Finasteride and Alcohol: What You Need to Know

Imagine this: It’s Friday night, and you’re out enjoying a couple of drinks with your friends when you remember you’re taking finasteride. You put down your sweaty drink cup and wonder, How do finasteride and alcohol interact? Can you drink on finasteride?

Well, maybe you don’t have to imagine that scenario at all and are currently Googling at the bar (say hi to everyone for us). Or perhaps you’re doing some research before a night out (or in — we don’t judge). Whether you’re taking the medication to treat hair loss or benign prostatic hyperplasia (BPH), we’ve got answers to your finasteride and alcohol questions.

Here, we’ll cover what you need to know about finasteride interactions with alcohol, the surprising way the medication may alter your drinking patterns, and how an alcoholic beverage or two may actually have positive preventative effects.

Before we go too in-depth about the relationship between finasteride and alcohol, it’s important to have a solid understanding of what finasteride is and how it works.

Finasteride is a medication used to treat two conditions, male pattern baldness and benign prostatic hyperplasia (BPH). It’s also sometimes prescribed to reduce the risk of low-grade prostate cancer.  Both BPH and male pattern hair loss (androgenetic alopecia) are at least partially caused by the male hormone known as dihydrotestosterone (DHT).

DHT is an androgen essential for developing male characteristics, including the testicles and prostate. But it can also build up in hair follicles and the prostate, causing hair loss and BPH, respectively.

Finasteride (the active ingredient in Propecia^® for hair loss and Proscar^® for BPH) is a DHT blocker. This means it stops the action of the 5-alpha reductase (5AR) enzyme so testosterone doesn’t convert to DHT.

Whenever you’re taking medication, it’s normal (and smart!) to consider its potential interactions with alcohol. There’s no official guideline that says you cannot drink alcohol while taking finasteride — and there’s also no research that concludes alcohol makes finasteride any less effective for treating male pattern baldness or BPH.

Heavy Drinking on Finasteride

Finasteride is known to lower the risk of low-grade prostate cancer. However, (and this is a big however) heavy consumption of alcohol does seem to negatively affect finasteride’s ability to lower this cancer risk. So much so, in fact, that research from The Prostate Cancer Prevention Trial concluded that “heavy drinking made finasteride ineffective for reducing prostate cancer risk.”

Heavy drinking (which the research defined as at least four drinks a day, five or more days per week) both significantly increased the risk of high-grade prostate cancer and neutralized finasteride’s protective effect against low-grade prostate cancer.

Meanwhile, there was no association found between prostate cancer and lighter drinking.

TL;DR? Moderate drinking (less than four drinks a day) doesn’t seem to negate finasteride’s cancer-protection capabilities. But heavy drinking has risks, specifically when it comes to prostate cancer.

Does Alcohol Improve Benign Prostatic Hyperplasia?

Moderate drinking might actually reduce the risk of BPH. Yes, you read that right. Here’s the deal: A meta-analysis of 19 studies (and over 120,000 men) looked at the relationship between alcohol consumption and BPH.

Compared to no alcohol intake, an alcohol intake of 36 grams daily (or about two and a half drinks) was associated with a 35 percent decreased likelihood of BPH. This doesn’t mean drinking will necessarily help your situation if you already have BPH, however (sorry)

Why’s this the case? There’s some evidence (beyond the word of your friend who just got back from Napa) that moderate alcohol consumption can be beneficial for cardiovascular health. Better cardiovascular health could also mean a lower incidence of BPH, according to research conclusions.

There’s a caveat, though. The study also found an increased likelihood of lower urinary tract symptoms correlated with moderate drinking. More research is needed, but it’s unlikely that heavy drinking has the same preventative effect on BPH.

We can’t in good conscience recommend daily drinking — recent research has found that any amount of alcohol may compromise your health in various ways. Ultimately, alcohol-consumption habits is a conversation best had with your healthcare provider.

A few drinks here and there while taking finasteride probably isn’t anything to lose sleep over. Moderate alcohol consumption isn’t known to impact the efficacy or safety profile of finasteride significantly.

