Given the FDAs April 2025 alert, informed consent for compounded topical finasteride should cover systemic absorption risk, known side effects (sexual, neuropsychiatric), transfer risk to household members (especially women of childbearing age), and the non-FDA-approved status of the formulation
Prescribers are reminded of the importance of this drug being taken exactly as directed: swallowed whole, first thing in the morning, with a sip (up to 120 mL) of water and with no food, drink or other medication for at least 30 minutes to ensure absorption and, therefore, efficacy (note that, although the Summary of Product Characteristics states that Rybelsus can be taken at any time of day provided it is taken on an empty stomach, since GLP-1 RAs delay gastric emptying it is likely that the best time to ensure the stomach is empty is first-thing in the morning, and this is usually recommended)
What matters first is how modalities are paired in the cohort, whether they are measured within the same individuals, only partially paired because of workflow and specimen availability, or effectively unpaired as in cross-study collections [451]
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This discrepancy between results in animal models and clinical studies may partly be due to myocardial insulin resistance in severely failing hearts and the use of beta-blockers [21]
I was a very sick teenager