How to Get a Finasteride Prescription: The Three Routes

To get finasteride in the US you need a prescription from a licensed clinician, because the drug's FDA label marks it "Rx only". There are three practical routes: your own doctor or a dermatologist, an online hair-loss service that prescribes and ships, or an online prescription sent to a pharmacy you choose.

Which route is best depends on whether you already have a doctor you can see, and on how much you mind paying a subscription for convenience. This guide takes each route in turn, then the websites that skip the prescription altogether, which are the ones to avoid.

Is finasteride available over the counter?

No. Finasteride is a prescription medicine in the US; its label carries "Rx only" and states that it is for men only and must not be used by women who are or may become pregnant. Anyone selling it to you without a prescription is breaking the rules the rest of this guide relies on.

Minoxidil is different. Topical minoxidil, the ingredient in Rogaine and in pharmacy store brands, is sold over the counter, so you can buy it without seeing anyone. Minoxidil tablets are another matter: they are a blood-pressure medicine, and using them for hair loss is off-label and a prescriber's call.

Route 1: your own doctor or a dermatologist

If you have a primary-care doctor or a dermatologist you can see, ask them. They can examine your scalp, check whether the pattern looks like ordinary male pattern hair loss, order blood tests if something else seems likely, and write the prescription if finasteride suits you.

This route has two advantages the others lack. The first is an examination: a doctor looking at your scalp can spot patchy loss, scarring or inflammation that a questionnaire can miss. The second is price at the till: with a prescription in hand you can fill generic finasteride wherever it is cheapest, including a cash-price pharmacy.

The cost is the appointment itself. What a visit costs depends on your insurance and your doctor, so ask when you book, and ask whether a follow-up message is included.

Route 2: an online hair-loss service

An online hair-loss service such as Hims, Keeps, Ro, Happy Head or Strut Health replaces the appointment with a questionnaire and, at most services, photos of your scalp. A licensed clinician reviews them, and if they prescribe, the service's pharmacy posts the medicine to you on a subscription.

The visit itself is listed as free at most of them, and you pay for the medicine once it is approved. Generic finasteride is listed at $20 to $26.67 a month at the four services that publish a price, on plans of one to twelve months. That is more than a pharmacy charges for the tablets alone, because the service's clinician, messaging and delivery are folded into the price.

This route suits someone with ordinary thinning and no doctor they can see soon. We compare the five services on price, clinician, cancellation and compounding in online hair-loss treatment services compared.

Route 3: an online prescription, filled where you choose

The third route combines the two: an online service writes the prescription, and you have it sent to a pharmacy of your choice instead of buying the subscription. Not every service advertises this, but some say it in writing.

Ro's terms of use say you may choose to have your prescription filled through the pharmacy of your choice. Strut Health's FAQ says you can pick up your prescription from your own pharmacy instead of having it shipped. Hims' terms mention subscribers who choose to fill a prescription with a pharmacy other than Hims' own. Before you start a consultation on this basis, ask the service whether the visit is still free if you do not buy its plan; none of the pages we read answers that.

If it works, this route can be the cheapest online option: Mark Cuban Cost Plus Drug Company lists 30 tablets of generic finasteride at $5.83 before shipping, and it still needs a valid prescription.

When the route should be a dermatologist

Some hair loss should not start with a questionnaire at all. See a doctor in person, and preferably a dermatologist, if any of these describe you.

• Hair is coming out in round patches, in clumps, or suddenly over weeks.
• Your scalp is itchy, sore, red, scaly or scarred.
• You started a new medicine, had a serious illness or lost a lot of weight in the months before the shedding began.
• You are a woman, or under 18: finasteride's label is for men only.
• You have other symptoms such as tiredness, weight change or feeling cold, which can point to thyroid problems or low iron.

Those are the cases in which pattern hair loss is not the likely answer, and a subscription would be treating the wrong thing.

What any prescriber will ask you

Whichever route you take, the prescriber needs the same facts: where the thinning is and how long it has been happening, your medical history, every medicine and supplement you take, and whether anyone in the household is or may become pregnant. Online services usually add photos; Happy Head also asks for government-issued ID.

Answer fully. Finasteride can lower PSA, a blood test used to screen for prostate cancer, and its label lists sexual side effects, depression and suicidal thoughts among the effects reported in use. A prescriber can only weigh those against your history if they know it. Our guide to what an online hair-loss consult asks you goes question by question.

The websites to avoid

Avoid any website that will sell you finasteride without a prescription, or that asks a few tick-box questions with no clinician behind them. The FDA's BeSafeRx campaign lists the signs of a safe online pharmacy: it always requires a prescription, gives a physical address and phone number in the US, has a licensed pharmacist you can ask, and is licensed by a state board of pharmacy.

Its warning signs are the reverse, plus deep discounts or prices that seem too good to be true. Tablets from an unlicensed site may not contain what the label says. We collect these and other warning signs in red flags in online prescribing.

Which route is cheapest?

For the tablets alone, a prescription from your own doctor filled at a cash-price pharmacy is usually cheapest, if the visit is covered or cheap. Of the online services that publish a price, Ro's $16 a month on a twelve-month plan was the lowest we found. We run the numbers for every route over twelve months in what finasteride costs, generic versus subscription.