That said, we don’t have clear data on exactly how much (or how little) alcohol you can drink while taking finasteride — and both substances are metabolized through the liver. That means if you’re drinking too much and taking finasteride, your liver could potentially be overworked.

For this reason, you should consult your healthcare provider if you have any concerns about the effects of combining alcohol and finasteride. They’ll be able to give you the clearest idea of how much is advised for you personally to drink while on finasteride, taking into consideration factors like your body size and your medication dosage.

Here’s something else to consider that may make the question of whether you can drink on finasteride moot: You might be less likely to want to drink alcohol after taking finasteride.

Exactly why this happens isn’t totally understood. However, some researchers think finasteride may lower the desire to drink alcohol because the medication blocks the production of neurosteroids (also called neuroactive steroids) that alter brain function, including the impulse to drink.

One study found that in former users of finasteride, their average weekly alcohol intake dropped from just over five drinks to two drinks.

It’s crucial to note that this study looked at men with persistent sexual side effects from taking finasteride. Because of this nuance, it’s hard to conclude what the relationship looks like between alcohol consumption and finasteride for the wider population that doesn’t experience those specific side effects.

Finasteride is generally well-tolerated by most men. Though adverse effects can happen, they’re rare.

Still, you should be aware of potential finasteride side effects, which include:

• Erectile dysfunction (ED)

• Decreased libido (lowered sex drive)

• Ejaculation disorder

• Dizziness

In extremely rare cases, finasteride at both the 1-milligram and 5-milligram strength can cause:

• Male breast swelling or tenderness

• Mood changes, depression, or anxiety

• Skin rash

• Male breast cancer

Alcohol can potentially worsen some of these side effects, not because of an interaction between alcohol and finasteride per se, but because heavy drinking can cause sexual side effects like erectile dysfunction independently of finasteride.

Excessive alcohol use can also interfere with testicular function and male hormone production, potentially resulting in infertility, according to research.

Unless one of your drinking buddies convinces you to shave your head, you won’t see significant hair loss after one weekend of boozing.

Having said that, one small study on identical twins concluded that drinking more than four alcoholic drinks a week was linked to hair loss.

On the flip side, this study showed that not drinking any alcohol at all was linked to hair loss. So it’s hard to pin down the actual link between alcohol and hair loss. (Two or three drinks a week seems fine for your hair, at least).

Excessive Drinking and Hair Loss

There’s an indirect link between heavy alcohol consumption and hair loss.

Specifically, nutritional deficiencies can cause hair loss. Excessive drinking can affect nutrient absorption and lead you to crave less nutrient-dense food. After all, has anyone ever craved a salad after a night of partying?

If alcohol prevents you from meeting your body’s nutritional needs, it’s possible for you to develop a form of reversible hair loss known as telogen effluvium.

You can learn more about this in our guide to alcohol and hair loss.

If you’re wondering about the relationship between finasteride (or Propecia) and alcohol, you’re probably in good company. Nearly 50 percent of men experience male pattern baldness by age 50, and almost 64 percent report having consumed alcohol within the past year (based on 2023 data). 

So, it makes sense that there’d be significant overlap between men taking finasteride and men who drink alcohol. So, can you drink on finasteride? According to the limited research we have available, moderate drinking may be okay. But don’t go overboard, and if you’re feeling confused, always seek medical advice.

Here are some key takeaways about finasteride and alcohol:

• It’s probably okay to drink lightly on finasteride. Moderate drinking doesn’t seem to significantly affect the effectiveness or safety profile of the use of finasteride for male pattern baldness or BPH. Still, heavy drinking can negate finasteride’s protective effect against low-grade prostate cancer and increase the risk of high-grade prostate cancer.

• Finasteride may reduce the desire to drink alcohol. However, you should always talk to your healthcare provider about the risks and potential benefits of drinking alcohol during finasteride treatment.

• Finasteride is generally well-tolerated. Side effects for finasteride are uncommon. But, drinking alcohol can cause sexual dysfunction on its own, which could be perceived as making certain side effects of finasteride (like ED) more severe.

Interested in learning more about how alcohol interacts with common medications? Check out our posts on Viagra^® and alcohol, and antidepressants and alcohol.