It is not a rare practice when people give different names to one and the same object. Linguists usually call this phenomenon a synonymy. If the same technique is used by a spy or some secret agent, they call it “a conspiracy”. It is amazing, but even such precise and unambiguous science as pharmaceutics also practices giving different names to the same medications.

This article is nothing but a small investigation, aimed at revealing the conspiracy of pharmacists and explaining the difference between generic and brand names of the medications, as well as answering the question why pharmaceutical companies create the same medications with different names and what it means for us as the potential consumers of those pills. While researching the issue, the author had to use all known to him spy techniques (which he learned during watching all the James Bond movies), as well as all the linguistic means (which he had not yet forget since graduating from the University:)

So, the investigation is focused on the substance, known as finasteride. Unlike this word, which may seem unknown to the majority of our readers, the words “Proscar” and “Propecia” are, undoubtedly, much more widely known to the public. The first truth is that Proscar and Propecia are nothing but two brand names of the same medication, called finasteride.

Here comes the question: if Proscar and Propecia are, in fact, the same substances, so what is the difference, if any, between these two pills and why did the manufacturer give two names to the same product?

The history of finasteride began in 1992, when the U.S. Food and Drug Administration approved its use under the brand name Proscar as the treatment of enlarged prostate in men. Later on doctors, prescribing Proscar, noticed that their patients, receiving Proscar, were less prone to baldness or even show the improvements in the hair growth. Scientists conducted the necessary experiments and discovered that finasteride can really treat male pattern baldness. As the result, the manufacturer of Proscar created the new name Propecia for its old drug and received the FDA approved for its use as the anti-baldness medication.

Naturally, it is interesting to find out whether Proscar can be used instead of Propecia and vice versa. Taking into account economical considerations (Proscar is much cheaper than Propecia), the issue of interchangeability of Proscar and Propecia seems to be of current importance.

To answer the question it should be clearly understood that in spite of the facts that both Proscar and Propecia have the same working ingredient (finasteride), the differences between them do exist. People should mind these differences when making a decision of using Proscar instead of Propecia, so that such usage would be effective and safe.

First of all, it should be noted that the FDA strictly limits the use of medications: in our case Proscar can be prescribed only against prostate enlargement and not against male pattern baldness and the prescription for Propecia can be given only to those patients, who suffer from baldness. The use of medication for treating disorders other than approved by the FDA are considered to be "off-label", which means that using Proscar instead of Propecia in order to treat male pattern baldness is not a crime, but it is at the own risk of a patient and/or his doctor, who prescribes the medication.

The other important difference is that one Proscar pill contains 5 mg of finasteride while Propecia contains only 1 mg. So, Propecia is 5-times weaker than Proscar, and in order to use Proscar for treating baldness, one should split the Proscar pill into five equal parts and take one part daily. Taking into the account the form of the Proscar pill, which is something like a triangle with cut edges, it could be challenging to cut the pill into five even pieces. However, using pill-splitter instead of a kitchen knife can be helpful to maintain the operation with the accuracy of a surgeon. By the way, such instruments are sold over the counter in the majority of pharmacies.

The other concern about using Proscar instead of Propecia refers the coating of the pill, which protects it from the influence of stomach acid and provides its absorption in the intestines rather than stomach. The point is that the interaction between the working ingredient of the pill and stomach acid may cause stomach irritation and uncomfortable feelings.

Finally, to provide safe off-label use of Proscar in treating male pattern baldness, people should keep in mind the precautions and contraindications for finasteride. The most important is that the medication should not be taken by women, who are pregnant or can become pregnant in the nearest future.

So, to sum up our investigation, it can be said that providing one and the same medication with different names is not a demonstration of creativity of the manufacturer, but a necessity to meet the requirements of health authorities and, of course, one of the marketing techniques, aimed at earning some extra revenues by promoting same medication for treating different disorders:)

Translating the investigation results into the consumer language, Proscar can be used instead of Propecia for treating male pattern baldness. The benefits of such off-label use of the medication are obvious: Proscar is much friendlier to the family budget in comparison to Propecia. Besides, medical insurance plans are more likely to cover the medications against potentially life-threatening conditions (such as prostate cancer, for example) than the pill to treat cosmetic problems, such as hair loss.

Nick