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Finasteride and Alcohol: What You Need to Know

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Grace Gallagher

Published 07/15/2024

Imagine this: It’s Friday night, and you’re out enjoying a couple of drinks with your friends when you remember you’re on finasteride. You put down your sweaty drink 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 it 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 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 BPH. It’s also sometimes prescribed to reduce the risk of low-grade prostate cancer. For male pattern hair loss (androgenetic alopecia), it’s typically prescribed at a 1-milligram daily dose, and a higher 5-milligram dose is generally used for BPH.

BPH is a non-cancerous condition that causes an enlarged prostate and can interfere with or block the flow of urine. It may not seem like it has much in common with male pattern baldness, but both conditions are at least partially caused by the male hormone known as dihydrotestosterone (DHT).

This androgen (the clinical term of male hormone) is 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.

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What Does Finasteride Do?

Here’s where finasteride comes in. Finasteride (which often goes by the brand name Propecia® for hair loss and Proscar® for BPH) is a DHT blocker.

DHT is a byproduct of testosterone, and DHT blockers stop the action of the 5-alpha reductase (5AR) enzyme so it doesn’t convert testosterone to DHT.

For this reason, finasteride and other similar drugs like dutasteride are what’s known as 5α-reductase inhibitors (aka 5ARIs).

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 saying alcohol makes finasteride any less effective for treating male pattern baldness or BPH.

What About 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 that research from The Prostate Cancer Prevention Trial concluded that “heavy drinking made finasteride ineffective for reducing prostate cancer risk.”

Heavy drinking (which was defined in the research 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 between prostate cancer and lighter drinking.

TL;DR? Moderate drinking (less than four drinks a day) seems to be okay while taking finasteride. But heavy drinking has risks, specifically when it comes to prostate cancer.

Here’s where things get really wild.

We just mentioned that heavy drinking can negate any positive effects finasteride has on reducing the risk of prostate cancer. But guess what? 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 benign prostatic hyperplasia.

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 benign prostatic hyperplasia.

This doesn’t mean it’ll help your situation if you already have BPH, however (sorry).

Moderate Drinking and BPH

Why is this the case? No one really knows for sure. But 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. And better cardiovascular health could mean a lower incidence of BPH.

We can’t in good conscience recommend daily drinking — alcohol affects your health in other ways, and ultimately, that’s a conversation best had with your healthcare provider. Still, it’s interesting to consider.

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.

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A few drinks here and there while taking finasteride probably isn’t anything to lose sleep over. Moderate alcohol consumption isn’t known to affect the effectiveness 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 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 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 things like your body size and your dosage.

Here’s something else to consider that may make the question moot — you might be less likely to want to drink alcohol after taking finasteride.

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

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

It’s crucial to note that this study looked at men with persistent sexual side effects as a result of finasteride. So it’s hard to say exactly what the relationship looks like between alcohol consumption and the vast majority of people who’ve used finasteride and don’t experience persistent side effects.

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

For context, just over one percent of men who participated in finasteride FDA clinical trials stopped using the medication because of adverse sexual side effects.

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

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 the CDC (Centers for Disease Control and Prevention).

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

Having said that, one small study of identical twins indicated 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 conclude what the actual link between alcohol and hair loss is (but 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 make you crave less nutrient-dense food — has anyone ever craved a salad after a night of partying?

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

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

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If you’re wondering about the relationship between finasteride or Propecia and alcohol, you’re in good company. Nearly 50 percent of men experience male pattern baldness by age 50, and almost 70 percent report drinking alcohol within the past year (based on 2022 data).

So it makes sense that there’d be significant overlap between men taking finasteride and men who drink alcohol. Can you drink on finasteride? Yes, but don’t go overboard.

Here are some key takeaways about finasteride and alcohol:

  • It’s 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. But 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. The FDA notes that side effects occur in less than two percent of men taking the medication. But drinking alcohol can cause sexual dysfunction on its own, which could be perceived as making certain side effects of finasteride (like ED) worse.

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

11 Sources

  1. Asfour L, et al. (2023). Male Androgenetic Alopecia. https://www.ncbi.nlm.nih.gov/books/NBK278957/
  2. Centers for Disease Control and Prevention (CDC). (2024). Excessive Alcohol Use is a Risk to Men’s Health. https://www.cdc.gov/alcohol/fact-sheets/mens-health.htm
  3. Gatherwright J, et al. (2013). The contribution of endogenous and exogenous factors to male alopecia: a study of identical twins. https://pubmed.ncbi.nlm.nih.gov/23629119/
  4. Gong Z, et al. (2009). Alcohol Consumption, Finasteride and Prostate Cancer Risk: Results from the Prostate Cancer Prevention Trial. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2739798/#!po=39.2857
  5. Irwig MS. (2013). Decreased alcohol consumption among former male users of finasteride with persistent sexual side effects: a preliminary report. https://pubmed.ncbi.nlm.nih.gov/23763349/
  6. National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2023). Alcohol Use in the United States: Age Groups and Demographic Characteristics. https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/alcohol-facts-and-statistics/alcohol-use-united-states-age-groups-and-demographic-characteristics
  7. PROPECIA® (finasteride) tablets for oral use. (1992). https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020788s020s021s023lbl.pdf
  8. Reddy DS, et al. (2012). Finasteride Inhibits the Disease-Modifying Activity of Progesterone in the Hippocampus Kindling Model of Epileptogenesis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3444667/
  9. Ronksley PE, et al. (2011). Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. https://www.bmj.com/content/342/bmj.d671
  10. Thompson IM, et al. (2003). The influence of finasteride on the development of prostate cancer. https://pubmed.ncbi.nlm.nih.gov/12824459/
  11. Zito PM, et al. (2022). Finasteride. https://www.ncbi.nlm.nih.gov/books/NBK513329/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA. 

Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world. 

Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.

Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time. 

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  • Dermatology Residency. San Antonio Uniformed Services Health Education Consortium

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