II. This can result in more aggressive DHT suppression (over 90% of serum DHT, compared to approximately 70% with finasteride).

Research suggests that dutasteride may be slightly more effective than finasteride for hair regrowth. However, there are important trade-offs when looking at finasteride vs dutasteride:

• Dutasteride is not approved for hair loss treatment in Canada (any use for this purpose is off-label). 
• Dutasteride has a much longer half-life of approximately five weeks, compared to 5-6 hours for finasteride (so if side effects do occur, it takes significantly longer for the drug to leave your system). 
• The more complete DHT suppression of dutasteride carries a theoretically higher risk of adverse effects.

For these reasons, finasteride remains the first-line treatment for hair loss in Canada. Its regulatory approval, shorter half-life, and decades of safety data make finasteride the more practical starting point for most patients.

How to Get Finasteride in Canada

Finasteride is a prescription-only medication in Canada, so you’ll need to consult with a healthcare provider to obtain it. 

You can visit your family doctor or a dermatologist in person and discuss your hair loss concerns. Alternatively, virtual care platforms now offer a convenient way to get a finasteride prescription in Canada from home. The process typically involves completing an online medical assessment, uploading photos of your scalp, and having a telehealth review with a licensed Canadian physician. If approved, the prescription can be filled at a local pharmacy or shipped directly to you.

Finasteride Cost in Canada

The cost of finasteride in Canada varies depending on where you buy it and which formulation you choose.

Generic oral finasteride 1mg is relatively affordable, typically costing between $15 and $27 per month at retail pharmacies.

Compounded topical finasteride is more expensive, generally ranging from $50 to $120 per month, depending on the provider and formulation.

When it comes to insurance, finasteride for hair loss is generally not covered by provincial drug plans. OHIP, RAMQ, and BC Pharmacare all consider hair loss treatment a cosmetic or lifestyle indication, and finasteride 1mg is excluded from their formularies. 

Finasteride Canada FAQs

How long does finasteride take to work?

Most men notice stabilization of hair loss within 3 to 6 months. Visible regrowth, if it occurs, typically becomes apparent between 6 and 12 months. Maximum results are usually seen after 1 to 2 years of consistent use.

What happens if I stop taking finasteride?

Hair loss will resume, typically within 3 to 6 months of stopping treatment. Any hair that was maintained or regrown through finasteride is likely to be gradually lost.

Can I use topical finasteride and minoxidil together?

Yes. Many compounded formulations combine both ingredients into a single topical solution.

Is finasteride safe long-term?

Finasteride has been studied for over 25 years and is generally well-tolerated. However, ongoing monitoring is recommended, and patients should discuss any concerns with their healthcare provider, particularly regarding mood changes or sexual side effects.

Finasteride Canada: Is It Right for You?

Finasteride remains the most established oral treatment for hair loss in Canada. Whether you choose oral finasteride tablets or a topical formulation, the drug works by addressing the underlying hormonal cause of pattern hair loss—something that no shampoo, supplement, or laser device can replicate.

The key to success with finasteride is consistency and realistic expectations. It takes months to see results, and the treatment is a long-term commitment. But for the majority of men who take it, finasteride delivers meaningful stabilization of hair loss, and for many, visible regrowth.

If you’re experiencing hair loss and want to explore whether finasteride is right for you, speaking with a healthcare provider is the next step. A doctor can assess your situation, discuss the available options, and help you build a treatment plan tailored to your needs.

Speak With a Virtual Doctor About Hair Loss Treatment